During my first few years living in Canada, I didn’t visit a dentist. The reason for that is because my insurance did not cover dental care, and as a poor student, I simply couldn’t afford it.
Although I didn’t have any oral health issues during that period and did not need to spend thousands of dollars on treatments, millions of Canadians aren’t as lucky as I was.
Given that dental care is not part of Canada’s universal health care regime, it is not uncommon for people – often the most vulnerable in our society - to avoid going to the dentist simply because they can’t afford the exorbitant costs of some procedures.
According to a study by the Canadian Academy of Health Sciences called ‘Improving access to oral health care for vulnerable people living in Canada,’ published in 2014, approximately six million Canadians avoid visiting the dentist every year because of the cost.
The three-year evaluation into the issue of access to health care found that many low income - and even middle income - Canadians suffer from pain, discomfort, disability, and loss of opportunity because of poor oral health.
Compared to the rest of the population, vulnerable groups in Canada are less likely to have dental insurance; more likely to avoid the dentist due to cost; more likely to consult dentists only in emergencies; more likely to have untreated dental decay, gum diseases, missing teeth, and dental pain; and more likely to avoid eating healthy foods such as fruits and vegetables due to oral health problems.
The study makes that point that in a wealthy country such as Canada, with explicit policy goals of reasonable access to health care as part of the Canada Health Act, these inequalities should be a matter of “national concern.”
Even though I am now insured, earlier this year I decided to postpone two dental procedures that weren’t considered an emergency and would end up costing me several hundred dollars.
Given that some dental problems can develop into more serious health issues, nobody in Canada should have to postpone or avoid a dental procedure due to its cost. As the study points out, oral health is part of general health - with the same social, economic, and behavioural determinants, and with direct links between poor oral and poor general health.
Furthermore, the study states that the current inequalities go against principles of the Canada Health Act, which are “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.”
While speaking with friends, I got the sense that dental care not being part of universal health care is simply “the way it is,” and that there’s no urgency to change this. But it’s about time we start thinking about a universal dental care.