Ear, nose, throat (ENT) and oral conditions are common presentations in general practice, making up 3.6 out of every 100 consultations.1 In Australia, around 3.6 million people suffer from hearing loss and more than 1.3 million people live with a hearing condition that could have been prevented.2 Each year in Australia, more than 500 children are born with moderate to profound permanent hearing impairment.3 Hearing disorders are more common in men than women and the proportion of people with long-term hearing disorders increases with age.3 General practitioners (GPs) are well placed to screen for hearing loss across all demographics.
The most common ear disease affecting children in Australia is otitis media, presenting as a spectrum of disease from otitis effusions to chronic suppurative otitis media.4 Intervention prevents secondary hearing loss which has a significant impact on speech and language development and is a cause of behavioural issues, early school leaving, and limited employment options in later years.4
The 2018–19 National Aboriginal and Torres Strait Islander Health Survey estimated 14% of Aboriginal and Torres Strait Islander peoples had a long-term ear or hearing problem.4,5 The proportion was the same for men and women, and similar for remote and non-remote areas.4,5 Aboriginal and Torres Strait Islander children have a higher rate of ear disease and associated hearing loss than non-Indigenous children.5 A number of initiatives co-designed with Aboriginal Community Controlled Health Services are in place to reduce the incidence of hearing loss and improve oral health status in Aboriginal and Torres Strait Islander patients.
ENT presentations such as vertigo may present with or without hearing loss and constitute approximately 54% of cases of dizziness.6 Other ENT presentations include acute or chronic nasal obstruction, allergies (allergic rhinitis) and sore throat.7 If not treated and managed, these can adversely affect quality of sleep resulting in daytime somnolence and fatigue.7 Approximately one-third of children aged five to 12 years will have an episode of sore throat each year, most cases are viral in origin, with 15–36% caused by bacteria, predominantly group A streptococcus (GAS).8 GPs are well positioned to manage such conditions and treat as per current guidelines.
Poor oral health and disease accounted for 4.5% of the burden of non-fatal disease in 2015, of which tooth decay, gum disease and tooth loss were the most common.9 Poor oral health affects chewing and swallowing, in turn affecting dietary intake and compromised nutrition.9 Poor oral health is associated with chronic diseases, including stroke and cardiovascular disease.10 It can also affect an individual’s appearance, self-esteem and self-confidence and their ability to talk and communicate effectively, thus impacting on social wellbeing and interpersonal relationships.10 GPs have a role in promoting good oral hygiene amongst patients and ensuring timely referral to appropriate oral and dental specialist services to avoid complications.
Head and neck cancer is the seventh most commonly diagnosed cancer in Australia, with the number of diagnosed cases doubling over the past 40 years and predicted to continue to increase.11 Smoking and alcohol are major risk factors accounting for 75% of the cases.11 GPs providing lifestyle modification advice and early detection can lead to increased survival rate.11