by Anjum Sultana & Jacquie Maund
Canada has a universal health care system, but not when it comes to our teeth and gums. At the April 17th oral health forum organized by the Association of Ontario Health Centres and the Ontario Oral Health Alliance participants learned that over 6 million people in Canada don’t see a dentist because they can’t afford it.
The annual forum brought together 100 people from public and private dentistry, as well as academics, community health providers and community members to hear from a panel of health and community spokespeople who shared their knowledge and ideas on how to address this health equity challenge.
Dr Paul Allison, Dean of Dentistry at McGill University, spoke about a recent study by the Canadian Academy of Health Sciences found vulnerable people have the greatest difficulty accessing oral health care services. This includes low income children and adults, working people without dental insurance, the elderly, Aboriginal people, immigrants, people with disabilities and people living in rural and remote regions. We also learned that there’s a growing number of middle income people who are finding they can’t afford dental services. And Dr Allison predicted a tsunami of people losing dental coverage as they retire – so it’s a seniors issue too. His research found that the private model of dentistry is clearly not working for the 25% of people who face the greatest barriers to access.
Health care provider Laura Hanson described how lack of access affects our overall health and wellbeing with studies showing links between poor oral health care and diabetes, cardiovascular disease, pneumonia, and Alzheimer’s.
Focusing on Ontario, Lisa Taylor from the College of Dental Hygienists of Ontario reported that 2-3 million people don’t have access to oral health care and at only 1.3%, our province has the lowest level of government funding for dental expenditures in Canada. The College is calling for oral health care to be better integrated into overall health system planning. The LHINs should include planning for oral health services in their regions with support for Community Health Centres, Aboriginal Health Access Centres and other primary care providers to include oral health services to vulnerable people.
Panelist Steve Barnes from the Wellesley Institute noted that we shouldn’t assume that dental coverage will be provided by employers. Almost half (45%) of all people earning less than $30,000/year in Ontario don’t have dental coverage. His report, Low Wages, No Benefits, calls for expansion of public dental programs to include more people with low incomes.
It was a lively forum with lots of energy and commitment to advocate for more equitable access to oral health care in Ontario. It was also a stark reminder of why access is so important. Mike Creek, from Working for Change, described how he had to stick a sterilized needle in his mouth abscess when he couldn’t afford a dentist and became isolated after his front teeth broke - he only went out at night to avoid being seen.
So what steps can we take so that our health system ensures people in need have access to the oral health care they require to be healthy? Dr Hazel Stewart, Director of Oral Health Services at the City of Toronto, called for oral health stakeholders to identify public policy solutions that are affordable and sustainable. We need new models of accessible publicly funded oral health care such as mobile dental buses that visit remote communities, dental professionals to visit long term care homes, and more dental clinics at Community Health Centres in low income neighbourhoods. We need to work with people in the community who can be peer educators to focus on prevention of dental disease. And services don’t all have to be delivered by dentists – dental therapists, dental hygienists and other health professionals have important roles to play.
TAKE ACTION: Add your voice to the current campaign of the Ontario Oral Health Alliance calling for faster action on expanded public programs http://e-activist.com/ea-action/action?ea.client.id=1734&ea.campaign.id=34232&ea.tracking.id=OOHA
LEARN MORE: Attend the workshops at the June 2-3 #AOHC2015 conference which give updates on work underway to address barriers to health care.
A9- Improving Access to Oral Health Care for Vulnerable People.
A12– Increasing Access to Primary Care for Seasonal Agricultural Workers
D2- Addressing Mental Health & Addictions Issues: the case for supportive housing
D8- Preparing for the federal election: update on pharmacare and other national asks
Anjum Sultana is the 2015 Policy & Communications Summer Intern for AOHC, and a Masters of Public Health Candidate at the Dalla Lana School of Public Health at the University of Toronto. Jacquie Maund is Policy and Government Relations Lead at AOHC