Sir, we write in response to the letter published in the BDJ in January 2012 entitled Unfairness for mouth cancer patients (212: 3). We wholeheartedly agree with this opinion. Treatment of head and neck cancer involves not only removal of the tumour but also restoration of function. The aim of treatment is to prolong life and restore quality of life as far as possible. Head and neck cancer invariably affects vital structures and consequently can have a profound effect on facial appearance and self-image. When the oro- and nasopharynx is involved, restoring functions, such as speech and ability to eat, can provide many challenges for the patient as well as the clinician.

With the increase in incidence of oropharyngeal cancers, particularly in those diagnosed as HPV positive, we are now seeing younger, more dentate patients.1,2 Patients undergoing treatment for head and neck cancer, particularly involving radiotherapy and chemotherapy, face very difficult challenges including mucositis, dry mouth, radiation caries and an increased risk of osteonecrosis of the jaws as a result of extractions. Many of these challenges are life long, and can result in complex dental treatment being required in the long term with associated considerable cost. Specialist restorative treatment is not universally available within the NHS in England.

We would like to share with you the specialist restorative oncology service delivered to all head and neck cancer patients at Torbay Hospital, South Devon. All patients receive a pre-operative oral screen by the restorative oncology team, and a full and ongoing treatment plan is made. Necessary treatment, prior to cancer treatment, is carried out within the department, and advice on oral care is given to help patients through their cancer treatment. In addition, after cancer treatment, patients receive continuing restorative care and regular hygienist care at no charge. We feel this puts head and neck cancer patients in line with the support received by patients suffering from other types of cancer. This service is of significant benefit to all head and neck cancer patients. With the evolvement of new commissioning, this issue needs to be discussed and understood.

Our newly launched website, www.mouthcareincancer.co.uk has been designed to provide information for head and neck cancer patients, healthcare professionals and patients undergoing chemotherapy for other cancers.

We would welcome feedback from other head and neck cancer specialist centres regarding their services and experiences in the hope that we can improve the care for these patients across the country.