Healthcare system should cover dental, says policy expert

by Leo Almazora12 Apr 2017
With one in six Canadians having difficulty accessing dental care because of cost, insurance, or travel issues, Canada’s public health system must be expanded to include oral health services, according to a pair of policy experts.

In a piece written for Huffington Post Canada, Jacquie Maund, policy and government relations lead at the Association of Ontario Health Centres, and Hazel Stewart, Director of Oral Health Programs at Toronto Public Health pointed out numerous problems with the current system of dental care.

“In Ontario, it's estimated that two to three million people have not seen a dentist in the past year -- the main reason cited being cost,” the pair wrote. While Ontario has some public dental programs, they cover only children under 18 years of age in extremely low-income families and, to some extent, people receiving social assistance.

Vulnerable groups, such as low-wage workers, seniors, and Indigenous people, have no access to dental care, and therefore have the highest rates of tooth decay, gum disease, and dental pain.

Those suffering from dental pain but too poor to see a dentist might go to unlicensed black-market dentists; more often, they approach their family doctors for help. “In 2014, there were almost 222,000 visits to Ontario physician offices for teeth and gum issues,” the article read. However, the doctors are not trained to deal with such issues, so they cannot provide appropriate treatment.

The authors determined that 2014’s statistics translated to a dental pain-related doctor’s visit almost every three minutes across the province. With OHIP paying doctors a minimum of $33.70 per 15-minute patient visit, the tooth-related appointments amounted to at least $7.5 million in additional costs for Ontario's health care system.

Citing a survey by the Ontario Oral Health Alliance, the article said many private dental practices refuse to accept adults who are on social assistance, admitting to frustration over the fact that low-income people cannot pay and often miss appointments. Low-income patients, on the other hand, prefer to be treated in public dental clinics where they do not feel stigmatized.

Given all that, the authors contended, it would be better for public healthcare dollars to be spent on public oral health programs for low-income groups. In particular, the authors suggested that oral services be delivered within community health centres and other places where vulnerable groups already receive care.

“At community health centres, low-income people can get their teeth checked while also being referred to other appropriate services, such as diabetes management programs, the mental health team, nutrition programs and primary health care — all delivered at the same location,” they said.

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  • by Georgette 2017-04-20 4:00:09 PM

    Just let say, I loved this article. However, when the universal health care was put in place, the dentists were asked to join, they just responded they didn't want the government to meddle in their business. So, what has changed? Are they willing to play ball with everyone now? They caused that problem, are they willing to make up for it now that the population is aging and that they may not have as many clients in the regular population? Most of the provinces have taken the coverage for children from 18 to 10-12 years old now. The seniors are just not covered unless they have dental insurances and even then what happens to the clients who are in long term care facilities where basically dentists do not want set foot? I do speak by experience, being one who has advocated for seniors in long term care facilities for years. As an RN and as an ex-dental assistant, even after doing fund raising and succeeding in building a dental operatory in a LTC facility, the services are barely delivered by lack of cooperation from the dentist community. Dental hygienists are willing to deliver their allowed services but they are frowned upon for doing so. There are still that old mentality existing in some dental community and it is detrimental in the delivery of services. As my working days are soon getting over, I am hoping that problem will be solved in the near future. To have the dental services included in the Universal health program would be a saving for our deteriorating health system, because if you really think about it, most of health problems start in the mouth.