We’re often reminded to book an appointment with our dentist for a regular dental exam and to get our teeth cleaned by a dental hygienist. However, in Canada’s private dental care system, you have to pay to access both of these oral health services.
And if you can’t afford to see a dentist or dental hygienist, you’re not alone.
Approximately one in six Canadians has difficulty getting oral health care because they can’t afford the cost, they don’t have dental insurance or it’s too expensive to travel to the nearest provider.
In Ontario, it’s estimated that 2-3 million people have not seen a dentist in the past year — the main reason cited being cost.
Ontario has some public dental programs, but only for children under 18 years of age in very low income families. There’s also a patchwork of basic dental programs for people receiving social assistance. There are no dental health provincial programs for low income adults and seniors.
It’s the most vulnerable people in our communities who don’t have access to dental care: low wage workers and their children; seniors and the institutionalized elderly; new Canadians; and Indigenous people. So it should come as no surprise that these are the groups in Ontario who have the highest rates of tooth decay, dental pain and gum disease.
Oral diseases affect a person’s general health and overall well-being.
There is a link between poor oral health and the severity of chronic conditions such as diabetes, cardiovascular and respiratory diseases. Oral diseases and missing teeth also affect a person’s sense of self-worth and their ability to get employment. It’s tough to look for a job while experiencing dental pain or if you’re missing front teeth.
So what are people doing when they’re in dental pain but can’t afford to see a dentist?
Many people turn to their family doctors in the hope they can get help. Some in desperation try to treat the pain themselves or go to black market dentists who are not qualified to provide dental care.
In 2014, there were almost 222,000 visits to Ontario physician offices for teeth and gum issues. That means that approximately every three minutes across the province, someone went to a doctor’s office seeking care for a dental problem.
But physicians are not trained or equipped to deal with diseases affecting teeth and gums, so they cannot provide appropriate treatment.
OHIP pays a doctor a minimum of $33.70 per 15-minute patient visit. So these visits added up to at least $7.5 million of additional costs for Ontario’s health care system in 2014 alone, with no proper treatment of the underlying health issue. This is a waste of healthcare resources, physicians’ valuable time and public funding.
It’s time to develop an effective public solution to this oral health care problem. It’s time to acknowledge that the private dentistry model does not meet the needs of low income and vulnerable people. And it’s time to stand firm and say the status quo is unacceptable.
A recent survey by the Ontario Oral Health Alliance found that in communities across Ontario, many private dental practices refuse to accept adults who are on social assistance programs. Many private dentists admit they are frustrated because low income people cannot pay and often miss appointments.
Academic research shows that most people living on low income prefer to be treated in public dental clinics where they are welcomed and valued and don’t experience stigma.
Let’s build on this evidence and work toward the goal of equitable access to oral health care for everyone living in Ontario.
Public health care dollars spent on acute care for oral health in ERs and physician offices would be better spent if invested to expand public oral health programs to low income adults and seniors delivered through models that are truly accessible for the elderly, people living on low incomes, newcomers and Indigenous people.
Such models include delivering services within community health centres, Aboriginal health access centres, public health units and via public mobile dental buses. In other words, in places where many vulnerable people already access their health and social services. At community health centres, low income people can get their teeth checked while also being referred to other appropriate services, such as diabetes management programs, the mental health team, nutrition programs and primary health care all delivered at the same location.
Let’s talk about how to best meet the oral health needs of people in our communities who cannot afford private dental care — because we all deserve a healthy mouth and smile.
This opinion piece is an updated version of an article that first appeared on the Evidence Network. It has been reprinted with their kind permission.
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Yeah.
I’m pretty sure that if something is not done about this, I will actually die or develop some sort of cancer, and then die.
The worst truth about all of this is that if you have Dental Benefits and go to a Dentist, they will ignore or skip passed important steps in procedures and exams or checkups, and they will do ‘lazy-work’, mistreat you or even deny benefits you are covered for.
Which is unethical.
And remember that failing to treat a tooth that needs a root canal, will result in a much worse scenario. Same rule applies to the need of a tooth extraction or filling.
So, to refuse alternative treatments or any treatments that you are covered for is unethical. The debate of ethics is NOT designed for you and your dentist in their office.
That is literally a matter for a Court of Law for sake of discussion. Many Dentists like to play the ‘I find that unethical’ game.
Makes me want to play ‘Let me find my Lawyer’ game
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Hi ! My name is Carole !
I readed the story about ODSP and or other thing .
I would say , that is very important people can fix theirs teeths for health or they going to die with desise . I don’t think you want people die and be responsible of their deaf . Did you ?
Now is only about money does days, and not helping people with their health . That is pretty sad .thank you
I’m missing a good half of my teeth. The upper teeth are missing closer to the back of the mouth where as the front teeth are missing in much of the both sides of the mouth with 7 front teeth that are only visible 3 of those teeth are overlapping each other. My remaining front and bottom teeth are crooked as well. I am always ill with either headaches, eye pain and the feeling of light headed feeling pretty well every 2 weeks i experience these symptoms. Sometimes i feel like my heart is racing a mile a second. My gums are inflamed and the y tend to bleed when i brush my teeth and gums. My gums have thinned out where if i was able to afford dental implants i would need to have surgery to have thicker gums to work with. I constantly feel dizzy and i’m always vomiting. Because i’m on ODSP i can only receive the basic Dental coverage but of course the way my teeth are in a few years i will not have to worry about dental coverage ever because i will not have any teeth left just a mouth full of decaying gums. I find it also very hard to smile or even converse with people because of my low self esteem. This has had a dramatic effect on my social life where i find myself living as a recluse. The crooked teeth i inherited from birth but was unable to have them fixed because my parents just couldn’t afford it. I realise that ODSP recognizes dental procedures like implants, Veneers and Braces as cosmetic and yes it does have very much to do with the persons overall appearance but it also has drastic affects on a persons health which can lead to death. Because of my lack of funds i had to research online for alternative approaches by purchasing like InstaMorph a molding product i purchased online for 10 dollars. I tried to create my own teeth and Dentures with every failing attempt and then i just finally gave up on the project. That’s my story unfortunately.
I have so much to say my case is still not settled however The College of Denturists” found dentust guilty and he must 6ee learn his trade but was offered money the lawyer (20%) disagreed. I look forward to sharing my story with you however looking at the clock this is it ridiculous time. My name is Tracy and if you look in the next day or so I will tell you my story and I’m telling you you will not believe it!
– ODSP has not raised the fee guide since 2009
– 45 million dental fund in 2009 was partially used for sport and smoke free ontario programs
– ODSP two tiered payment system for dentist/dental hygienist (independent) highly unfair
– Many dentists in Urban areas do accept ODSP
– preventive care can be extended to low cost dental hygiene clinics to alleviate “stigma” concerns and allow further access to preventive care
– private dentists should be allowed limited lower fee guides to service restorative and extractions at minimum. For access to care.
Wrong. I have noticed that the dentists who agree to providing dental services to OW and ODSP recipients use inferior materials for fillings that last, oftentimes, for only a few months. The recipients often have repeated fillings for the same teeth so that those dentists can scam more money from the agencies. And those dentists are not the brightest in their field, either.
Another problem with those dentists is that they don’t and won’t prescribe proper pain killers for the painful tooth extractions — I mean yankings — they perform on their financially poor patients. While extractions are covered on the OW/ODSP fee schedules, the simple act of writing out a prescription is not. Those dentists won’t even waste a few additional minutes on that because that is not covered. They hurry the OW/ODSP recipients through by telling them to take an Ibuprofen when they get home.
So true. I did not see a dentist for 6 years…could not afford it!!!
Excellent critiques of the situation that the general public is facing involving Dental Health Care involving most Dentists. Some are very caring and silently devote time and skill to look after needy patients. As a senior, I have not seen a “Dentist” since 2004 as costs are above what I can afford, and I refuse to support the lifestyle or ego’s of Dentists building Empires of 20 or 30 employees. Many have become “Business” owners, being advised by non-medical consultants, and have lost site of the profession of dental health care.
In my town of 17,000, dentists routinely deny services to ODSP and Ontario Works patients by quite simply stating that their “Quota has been filled or that they do not accept specialty insurances” I’m so very happy that in some areas peoples’ needs are being met but in some (or should I say most?) communities in Ontario they are being sadly neglected. My practice is in the same building of a shelter and I turn them away daily due to the inability to help them in any way. Throwing out a bunch of names of practices for the purpose of self-advertising also does not help when the majority of clients live so far away with believe it or not, minimal public transit available in order to access these practices.
It’s not just cost it’s also trust you feel like you are going to collision centre without knowing the real cost of the services you need also most of the time you have to pay everything in one payment and there’s no really great health insurance that can cover all you need, however I can help with some health insurance can defently can help with the cost. We’re paying big bills and taxes people should ask our province and federal for what, since each year we’re getting less with no real explanation, hope people will raise their voice now.
Happy Canada day, still Canada is the best spite of our leaders that most of them know how to talk and maybe to smile…
Itay Yahel
http://rnao.ca/policy/action-alerts/ask-premier-wynne-to-expand-public-dental-programs
Medical providers have collected the evidence “Every nine minutes, someone goes to an Ontario ER with a dental complaint. In 2015, there were almost 61,000 ER visits for oral health problems at a public cost of at least $31 million. In addition, there were almost 222,000 visits in 2014 to physicians (not including other primary care providers) for dental problems at a public cost of at least $7.5 million. These visits to ER and primary care may provide people temporary relief through treatment with painkillers and antibiotics, but their dental problems will not be resolved. Immediate investments should be made in prevention and treatment. Addressing the oral health needs of all Ontarians will have physical, mental, and social benefits, and lead to more equitable access to oral health services.” Dental Hygiene Care should be provided to everyone starting at age 1 ~ prevention and interception of minor problems is best for overall health and fiscally responsible.
The Dental Professionals do not have a bias as to one’s economic status and are the key at prevention in their field. I have been fortunate over 26 years as a Registered Dental Hygienist to work from babies to seniors alike and am happy as needed to refer to Public Health, Healthy Smiles, or CINOT if need be. My bosses at North York Smile Centre, Dr.’s Rob Eisen, Jerry Jesin and James Ko and our team of excellent Dental Assistants and Hygienists and admin staff are partners with all of our clients in this regard. If there is something one cannot afford, we will definitely point the client in the right direction. Many other private dentists will do the same: Dr. Saul Hafner, Concord, ON, Sleep For Dentistry Dr. Peter Nkansah, Dr. David Isen, Newtonbrook Dental Dr. Mark Safari Brownsline Dental, Etobicoke, ON…and the list goes on. With the links to Dementia, Lung Disease, Diabetes and Cardiovascular problems in relation to oral health, we are your first step at prevention in your oral health care. Saving you money and time in the long run. We look forward to meeting and helping you soon.
Cheryl Zellitt RDH
Hygiene -4_Hire
Toronto and outlying areas
Just out of curiosity….after reading your comment I understand that you say you are happy to REFER patients to Public Health, HSO and CINOT. That’s great… The programs you mention are for children not adults. How do you treat these unfortunate adult members of your own community when what is at issue is FINDING a dentist who will treat them? We all know these programs exist…..the issue is FINDING a dentist in private practice that accepts these programs. What about all those who do not qualify for these programs? You say “we will definitely point them in the right direction”……..does that mean that your office doesn’t treat them either? In bigger cities there are better chances of clinics…….not so in most of the province. Everybody is happy to refer…bottom line is that nobody wants to treat them.
Good points to the references advertisement.
Dental Hygienists are Making a Difference every year when they Open their HEARTS and Clinics to participate in the “Gift from the Heart”. This is a one day event every year, where dental hygienists provide FREE dental hygiene care to those in their communities that need it the most. The working poor, seniors, those with special needs, and the list goes on and on.
We all know of people in our towns and cities that just cannot afford dental hygiene care. We will the government realize that healthcare does not start at our tonsils!. Healthcare must include oral health care! Oral Health is linked to overall health!
Stand up and voice your concern! Dental Hygiene business owners are an integrate part of our healthcare system.
So many people go to a DDS when they are in pain yet when they get there they are forced to go through a calculated process which costs more than the original reason and lines the dentists pockets. Initial exam, full series of xr’s etc which eats up so much money before they can have their pain looked after. The consultants have convinced the dentists to use this “system” instead of dealing with the pain and then having the patient return for further work. Can you imagine if you went to a physician for a sore knee and they forced you to have full body scans etc (and pay for them) before even looking at the knee, and don’t forget the high pressured sales performed by treatment co-ordinators who are more interested in how you will be paying for treatment? Not professional……
The ongoing misrepresentation of provider ownership structure (public vrs private) and access and coverage is unhelpful. This deliberate confusion/ conflation of these distinct attributes is one of the main reasons the public provision of health services in Ontario and ROC is so difficult to improve and continues to fall further behind in the OECD tables. The defintional confusion is driven and funded by stakeholder’s self interest in the “public” provider/ payer health system. Shame for putting self interest ahead of collective interests as progressives continue the decade and a half slide into being a reactionary voice. I can only hope that millennials will see through this ruse and begin to move forward again.
Hi Colin,
Could you please explain what you mean by this?
Thank you.