Canadians may have a new reason to smile. A proposed national dental program under the new Liberal-NDP agreement may be one of the biggest expansions of health care in Canada in decades.
This is good news, according to one Western University professor, and its impact goes far beyond dental health.
“We know that being unable to get something treated such as an infected tooth can have consequences on the health care system,” said Dr. Noha Gomaa, a professor in dentistry and epidemiology and biostatistics at the Schulich School of Medicine & Dentistry.
Gomaa’s research focuses on the impact of oral health on other major health conditions, with a special focus on issues of access to oral health care and health equity.
She says an unhealthy mouth is linked to several health conditions such as diabetes, cardiovascular diseases, and potentially many others.
Poor oral health may also have connections to adverse pregnancy outcomes, such as preterm or low-birthweight babies, Gomaa said. She pointed to recent stories from Canada and the United States of people losing eyesight or suffering brain abscesses due to an infected tooth they were not able to afford treatment for.
“An acutely infected tooth that is left untreated may have severe consequences, such as the infection spreading to other organs like the lung, the eyes, or the brain, causing hospitalization, blindness or even unfortunately death,” says Gomaa.
The proposal
The Schulich Dentistry professor said the proposed national dental program is great news for many Canadians and is a, “promising step toward ensuring dental care can finally reach those who are most in need.”
“A pressing question is what this proposed program will look like, specifically, what dental services will be included, and how they will be delivered,” Gomaa said.
According to the proposal, families without dental coverage and with an annual income of $90,000 or less would be eligible for coverage.
The plan also includes a provision for flat-rate fees, which can be charged whenever someone makes a claim, and will apply to anyone who earns $70,000 or less annually.
“From what we currently know about the proposed plan, it sounds like we may finally be getting closer to mending the current patchwork in our dental care system that has left many Canadians falling through the cracks; having to give up life essentials to be able to afford seeing a dentist,” said Gomaa.
She noted that many dental public health scholars across Canada have been studying and advocating for some sort of national program for years.
“When looking at the income thresholds proposed, I believe they sound reasonable based on what we know about the income categories in which Canada’s working poor lie,” Gomaa said.
She explained there are numerous people who have low-paying jobs with no dental benefits, but they don’t qualify for government programs that provide dental insurance because they might be just above the income threshold.
The price tag
The next Federal Budget, which is due to be released April 7, could provide indication of the cost of a national dental care program. The Parliamentary Budget Officer costed out a similar plan in 2020, estimating the first year of the plan would cost about $4.3-billion, and then about $1.5-billion annually until 2025.
This new proposal would see the program rolled out over several years, so earlier cost projections likely would not match up.
Despite the potential multi-billion-dollar price tag for such a program, Gomaa said the benefit to the overall health-care system may outweigh the costs in the long term.
“From what we know about the costs that not getting dental treatment can have on the health-care system, such as costs related to emergency department visits, visits to physician offices, as well as productivity losses in terms of the hours lost off school or work because of dental problems, I think it would be safe to say that early intervention for what are mostly preventable conditions, does have the potential to actually save public dollars,” she explained.
Gomaa said a collection of basic dental services, supported by the best scientific evidence, should be accessible to everyone.
She also suggested the national dental program include “top-ups” in services for those who need it most, such as individuals with disabilities or those whose oral health is at a higher risk due to underlying health conditions.
Only time will tell what the program will look like completely, but Gomaa is optimistic that this proposed plan is a major step in the right direction. Now, it’s all about execution.
“Surely, this is a real opportunity for us to leverage what we know about dental care policy here in Canada, and to learn from international experiences to ensure that the new proposed program meets the dental needs of all Canadians,” said Gomaa.
