Australians diagnosed with oral cancer are facing significant financial burdens, with some patients needing to pay up to $50,000 out-of-pocket for dental prosthetics. This situation arises from gaps in the healthcare system, according to surgeons and advocates. They describe a complex and inequitable process that leaves cancer patients struggling to afford necessary dental care.

Jonathan Clark, director of head and neck research at Chris O'Brien Lifehouse hospital, expressed concern over the choices patients must make. "I don't think it's fair that patients need to make that choice," he said. Many patients are forced to consider remortgaging their homes or depleting their retirement savings to cover the costs of dental prosthetics.

While some oral prosthetics are covered by public or private funding, the essential replacement teeth are often not subsidized. "If we're talking about a breast prosthetic that's needed to be placed because of a woman having breast cancer, that's covered," Clark noted. "But if you've had your jaw removed and you've lost your teeth … for some reason that's not covered."

Retired teacher John Mealings, 73, is one of the patients affected by this issue. After being diagnosed with stage 4 oral cancer, he underwent surgery that involved reconstructing his jaw with his leg bone. Now, he faces a $20,000 bill for replacement dental prosthetics. "I'll have to dip into my superannuation, but at my stage of life at least I have some super I can dip into," he said.

Clark believes the lack of coverage for dental prosthetics is tied to a long-standing debate about whether dental care should be included in Medicare. He argues that dental prosthetics after cancer surgery should be treated differently due to their high costs. "For patients with mouth cancer, we're not talking about covering every aspect of dentistry," he explained. "It is this specific requirement for a dental prosthetic that will restore form and function after major cancer surgery."

A potential solution to the high costs is the use of 3D printing technology. At Chris O'Brien Lifehouse, surgeons are utilizing 3D printing to create patient-specific dental prosthetics, referred to as "Jaw-In-A-Day." Oral and maxillofacial surgeon Tim Manzie explained that these devices are significantly cheaper and can be fitted during cancer removal surgery. "It allows someone to basically go off to sleep in the morning, have part of their top or bottom jaw removed and then wake up with a completely new jaw and new teeth in place," he said.

Although the 3D-printed devices are not intended as long-term solutions, they provide an affordable interim option for patients while they heal. Mealings was one of the first patients to receive a 3D-printed prosthetic, which has lasted over two years. "You certainly couldn't function without teeth … they're essential to eating, chewing and the like," he said.

Despite the benefits of 3D printing, only a few hospitals currently offer these prosthetics. Clark has called for increased government funding to make these options available to more patients. He likened the situation to building a car where every component is covered except for the wheels and tires. "You can't drive a car with no tires and you can't restore form and function after mouth surgery without teeth," he stated.

Nadia Rosin, CEO of Head and Neck Cancer Australia, emphasized the need for broader government funding for dental prosthetics. She noted that approximately 5,000 patients are diagnosed with head and neck cancer each year, and many lack access to necessary care. "These people's lives are being saved by this complex surgery, but they need help to be able to put their mouths back together again once they're cured," she said.

Jen Mackay, a tongue cancer survivor, expressed frustration with the government's response to the issue. She has been advocating for better funding for dental prosthetics for mouth cancer patients. "This is really disappointing. It misses the point that head and neck cancer patients with specialized needs aren't being addressed by the public health system," she said.

Mackay, who has faced her own financial struggles due to the costs of dental care, highlighted the need for change. "One of our options is to remortgage the house to come up with the money to pay for the teeth," she said. She remains committed to advocating for a fairer system for future patients. "Until everything is equitable across cancer treatment ... I will keep arguing the point to get dental prosthetics and facial prosthetics funded for head and neck cancer patients and I won't stop until it changes."