In their new regular contribution to BDJ Team, the British Association of Dental Therapists (BADT) share an article written by dental therapist Holly Broadfoot, the BADT's North West Rep on Council. This is a collaborative article viewing a patient and clinician journey following a mouth cancer diagnosis.

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Holly Broadfoot

My dad and I have been on this journey since December 2022, following the finding of a non-suspicious, pain free, draining buccal sinus during a routine examination. On 16 May 2023, after many months of tests and appointments, this was diagnosed as a squamous cell carcinoma of the mandible.

[Dad] I'd imagine plenty of people have written about their experience with cancer. I'd never read any but had seen many friends and family taken by such, and experienced the heartache for all around them; strangely they themselves never spoke of it.

So when it knocks at your door, it's a quiet knock. I didn't realise that's what I had. Then boom. I didn't panic, I knew, or like to think I knew I'd get through it. I was quite casual really.

Having sent dad to the hospital on his own, thinking the results of all the tests would be something along the lines of osteonecrosis of the jaw, receiving the phone call from him almost casually in the middle of the day made me sick to my stomach. I couldn't speak or even process the diagnosis. I knew I had to be the strong one in the family. It's such a role reversal when the child becomes the adult and has to emotionally and mentally stay strong for her dad.

What I didn't know was the symptoms would sit in the background for months then suddenly erupt. My mouth became a mess, split gums, oozing whatever, horrible unusual tastes, lethargy you wouldn't believe, sleeping most of the day. Or if I tried to do something which took energy I'd collapse. I was in agony and would present myself again and again at the maxillofacial department for help. Awaiting them to tell me it was an infection.

Then I totally picked up, energy back, feeling myself, so I knew it was an infection. How wrong I was.

They fast track you now, it comes quick, scans, blood tests, angiograms, referrals, tests and more tests. Then the operation - jaw out, leg and teeth in. Done.

The operation was carried out on 19 June 2023 which involved removing my dad's mandible along with the soft tissues and associated lymph nodes. At the same time dental implants were placed in his fibula before it was removed and implanted into the jaw with a titanium plate, and placing an implant retained bridge. The surgery was something I'd never even heard about but since then seem to have come across it on the news or on the TV more and more. The same surgery was even featuring on a programme on Channel 5 around the same time - a strange coincidence.

Expertise you can't imagine, care you absorb in bucket loads because they do care, hugely.

Ten days in hospital is the start, not much pain to be honest. But my goodness you're uncomfortable. A mouth as arid as the desert, tubes coming out of everywhere, eight I think. A day was heaven when they said they would take one out, countdown to zero tubes kept me going.

Visiting my dad in the hospital for the first time following surgery was such a surreal experience. He could barely keep his eyes open and looked swollen from head to toe. He couldn't speak but all he could do was squeeze my hand and I knew this is where the recovery would really begin.

Waking you every hour for four days to see your new mouth is alive. When you hear the pulse from your mouth you have a huge sigh of relief. If it's not there, it's a repeat of the above.

Your discharge from hospital comes around quick. So, 100 or so appointments later, you're kind of getting there. They do care, and that means a lot. So the journey continues.

Upon discharge, dad seemed to be up and about relatively quickly and was soon back up on his feet. But the journey hasn't been easy. Since then, there have still been multiple appointments back and forward from the hospital to deal with the bumps in the road.

Initially his leg took a long time to heal with some muscular and tissue complications. The muscle tried to heal outside of the graft, which was not a pretty sight.

Looking ahead, we know this journey isn't over, but we've learned to take things one step at a time. Dad's recovery has shown us that resilience is built in the day-to-day grind, in managing setbacks and pushing forward.

The implants have also caused a few issues and currently the implant retained bridge has been taken out to help deal with some atypical nerve pain. There have been rounds of physiotherapy and acupuncture, some nerve blocker medications that seem to be helping but a lot of tightness and pain is still having an effect on his quality of life. But life, that's the main thing; my dad still has a life, and he will be one of the lucky ones to be told he is cancer free and the rest we can manage as a family.

Looking ahead, we know this journey isn't over, but we've learned to take things one step at a time. Dad's recovery has shown us that resilience is built in the day-to-day grind, in managing setbacks and pushing forward. There will still be challenges, but with each appointment, each adjustment, we're adapting, grateful to be moving forward and ready for what's next.