Helping cancer patients get priority dental care
Thousands of people have told Healthwatch that the crisis in NHS dentistry has left them living in pain with untreated teeth, gum problems or unable to get regular check-ups. For some people the lack of NHS appointments is even more dire, including for people recently diagnosed with cancer.
Why is this a particular problem for cancer patients?
Cancer treatments like chemotherapy and radiotherapy can cause oral health side-effects, such as infections, which at their worst can cause sepsis. These treatments can also cause taste and saliva changes, and increased likelihood of decay and gum disease.
This is why oncologists tell patients to get a dental check-up before they start treatment for any type of cancer, so dentists can treat any existing oral health problems and advise them how to protect their oral health during and after their cancer treatment.
What you have told us
People with cancer, or their relatives have told local Healthwatch in Bolton, Cornwall, Norfolk and other areas of England about the impact of not being able to find an NHS dentist, including delays to treatment or needing to pay thousands for private treatment:
“I need a dental sign-off in order to continue essential treatment related to a cancer diagnosis. I am unable to find an NHS dentist and cannot afford private treatment therefore I cannot have the medication required to continue my treatment.”
Story shared with Healthwatch Dorset
“I take a lot of medication for diabetes and prostate cancer and my teeth have started to crumble. I had 10 teeth taken out £2000. In the autumn I go back again for two half dentures £3000. That’s £5000. I’ve worked until 70 and even as a student I paid taxes.”
Story shared with Healthwatch Norfolk
How we acted on your feedback
We shared our evidence with England’s Chief Dental Officer, who we meet regularly, as well as officials at the Department of Health and Social Care.
We have called for everyone to be able to register permanently with a local NHS dentist, in the same way that the public can sign up with an NHS GP, so there is a safety net for all people when they need it most.
What changed as a result
In December 2024, NHS England published new guidance stating that patients due to start cancer treatment should get priority access to an NHS dentist.
It referenced evidence about the problems for cancer patients shared by Healthwatch England as well as NHS Cancer Alliances – groups of clinicians and hospital managers.
The guidance tells Integrated Care Boards (ICBs)– the regional bodies that fund and oversee NHS dental care – to ‘review and ensure prioritised access for appropriate oral health assessment, prevention (advice and interventions), and treatment for patients diagnosed with cancer who cannot access a dentist prior to their intended start date for cancer therapy; and to make appropriate provision available if gaps are identified.’
The guidance itself notes the problem caused by the lack of a GP-style system in NHS dentistry: 'As there is no registration of dental patients, unlike general medical practice, proactive measures are needed to support those without access to a dentist to secure care.’
The guidance says ICBs could adopt a variety of solutions such as:
- Oncology teams referring people to hospital dental clinics.
- Flexible commissioning, like one pilot scheme in the South West, where the ICB funded some high street NHS dentists as on a sessional rate to provide check-ups and ongoing oral health care through people’s cancer journeys.
- Being seen at community dental services (which already provide specialist care to some children or disabled people).
What other action are we taking on NHS dentistry?
We have given evidence to parliamentary select committees and to the National Audit Office about how the lack of NHS dental appointments affects other groups of people, such as children, pregnant women and people on low incomes who can’t afford to go private, as well as in rural and geographically isolated areas.
We also successfully made the case for action on delivering extra urgent dental appointments to be included in the latest NHS Mandate, using our role as a statutory consultee to the annual instructions about service priorities that are issued by the Department of Health and Social Care to NHS England.
Want to read more about our calls for change to NHS dentistry?
You can find out more about our evidence, recommendations and impact in our latest policy position.
