BC FORUM News - From The Advocate, Summer, 2021

Lack of dental care leaves a big hole

By Hasan Sheikh and Brandon Doucet

The COVID-19 pandemic has reinforced just how foundational medicare is. As we recover from the effects of the pandemic, we must strengthen that foundation. It’s time for Canadians to start using their health card, not their credit card, to access dental care.

Dental care is not a luxury. Oral health is a critical part of overall health. Poor oral health can cause or worsen other medical conditions due to chronic inflammation. Providing dental care improves diabetic control and reduces the risk of aspiration pneumonia in long-term care homes.

It has even been shown to increase employability. It’s hard to confidently interview for a job if you’re afraid to smile.

Eliminate costly barriers

One in three Canadians lack dental insurance and one in five avoid seeing a dentist each year due to cost. In terms of dental care, our “universal” health-care system is anything but. Of all dental care spending, only five per cent is public. That is less than the United States, where 10 per cent of dental care spending is public, and not even close to the United Kingdom, where it is 46 per cent.

This already dire situation was worsening before the pandemic, with more seniors retiring and losing their work-related benefits and more people working in the precarious gig economy. COVID-19 has only exacerbated this.

If Canada’s health-care system were a mouth, it would be too embarrassed to smile for fear of showing the large gap that is our missing dental care system.

Many Canadians forgo routine care because they can’t afford it, leaving small problems to fester and grow. Our current system not only stresses our individual wallets, it also puts additional strain on our healthcare system.

With four in 10 low-income Canadians avoiding seeing a dentist due to cost, many end up relying on our emergency departments. The cost of these visits across the country is estimated to be more than $150 million a year.

The Canada Health Act makes the objective of Canadian healthcare policy very clear: “to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers.”

Given this, we must guarantee access to essential dental care for every Canadian.

Expanding public spending to guarantee dental insurance for all would help Canadians access routine care, reducing the need for more costly and complex procedures later. This would benefit individuals and reduce costs for employers.

Improve access to care

While public financing is important, it doesn’t guarantee access to a provider. The private delivery model has left many poor and rural communities significantly underresourced. Public delivery of some dental care can ensure that people actually have a provider near their community.

Many dentists in private practice have historically been hostile to universal dental care and public delivery. That’s no surprise because it cuts into their monopoly on care.

Doctors were once the same. Doctors were the biggest opponents of medicare when it was first introduced in Saskatchewan. On July 1, 1962, the day medicare was born, most of the province’s doctors went on strike. But now, very few would want an American-style health-care system like we currently have for dental care — especially during the pandemic.

The COVID-19 pandemic hasn’t given Canadians many reasons to smile. Investing in a universal, publicly-funded dental care system would ensure that a healthy, pain-free smile is in sight for every Canadian.

Hasan Sheikh is a lecturer in the department of family and community medicine at the University of Toronto; Brandon Doucet is a dentist practising in Newfoundland with interests in surgery and public health and the founder of Coalition for Dentalcare. This article originally appeared at theconversation.com, an independent source of news and views from the academic and research community.