Better access to dental care

By Dr. Richard Holden

Many Canadians living with disabilities don’t have the access to dental care that they need and they are less likely to have employer-based dental benefits. Data from the Canadian Community Health Survey by Statistics Canada gathered in 2018 tells us that among those who self-identify as part of this demographic, there is an estimated 1.6 million people who only visit the dentist for emergency care. And, alarmingly an estimated 575,000 of them don’t receive dental care at all.

There have been many obstacles to care for people with disabilities that include both practical challenges and lack of resources allocated for their dental care. In fact, across Canada chronically underfunded provincial or territorial programs have provided funding for this care. 

At the Canadian Dental Association (CDA), we’ve been advocating at the federal level for greater access to care for many years. As well, we’ve been working to address some of the other barriers to dental care that people living with disabilities currently face. 

As a dentist for over 30 years, I understand the challenges of providing dental care to adults with a variety of health care needs in P.E.I. I visit group homes to perform dental exams and provide dental treatments in hospital. At the practice where I work, many of our patients who live with disabilities can be accommodated in our office environment. Many of my patients are seniors and more than one third of them live with a disability so I’ve seen first-hand the difference that access to dental care has for their quality of life.

I’m excited about CDA’s new tools for oral health professionals that help them to provide seamless, person-centred care and the new dental care benefits that will come as a result of the federal government’s commitment to play a bigger role in improving oral health—the new federal budget included funding of $5.3 billion over five years to Health Canada to provide dental care for underserved groups. 

The CDA Dental Treatment Case Complexity Form and Recommendations is an assessment tool to help the dental team make treatment or referral decisions when seeing persons with a variety of different health care needs. The CDA Dental Patient with Special Health Care Needs Transition Process includes resources to help guide patients, families, caregivers and oral health care providers through the process of transitioning a patient from one practice to another, most commonly from a pediatric to an adult practice.

One of my colleagues has two brothers who were born with developmental disabilities. He explains that dental care was only one among many competing health care needs. Thankfully, a family dentist was able to provide care for his brothers in his dental office when they were children, though many youngsters with similar needs received dental care in hospital and under anesthetic.

The Canada Health Act currently provides surgical facilities and the service of anesthesiologists for hospital-based dental care. However, the pandemic has caused significant surgical backlogs that have made this kind of care more difficult to access. As dentists, it is critical that we strive to provide as much dental care in our offices as possible, with a strong emphasis on prevention to reduce disease and the need to treat in a hospital setting. Homecare workers and caregivers also play an important role in reducing oral disease. And, while hospitals will always be necessary in some circumstances, routine and preventative care is best done in dental offices. 

Remarkably, this new federal funding for dental care has the power to facilitate better dental care for over 2 million Canadians living with disabilities. The fastest and best way to access this much-needed dental care is to bolster the existing programs in each province and territory. In this moment, the federal government has the opportunity to make these programs effective, sustainable and robust. By scaling up existing programs we would be enabling dentists and the patients in different parts of the country to start filling the gaps particular to their own communities while preventing disruption to the care that many already have. 

My wife and I have been working as dentists in our community in P.E.I. since the late 1980s. We take care of people, not just teeth, and both work hard to make accommodations with care that take into account their individual needs, values and circumstances. Federal funding of provincial and territorial programs to provide dental care to people living with disabilities will have a positive and profound impact none too soon. 

Dr. Richard Holden is a practising dentist in Charlottetown and president of the Canadian Dental Association.

Photo: Anna Shvets, Pexels.

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