Making seniors’ oral health a priority

Many of Canada’s 30,000 registered dental hygienists, like Julie DiNardo, RDH (left) with client Gino Pocobene, and Regina Burmudez, RDH (right) with 91-year-old Jean Sych, are essential primary health-care professionals providing individualized services, in the comfort of seniors’ own homes, that contribute to their overall well-being and quality of life. supplied

Seniors in Canada, who now comprise approximately 18.5 per cent of the population, are living longer and enjoying active lives thanks to enhanced health and wellness. However, according to a survey commissioned by the Canadian Dental Hygienists Association (CDHA), 56 per cent of Canadians over age 60 have no dental insurance. That is putting vulnerable seniors at risk, says Sylvie Martel, director of dental hygiene practice at CDHA.  

Oral health professionals and researchers have established the link between a healthy mouth and a healthy body, notes Martel. “Oral health is critical to overall well-being.

“Poor oral health can exacerbate existing medical conditions such as diabetes, heart diseases, stroke, and bronchial asthma or aspiration pneumonia. The impact is huge because it's not just your mouth, teeth and gums that are affected. It’s your overall health,” she adds. 

Renata Albonese, a dental hygienist who is one of 21,000 members of CDHA, agrees that “oral health definitely has an impact on older peoples’ quality of life.

“Within today's aging population, people are keeping their natural teeth longer, which means that maintaining good oral hygiene is more important than ever,” says Albonese. Elderly people are more susceptible to tooth loss, tooth decay (dental caries), gum disease (gingivitis or periodontitis), dry mouth (xerostomia) and oral cancers.

Unfortunately, access to professional oral care can be challenging and costly, especially for seniors on a fixed income and in long-term care. 


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Without adequate financial support, too many Canadians will forgo the oral care services they need. And that has an impact on the health-care system as a whole.
— Sylvie Martel Director of Dental Hygiene Practice, Canadian Dental Hygienists Association

Albonese’s 91-year-old mother, Jean Sych, believes seniors need more help accessing oral health care. Sych recently had her teeth examined and cleaned by a dental hygienist who came to her home in Mississauga. 

“With seniors it's really hard,” says Sych, whose three sisters, ages 93, 89 and 83, “are all in the same boat.” 

Sych, who suffers from arthritis and mobility challenges, says she is grateful for the at-home services of a professional dental hygiene practitioner. But she is concerned about the high cost of dental treatments.

“I think for seniors it's very difficult to afford services,” she says, questioning why dental care costs are not covered under the provincial health-care plan like other services.

“I think it’s very important that government supports seniors because oral care is very important for your health.”

For CDHA, established in 1963, seniors’ oral health has been a long-standing priority, says Martel. The organization recently responded to a call from the Health Standards Organization (HSO) for input into revisions to the national standards for long-term care homes in Canada. 

Despite its importance, oral care is not part of the day-to-day routine in residential care, points out Martel. 

“We all know that seniors’ homes have been hit dramatically with COVID. But even before the pandemic, long-term care services were stretched to the limit. Oral care kind of fell by the wayside.”

Dental hygienists are essential primary care providers who can play a pivotal role in the delivery of preventive and therapeutic health-care services, says Martel. “Oral care professionals need to be at the table in long-term care homes and in hospitals as valued members of care teams.” 

CDHA is also pushing for governments to step up to help pay for crucial programs aimed at promoting oral health, adds Martel.

Dental health care is largely provided by the private sector in Canada, notes Martel, with the federal government picking up only 6 per cent of Canada’s national dental expenditures. That amounts to funding of only about $378 per Canadian per year. “Without adequate financial support, too many Canadians will forgo the oral care services they need,” she adds. “And that has an impact on the health-care system as a whole.”

Canadians who experience oral pain, including seniors and those with low incomes and no dental insurance, have no recourse but to seek out relief by going to their local hospital. Martel points to a study published in 2017 by the Canadian Journal of Public Health stating that, annually, about 1 per cent of all emergency room visits are made by individuals with non-traumatic, non-urgent and preventable dental conditions. These visits costs taxpayers millions of dollars each year. Additionally, says Martel, in most cases the cause for the visit is not treated and the problem persists, resulting in further costs down the road. 

CDHA is recommending the federal government address these gaps in Canada’s publicly funded health-care system by working with the provinces and increasing oral health funding for vulnerable seniors and those living in long-term care.

“Because of COVID, public health is now at the forefront of everything. It [the pandemic] has shown us that we need to focus more on prevention and think about the future, which in Canada includes a rising population of seniors.

“We really need to have the buy-in of the federal government that oral health is crucial for overall health.  It’s time for health care in Canada to include oral care,” she adds. 

To view this report on The Globe's website, visit globeandmail.com

To view the full report as it appeared in The Globe's print edition: Healthy Aging