Recalls and the Mouth Cancer Catch 22

Recalls and the Mouth Cancer Catch 22

Government health spokespeople have a tricky balancing act when it comes to Oral Cancer. On the one hand they want to support regular screening programmes which aim to identify disease early. A win for everyone, with better treatment outcomes for patients, and potentially lower costs for the NHS. A chance to talk about holistic care and prevention. But also a problem. 

As part of the continued attempts to squeeze more appointments out of an inadequate and cash limited budget, Government have seized upon NICE dental recall guidelines. The National Institute for Health and Care Excellence are always popular in government when they speak as The National Institute for Health and Care Economy.

As reported in GDPUK  the full weight of the NHS machine has now been put behind a shift towards two yearly dental recalls. ICB’s will be collecting data on compliance by contractors, and those with wayward profiles can expect some pointed enquiries. At  least those who are judged to be seeing their patients too often, can.

Perhaps they should quote Andrew Stephenson who is an Assistant Whip and Minister of State at the Department of Health and Social Care. He was asked by Grahame Morris (Labour Easington) “What steps he is taking to improve the early detection of mouth cancer in the North East.”

According to the Minister; “Every dental check-up constitutes an oral cancer screening.  Dentists and other dental professionals including hygienists, routinely check the soft tissues.” They would also “make an assessment and record an individual’s oral cancer risk.” The Minister added that they would prioritise those at higher risk for more frequent recall in line with NICE guidance. He then went on to talk about the November 2022 changes which included “fairer pay” for all NHS dentists. He even referred to the requirement to update website entries regularly. He ended by referring to NHS Englands early diagnosis strategy which applies to other conditions, and the NHS mouth cancer awareness leaflet for dental teams.  Causes of mouth cancer - NHS (

This leaflet contains a lot of advice. For example: “Get your symptoms checked.” Under photos showing possible mouth cancers comes the advice to “see a GP if” and then lists; a mouth ulcer over 3 weeks old, a lump in the head and neck, a red or white patch in the mouth, persistent pain or difficulty swallowing.

At the very end of the list it says: “A dentist can also help with ulcers, lumps patches or pain in your mouth.”

Returning to that all important risk assessment the leaflet provides some useful guidance on lowering ones risk of mouth cancer, although it adds that, “you cannot always prevent mouth cancer.”

Under the heading, “How to lower your risk of mouth cancer,” quitting smoking as well as chewing tobacco and paan, and consuming less than 14 units of alcohol a week, are joined by exercising regularly, and eating a healthy diet including ‘5 a day.’

NHS practices with the temerity to see their patients for regular examinations may want to ask how many steps their patients covered this week, and what they had for lunch, in preparation for when the ICB come knocking.


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