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NHS dentist crisis sparks fears deadly mouth cancers are going undiagnosed 

Oral cancer could go undiagnosed due to dentists refusing to offer consultations, medical leaders have warned.

Routine dental appointments are always checked for signs of the disease, including inflamed or white patches in the mouth and small lumps or blisters. These examinations are vital, as the symptoms are often painless or not considered serious by patients.

If anything of concern is seen, a referral may be made to hospital specialists for a definitive diagnosis. Nearly half of oral cancers are detected for the first time in this way.

But last week a major survey showed that nine in ten NHS dental practices in England are not accepting new adult patients and eight in ten are not taking on children.

Routine dental appointments are always checked for signs of the disease, including inflamed or white patches in the mouth and small lumps or blisters.  These examinations are vital, as the symptoms are often painless or not considered serious by patients.

Routine dental appointments are always checked for signs of the disease, including inflamed or white patches in the mouth and small lumps or blisters. These examinations are vital, as the symptoms are often painless or not considered serious by patients.

As a result, cases of oral cancer, also known as oral cancer, will undoubtedly be missed, says Dr Jane Wilcock, chair of the Royal College of General Practitioners North-West faculty. ‘Patients are often unaware of a problem in the mouth until a hygienist or dentist notices something suspicious, such as a red or white spot in the cheek or on the gums.

Not all will turn out to be cancer, but some will. The problem is that many people just can’t see an NHS dentist at the moment. With fewer studies, cases of oral cancer inevitably go undiagnosed.”

Cancer expert Professor Patricia Price, Chair of Radiotherapy UK and co-founder of the #CatchUpWithCancer campaign, says: ‘With oral cancer, speed of diagnosis and treatment is extremely important. If opportunities for early intervention are missed, more oral cancer patients will die unnecessarily.’

In January, the government pledged an additional £50 million to fund an additional 350,000 dental appointments, but the latest figures suggest this has had little effect.

The number of NHS dentists has fallen to its lowest in a decade to around 22,000, with nearly 1,000 quitting in the past year. Another 40 percent would like to change jobs or take early retirement this year.

Healthwatch UK spokesperson Jacob Lant says calls to their helpline reveal a frustrating situation. “We’ve heard of patients who haven’t been able to get a dental appointment for two years and then tried to make an appointment, only to find that they’ve been deregistered because they haven’t been in so long. They cannot then re-register, because practices do not accept new patients.’

New cases of oral cancer were already on the rise before the pandemic. In 2019, more than 8,722 people were diagnosed in the UK – a 97 percent increase since 2000. Given that trend and with no new data since 2019, the fear is that new cases will go undiagnosed.

An NHS Trust in England reported a 65 percent drop in oral cancer referrals between 2020 and 2021, according to recent research from the Oral Health Foundation

An NHS Trust in England reported a 65 percent drop in oral cancer referrals between 2020 and 2021, according to recent research from the Oral Health Foundation

An NHS Trust in England reported a 65 percent drop in oral cancer referrals between 2020 and 2021, according to recent research from the Oral Health Foundation

An NHS Trust in England reported a 65 percent drop in oral cancer referrals between 2020 and 2021, according to recent research from the Oral Health Foundation.

About two in three oral cancer patients are men and three in four are older than 55.

Tobacco use and heavy drinking increase the risk. It is also caused by the human papillomavirus (HPV) – the same infection that causes cervical cancer.

In a third of the cases, the tumor is in or on the tongue. It can also occur in the cheeks, palate, tonsils, salivary glands and in the upper throat, also in the larynx or voice box as it is better known.

Early warning signs include mouth ulcers that will not heal, persistent red or white patches in the mouth, unusual lumps and swelling, and persistent hoarseness. If detected early, when the tumors are small, 85 percent of patients survive the disease. However, most cases are picked up once the cancer has spread. About half of these patients die within three years of diagnosis.

Early treatment may only involve surgery, but more advanced cancers require radiation therapy and chemotherapy.

“In later stages, surgery can remove a large part of the tongue, mouth or throat,” adds Dr Wilcock. “This can make life incredibly difficult.”

Oral Health Foundation spokesperson Dr Ben Atkins says: ‘I have worked as an NHS dentist for 25 years and I have never seen challenges such as we have now. We are now at a critical point.’

He adds: ‘If someone has an ulcer that isn’t healing or has another problem in their mouth, and they can’t make an appointment with a dentist, they should see a doctor or pharmacist as soon as possible and get themselves examined. .’

One person who knows all too well about the devastating impact of oral cancer is Kayleigh Samson, 31, whose mother Elizabeth died of the disease at the age of 52 in April 2021. Elizabeth, from Ayrshire, first developed symptoms – including facial pain – in March 2020, just as the first Covid lockdown was imposed. Antibiotics prescribed remotely by her GP did not help. When the pain moved to her mouth, she tried to get a dental appointment but was told she didn’t meet the criteria for emergency treatment because she didn’t have a broken or missing tooth, or had bleeding in the mouth.

Elizabeth managed to get a dental checkup in November of that year and was referred a month later for further tests at the hospital, where she was told she had a salivary gland tumor. “The doctor said it was very aggressive,” Kayleigh recalls. ‘Mama didn’t smoke and only drank on special occasions. She’d tried to tell people something wasn’t right, but she’d been fobbed off.’

In January, Elizabeth had surgery, losing three-quarters of her tongue and 13 lymph nodes in her head. But it came too late, as the cancer spread to her brain and lungs.

Kayleigh says, “It all happened so fast it’s still hard to comprehend. My advice to anyone who feels a problem in their mouth is to keep pushing to see someone – anyone who might be able to take a look and offer advice. ‘

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