VIDEO: Australians with oral cancer helped by 3D printing

STEPHANIE DALZELL, REPORTER: The hope of spring hangs in the air here in regional New South Wales. 

JEN MACKAY:  Come on boys.

STEPHANIE DALZELL: Jen Mackay’s tribe of goats are devouring their food. A simple enough task but not for Jen. 

JEN MACKAY:  So I no longer make proper effective saliva which makes eating really difficult. And then I also have half a tongue which has heavily impacted on my speech.

STEPHANIE DALZELL:  A few years ago, Jen noticed an ulcer on her tongue that wouldn’t go away. After months of being told it was nothing to worry about, she eventually discovered it was stage 3 cancer. 

JEN MACKAY:  I had a 12-hour surgery. They removed half of my tongue and replaced it with my thigh. I ended up in intensive care. 

STEPHANIE DALZELL: But there was more pain to come. After complications from radiation Jen needed her jaw and teeth removed. She’s now facing an eye-watering bill of more than $20,000 for a dental prosthetic.

JEN MACKAY:  One of our options is to re-mortgage the house to come up with the money to pay for the teeth. You know, it's not ideal. We've only been here for four-and-a-half years. I'm not even sure the bank will let us do that, but you know it is an option we have. 

STEPHANIE DALZELL: Hundreds of kilometres away at Sydney’s Chris O’Brien Lifehouse doctors Jonathan Clark and Tim Manzie are figuring out Jen’s next steps. 

DR TIM MANZIE, CHRIS O’BRIEN LIFEHOUSE:  This is Jenny. So she’s had a previous tongue cancer.

STEPHANIE DALZELL: Despite routinely saving the lives of people with cancer, there’s one thing these doctors struggle to protect patients from - cost. 

PROF. JONATHAN CLARK, CHRIS O’BRIEN LIFEHOUSE:  If we're talking about a breast prosthetic that's needed to be placed because of a woman having breast cancer well, then that's covered. 

But if you've had your jaw removed and you've lost your teeth, for some reason, that's not covered. And I don't really have a good explanation for why there is this divide, but I think it really isn’t fair that there is this inequity, 

STEPHANIE DALZELL: It’s a complex system with some exceptions but generally there are no subsidies for the replacement teeth often needed after oral cancer surgery. 

JONATHAN CLARK:  All of this is covered by either public funding or private health funding, and so we’re talking about the transplantation of the bone from the leg, the removal of the cancerous section of jaw bone, the titanium plate but the only thing that’s not covered is the dental prostheses - this tiny little bit which is so critical to your ability to chew and to eat and to maintain nutrition. 

STEPHANIE DALZELL:  And so why isn’t that bit covered?

JONATHAN CLARK:  I think it is really a historical separation between medicine and dentistry but it is one that I think the government doesn’t want to solve because it really opens Pandoras box. 

STEPHANIE DALZELL: The Pandora’s box, a long running argument about whether dental should be added to Medicare. 

But Professor Clark says dental prosthetics are entirely different and with some costing up to $50,000, he’s witnessed many people survive cancer only to encounter an unthinkable choice: paying for teeth or going without. 

JONATHAN CLARK:  It almost makes me feel ashamed to be part of the health system where that's what the only option is.

STEPHANIE DALZELL: Having diagnosed the problem, these doctors are now working on an affordable, short-term fix. 

TIM MANZIE:  So Steph this is one of our newer 3D printers. 

STEPHANIE DALZELL: Turning resin into teeth, machines like this one are helping to fill the gaps. 

TIM MANZIE:  So we can try and customise this for the patient’s tooth shade or colour of their natural teeth. 

STEPHANIE DALZELL: Called “Jaw in a Day” - the prosthetic can be fitted during cancer removal surgery. 

TIM MANZIE:  So they’ll paint the gum on pink and prep them. 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. 

It simply used to be aiming for cure but now that we know people are living longer after we've treated them is that we want them to have a quality of life that they are happy with. 

I’m going to see John today and he has had a really good outcome. He has still got his original teeth on. 

JONATHAN CLARK:  For how long?

TIM MANZIE:  Nearly two-and-a-half years. 

STEPHANIE DALZELL:  At the end of a 12-hour surgery to remove his stage 4 oral cancer John Mealings was one of the first people to be fitted with 3D teeth made in this lab.

TIM MANZIE:  Hey John how are you? 

JOHN MEALINGS:  Tim good to see you again. 

TIM MANZIE:  Have a seat.

JOHN MEALINGS:  If you can imagine a set of false teeth for your bottom jaw it's basically half of one of those. And it just sits on the side of the jaw just mounted on the bone that's there. But the fact that they're made by a 3D computer is quite remarkable.

TIM MANZIE:  It looks like you are cancer free which is excellent.  

STEPHANIE DALZELL: Without 3D printed teeth John would have had to pay for an expensive and temporary dental prosthetic while his mouth healed and changed after treatment. 

TIM MANZIE:  Your 3D printed, your fake teeth look excellent mate you’ve done a really good job of cleaning around those implants

STEPHANIE DALZELL: These products aren’t a permanent solution - they’re not durable enough - but they save patients thousands of dollars and mean they can wake up from major cancer surgery with teeth. 

Despite that, only a few places offer this, most are backed by philanthropic funds. 

That’s why doctors here want state and federal government support, so that all patients get equal access and a mouth that functions as fully as it can after lifesaving surgery.

JONATHAN CLARK:  It's a bit like having a car. You can't drive a car with no tyres, and you can't restore form and function after mouth surgery without teeth

NADIA ROSIN, HEAD AND NECK CANCER AUSTRALIA:  It's a huge gap in head and neck cancer care. We often say that it's the missing piece of the puzzle. 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.

STEPHANIE DALZELL: Jen Mackay has travelled to the capital as an advocate for the thousands of Australians with oral cancer. 

JEN MACKAY:  Today I’m here to talk to politicians, hopefully by raising awareness they’ll understand there’s a gap and fill it. 

STEPHANIE DALZELL:  As she arrives, she reads government statements provided to 7.30 about why replacement teeth aren’t currently subsidised for cancer patients.

The federal government said it’s waiting for health department advice on an independent review to identify gaps in coverage for prostheses and strategies to address them.

While in New South Wales, where Jen and John live, the state government said affordable and timely access to dental services is a whole of sector responsibility.

Jen, you’ve just read these statements, what’s your response?

JEN MACKAY:  This is really disappointing, it misses the point. This is a small percentage of the population that really needs help 

Until everything is equitable across cancer treatment, I don’t think we’re there. 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.