Dentist warning over undetected oral cancer during treatment backlog

A senior dentist has warned of the risks of oral cancer going undetected, with Covid leaving patients unable to attend regular routine appointments.

It comes after concerns raised by the British Dental Association over a backlog, with long waits for treatments such as fillings.

On Tuesday, the Scottish Parliament’s Health, Social Care and Sport Committee heard evidence from Donald Morrison, general dental practitioner for the British Dental Association.

Donald Morrison gave evidence to MSPs virtually. (Scottish Parliament TV)

He told MSPs that oral cancer is regularly screened and picked up, and is “relatively simple” to treat in the early stages.

But, he warned of the challenges brought in treating oral cancer if it is not spotted until later stages.

“One of the most important things for us as health professionals is that oral cancer is one of those cancers that is picked up really asymptomatically,” said Morrison.

“And it’s one of those things that’s regularly screened and picked up. Scotland has one of the highest oral cancer rates in Europe.

“And the treatment, in early stages, is relatively simple, but the quali of it is horrible disfigurement and really quite drastic difficult surgery.

“So, I think the imbalance between the two things is just such a big, big major part of screening the patients and seeing these patients on a regular basis which we just can’t physically do just now.”

Morrison warned that Scotland is at the “tip of the iceberg” on the issue.

He continued: “You’re twice as likely to die of oral cancer in Scotland if you’re from a deprived community and that’s only going to just increase.

“The inequalities gap will grow larger and larger and we’re only at the tip of the iceberg on this.

“This is going to, in the next 18 to 24 months, really come home to roost.

“So, I’d be very, very concerned about the fact that because of the way the screening works, we’re not even feeding these people into the system yet because we don’t get to see them.”

SNP MSP Gillian Martin is the convener of the Health, Social Care and Sport Committee. (Scottish Parliament TV)

Committee convener Gillian Martin asked: “Could I just clarify, is that something that you’re picking up signs of oral cancer when you’re doing more routine work and the check-ups and the other types of dentistry, and that’s where you’re spotting it early?”

Morrison explained that patients can be unaware that there is any signs of oral cancer.

“Not only spotting it early, but people don’t feel it when we find it,” he responded.

“Often, you’ll get someone presenting with something that… they’ll say, ‘this is a bit sore, I’ve noticed it, can you do something about it?’

“But, often you look in the mouth as a routine and you see a lesion and you say to the patient, ‘how long have you had that?’, and they say, ‘well, I haven’t even felt it, I didn’t even know it was there’.”

“Then you say, ‘well, let’s have a look at it in a couple of weeks time’. It’s unresolved, it’s then put into the system, the oral surgeons will see it, they’ll biopsy it and find it’s cancer and remove it in the space of six to eight weeks.”

He added: “If left to go untreated, the patient doesn’t always feel very uncomfortable, but the time it’s fed on, it’s a radical section, the patient will be deformed by the surgery, it’s major chemo, all these things go into treating someone with head and neck cancer.

“And yet, when we pick up these things as a screening process, and we look at the patient every six months, you detect it and it’s treated very early.”