Better Access to Dental Care for All Canadians

On March 22, the federal government announced that it wants to play a bigger role in increasing access to dental care and improving Canadians' oral health. As a dentist, I'm excited about the benefits that greater investment in oral health and focus on access to care will have for the approximately 33% of Canadians who don't have employer-based dental benefits.The Canadian oral health care system provides excellent care to most of the population. Health Canada statistics from 2010 reveal that nearly 75% of Canadians had visited the dentist in the last year and 85% within the last two years, which is a large percentage even when compared to other high-income countries. When you ask Canadians about oral health, 84% rate their own as good or excellent.Even so, there are people who still struggle to get the care they need. Seniors, children, people living with disabilities, Indigenous and racialized families, and low-income Canadian all need better access.I've spent much of my career trying to bring attention to this problem. For 30 years, I've provided dental care to adults with special health care needs in PEI. Access to health care for these individuals is a challenge at the best of times, and they often are unable to advocate for themselves. Over the years, as my patients grow older, I have shared in their experiences of changing life circumstances and health. Some have moved into long-term care settings. Others have limited access to regular dental care due to affordability or mobility. As a representative of both provincial and national dental organizations, I've advocated for improved access to dental care. All Canadians should enjoy good oral health, regardless of their economic, geographic or social circumstances.In this moment, we have a chance to make great strides toward an ideal vision of an oral health care system that is equitable and has the capacity to serve everyone. Oral health care is health care.The provinces and territories have a mosaic of programs that aim to provide dental care to people who otherwise lack access, but they have been chronically underfunded. The federal government has an opportunity to provide desperately needed funding that would make these provincial and territorial programs effective, sustainable and robust. Providing federal funding for provinces and territories to build on existing programs that already have the necessary infrastructure is the best and fastest way to provide dental care to the Canadians who need it now.Scaling up from existing programs would enable different places to start filling the gaps that are particular to their own communities. Places like Newfoundland and British Columbia don't have seniors programs. Some programs include preventative care, while others do not. Federal funding to bolster provincial and territorial programs also allows for a smooth transition process without disruption to the dental care that most Canadians already have.In my practice, I've seen the difference that access to care can make to the quality of life of the people we serve, especially those who are the most vulnerable in our society. I'm eager to be part of the practical and future-focused conversations about how dentistry, as a profession, can provide quality-of-life-enhancing care to many more Canadians.I would like to see the benefits of preventive care more equally shared among Canadians. Preventative care, after all, keeps people from needing dental treatments in the first place. People with dental infections sometimes end up in emergency rooms when they could be much better treated in a dental office. Better access to care could fix that. New research continues to show that the mouth and body are interconnected, and oral health profoundly impacts overall health. We all benefit from a healthier Canada.The last two years have been a challenging time for dentistry, as for all Canadians. At the beginning of the pandemic, dental practices were closed across the country except for cases of emergency care. To reopen, dental offices invested in renovations to isolate patients from each other, new ventilation and air-scrubbing technologies, and increased personal protective equipment. A shortage of dental staff, including dental hygienists and dental assistants, was exacerbated by the pandemic, and some offices still can't offer as many appointments because of it.In Canada, a majority of dental offices are small businesses. With growing costs for materials, supplies and staff, it is not unusual to see offices where overhead expenses are 70%. Provincial and territorial dental programs pay less, sometimes far less, than 50% of the cost of the treatments and care that dentists provide, which means that even the most well-intentioned dentists can't take on more than a certain number of patients who are covered by these programs. Better funding will enable dental practices to offer high-quality care to more people in their practice.My wife and I have both been working as dentists in our community in PEI for our whole careers. We see our patients outside our office doors all the time. We both feel a great deal of responsibility toward our patients. Sometimes a patient will lose a job. Or retire. Or get sick. We do what we can to make sure they continue to have access to dental care.In my ideal world, every Canadian, no matter what their situation, will have access to dental care that meets their individual needs.Dr. Richard Holden is a practising dentist in Charlottetown, PEI, and president of the Canadian Dental Association.

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