Significant step forward for children’s oral health
Dental hygienists know that providing oral health care to children as early as possible helps lay the foundation for healthy teeth and gums for the long term. supplied
Canada Dental Benefit to help more families afford vital oral health care
Dental hygienists see the impacts of poor oral health first-hand and have long called for expanded access to preventive oral care services for Canadians. Ensuring proper dental hygiene care for children is especially important, given the consequences for their healthy growth and development if children’s oral health is neglected early in their lives.
Canada has now taken action to reduce cost barriers that have kept many Canadians from getting oral health care for their children. On December 1, 2022, the federal minority government, with the support of the NDP, officially launched the interim Canada Dental Benefit for children under 12 – the first stage in the development of a long-term, Canada-wide dental program.
“This was absolutely a historic announcement and a significant advancement for Canadian children’s oral health that will be remembered for generations,” says Anne Caissie, president of the Canadian Dental Hygienists Association (CDHA).
“This is momentous progress that recognizes the connection between oral health and overall health. And it reinforces the principle that Canadians should have equitable access to all types of health care and that cost should not be a barrier.”
Under the interim Canada Dental Benefit, families with an annual income of less than $90,000, and who don’t have access to private dental insurance, are eligible for coverage for their children. It’s estimated that around 500,000 children across the country will qualify to receive a tax-free, direct payment of up to $650 a year for two years for oral health services.
“For too long, oral health and overall health have been segregated and treated differently within our health-care system. ”
Equitable access to oral health care
One-third of Canadians currently do not have dental insurance, and in 2018, more than one in five Canadians reported avoiding dental care because of the cost, according to the federal government. Research shows that Canada’s most socioeconomically disadvantaged populations, who are the least able to afford oral health services, have the highest rates of dental decay, pain and disease.
“When Canadian Medicare was first legislated in the 1960s, oral health care was excluded, in part, because of limitations in oral health human resources at the time, cost, and the belief that a person’s oral health and the ability to seek dental care was not a social responsibility, but an individual one,” says Donna Wells, manager of professional practice for CDHA. In the decades since, governments have developed some public dental programs, she explains, but that has resulted in a patchwork across the country, and inequities in access have remained entrenched.
“Only six per cent of Canada’s national dental expenditure is government funded – the second lowest rate worldwide among high-income countries. The types of services vary widely between provinces and territories, and in some, dental hygienists are not recognized as eligible providers.”
CDHA was one of the professional dental associations at the table as the government and partners worked out the details of the interim Canada Dental Benefit. CDHA strongly advocated for dental hygienists to be eligible oral health care service providers under the program, and the government agreed – recognizing that dental hygienists are not only vital members of oral health teams, but are integral to making the program more accessible because of their flexible, innovative practice models.
“Dental hygienists who practise independently can bring their services directly to people in a wide range of community locations,” says Wells. “Many dental hygienists operate mobile clinics, some with customized vehicles, allowing them to visit private homes and other settings to meet a variety of needs. They support busy families with multiple children, serve people who can’t travel because of mobility or developmental challenges, and make life easier for those who fear going to dental offices as a result of traumatic experiences.
“Dental hygienists also provide services to children in Nunavut, in remote communities underserved by dentists. Expanding accessibility is a key aim of the new program, and the country’s 31,000 professional dental hygienists can help realize that goal.”
Starting children on a path to a lifetime of good oral health
Dental hygienists welcome the interim dental benefit for children because it will expand access to early preventive care, laying the foundation for proper oral hygiene and good health for a lifetime.
CDHA recommends taking a child for their first dental or dental hygiene appointment within four to six months of the child’s first tooth coming in, or at least by the age of one. “We can provide an assessment on whether the child is at risk for developing tooth decay,” says Wells. “We can also identify a habit like thumb sucking that might eventually lead to the need for orthodontic work if not corrected. As well, educating on nutrition is critical, as we know that poor nutrition, such as too much sugar and simple carbohydrates, increases the risk of cavities.”
Wells recalls an experience at one of the clinics she was working in, where a mom brought in her son, who was eight or nine, for his first dental appointment. “We discovered he had eight cavities. It was hard on the mother because she felt guilt and was also worried about paying for all those fillings. And for her son, his first experience with oral health professionals included freezing and drilling, and that’s not what we want. We want kids to have a good experience when they visit; starting early helps lay that foundation.”
Continued engagement for the next phases of the national dental program
Wells says CDHA remains committed to working in partnership with government and experts to ensure access to a range of oral health services and supports as the next phases of the long-term dental care program are rolled out.
The goal is to expand dental coverage this year to income-eligible under-18-year-olds, seniors and persons living with a disability, with full implementation for all families with incomes under $90,000 by 2025. It is estimated that 6.5 million Canadians will be eligible for the plan once it is fully implemented.
“For too long, oral health and overall health have been segregated and treated differently within our health-care system,” says Caissie. “We’ve started to tackle these inequities, and as dental hygienists, our goal is to continue to ensure all Canadians have access to the same level of oral health care across the country.”
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: Family Oral Health