Gerard Craughwell (Independent)

I move:

That Seanad Éireann:

acknowledges that: - Ireland's current approach to pre-radiation oncology dental care and post-surgical dental rehabilitation is under-resourced, under-staffed and unsafe. Adequate pre-radiation and post-surgical dental services are essential components of cancer care;

- immediate investment and legislative action are necessary to ensure that patients with head and neck cancer (HNC) receive timely, equitable and safe treatment;

- HNC patients in Ireland face significant and avoidable risks due to inadequate pre- and post-radiation and post-surgery oncology dental services;

- the Dublin Dental University Hospital (DDUH) currently manages approximately 400 new patient referrals annually with only a single consultant-led service, and Cork University Dental School and Hospital manage approximately 160 patient referrals annually, with only a single specialist-led service;

- severe capacity constraints are leading to delays in radiotherapy, inadequate dental preparation and increased long-term debilitating risks such as osteoradionecrosis (decaying/dead jaw and facial bones) and radiation tooth decay (dental caries);

- HNC is affecting increasingly younger patients, who will live with the side effects of the disease and its treatment for the rest of their lives;

- this is a national issue, and as a result of the Human Papilloma Virus (HPV), the incidence of HNC is rising, currently involving a quarter of the current pre-radiation dental referrals; such cases are projected to increase by 66 per cent by 2045;

- current delays in dental treatments and post-surgical oral rehabilitation contribute directly to radiation treatment postponements, reducing survival rates from this cancer and compromised quality of life; notes that: - there is a geographical spread with 4 per cent of referrals from the Mid-West, South-West, West and North-West regions combined, 46 per cent from Dublin City and County and 50 per cent from the North-East, South-East and Midlands with associated substantial costs and travel time for patients and their carers to attend dental appointments in Dublin;

- there is at least a 9 per cent increased mortality rate associated with every 4-week delay in the commencement of definitive radiotherapy;

- 43 per cent of patients present without a regular dentist, further limiting post-treatment care, while 181 patients await post radiotherapy review – some for up to 14 months;

- the running costs of providing these services in the DDUH at current activity levels is €1.367 million annually, approximately €811,000 is funded by the HSE, leaving an additional funding requirement of €556,000;

- the absence of a national HNC dental pathway and critical workforce gaps in prosthodontics, oral surgery and dental hygiene compound this crisis;

- there is a strong connection between HPV and the presence of HNC, this underlies the importance of the HPV vaccine for young males and females;

- based on empirical evidence there is a need for treatment facilities in the West (Galway) and increased services in the South (Cork);

- currently, the necessity for patients to travel to Dublin for treatment significantly impacts families in relation to time and finances; calls on the Minister for Health to: - provide a commitment to ring-fencing funding of €1.367 million annually for pre-radiation oncology dental services in the DDUH, with adjustments in line with inflation and expansion of services;

- provide full supports for regional dental oncology care centres in Cork and Galway;

- introduce statutory recognition of pre-radiation and post-surgical rehabilitation dental services so that they will be formally integrated into cancer care pathways;

- create permanent consultant posts in oral surgery and restorative dentistry for Cork and Galway centres;

- outline guaranteed timelines so patients can be seen by dental services within 7 days of their cancer multidisciplinary team meeting;

- implement a minimum 10-day healing period prior to the commencement of radiation therapy;

- introduce a comprehensive suite of rehabilitative dental and medical services for post-operative and irradiated patients.