24th January 2020

In 2016 I was diagnosed with Triple Negative Breast Cancer – completely out of the blue – after a routine mammogram.  When you’re diagnosed with cancer, it’s difficult to think clearly.  You typically focus on the life-saving treatments such as chemotherapy and radiotherapy and the fact you have cancer – everything else takes a back seat.  It’s also a strange world that you’re thrown into because your GP normally takes a back seat and you have a new team who steps in - an oncologist, a surgeon and usually a specialist nurse – not to mention the terminology and acronyms you suddenly have to learn. 

It’s very easy at diagnosis to become completely overwhelmed and the last thing on your mind is your dental health.  I, and I suspect many others, think of dentistry as outside of my general health and almost a separate entity (the same with eye health and opticians).  I suspect I’m not alone in feeling like this and, although my dental health has always been important and I attend regular check-ups, my dental care didn’t even cross my mind.

At some point early in diagnosis, cancer patients are given a form to apply for exemption from paying prescription charges for a period of 5 years (renewable if the patient is continuing to have cancer treatment).  Many patients assume the exemption covers dental treatment and it’s only when they go to their dentist, they discover it’s not. To confuse matters, pregnant ladies are given free dental care for a year after their baby is born so it’s completely understandable that you’d logically think that dental treatment would be covered.

The advice given to cancer patients also varies greatly.  Some are advised to see their dentist before treatment starts and others aren’t given any advice at all.  I was told by a fellow cancer patient to have a check-up but wasn’t advised to do so by my medical team.  Not having a check-up (and any work needed) before chemotherapy can have disastrous consequences.  Chemotherapy is halted if the patient develops an infection.  If dental work is needed during treatment, many dentists will not help a patient and they are referred to a dental hospital.  Recovering from an infection with a suppressed immune system is problematic and a longer process than when you’re well and this can considerably extend your treatment.

While I’m discussing the need for pre-treatment check-ups, I think it’s important to mention that I’ve been told countless times that patients are unable to see their dentist in a timely fashion.  The wait to see my dentist is typically over 6 weeks and when faced with waiting 6 weeks for a dental check-up or starting chemotherapy in 4 weeks, the dental work takes a back seat.  To exacerbate the issue, many dental practices are not taking on NHS patients and this forces cancer patients to pay for private treatment or, worse still, not go at all.  Sadly, this is a real choice faced by many.

After hearing so many horror stories of expensive dental work required by cancer patients, or patients being unable to afford dental treatment, I decided to start a campaign on Change.Org asking for free dental treatment for all cancer patients.  Costs were at the forefront of my mind at that time but actually, on reflection, I believe the campaign needs a wider approach and when I meet with a representative from the Department of Health and Social Care, I will be asking them to consider a 4-point plan:

1. Free dental treatment for all cancer patients – with an exemption in the same manner as prescription charges;
2. Ensure patients are advised by their GP (who is normally the first medical professional to be aware of the diagnosis) to visit their dentist prior to treatment starting. I would like this information to include a list of dentists in the local area who:
3. Are willing to allow cancer patients to join their practice as an NHS patient; and
4. Will give priority to any treatment that may be required before, during or for a period after cancer treatments stop.

I’ve mentioned above the need for pre-treatment check-ups and treatment to be carried out but actually, the effect on teeth and gums after treatment can be devastating.  Also, with many patients being given Bisphosphonate therapy, there’s a risk (even though small) of osteonecrosis to the jaw, a rare but serious condition in which the cells in the jawbone start to die.  I was never told to visit my dentist before having bisphosphonates OR warned of the risk of having teeth extracted during the 3-year period I was having that treatment.  I was never told to tell my dentist of the treatment and actually, because it was after chemotherapy and radiotherapy and was a “nice to have” rather than a “must have”, I didn’t attach too much importance to it. 

Interestingly, there are dentists who are more proactive and will make sure they are included with a cancer patient’s overall health and, since the campaign started, I have met Dr Mohsan Ahmad, Chair of the Greater Manchester Dental Network and was delighted that he is already running a programme that aims to address all of the above (with the exception of the cost issue) which is very encouraging – I would love to see his work extended nationwide.

My local MP, Kate Green, is fully on board with the campaign and I have been encouraged by how the dental community have reacted to it also. I am hoping that with over 105,000 signatures in under 2 weeks, the voice of the campaign will be heard.  I still need more signatures (and as many MPs on board as possible) and I’d like to ask you to add your signature to this important campaign.

Support free dental care for cancer patients at www.change.org/cancerdentalcare.  

If you want to go a step further, I would finally like to ask you to contact your local MP to reinforce support that would help to get Parliament’s notice.  To quote Sara Hurley, the Chief Dental Officer for NHS England, “let’s put the mouth back into the body”.