Whenever there’s talk of an election in Ontario or Canada, the importance of affordable, or free access to dental care becomes a topic of discussion once again. While the Ontario healthcare system is often viewed as one of the best in the world, those from other countries also wonder how it is that dental care was never included in our healthcare to begin with, especially for treatments such as dentures, which are imperative to being able to eat and smile in today’s world. The Network for Canadian Oral Health Research (NCOHR) outlined five separate, unrelated reasons why(*):
1) Legislative reasons: The Royal Commission on Health Services (1961-1964) suggested a targeted, public approach to dentistry rather than a universal style coverage. The Medical Care Act (1966) which combined the existing hospital system with physician care, was set up so that federal funds would be provided to the provinces to invest in dental care as well as universal coverage but without the existing hospital system in place, and a targeted approach from the onset, the dental procedures covered under provincial healthcare was lacking. This funding was then further cut back in the 1980s as the economy went south.
2) Professional reasons: A public built dental healthcare system has generally never been preferred by the dental profession. It’s tough to build a system of public health with resistance from the professionals within the industry who would provide the care.
3) Socio-cultural reasons: Before our public healthcare system was created, it was a time of higher unionized employment and an increased focus on in-home oral care using toothbrushes and fluoridated toothpastes. As unions become more common, they played a key role in building private insurance plans for employees that included extensive dental care coverage. And the increased attention to in-home dental care created a view, at the time, that dentistry was more of an emergency care need, rather than preventative.
4) Economic reasons: Adding dental to the healthcare system would be a massive increase in the cost of the overall public healthcare system, with dental problems being one of the most common health worries among every part of the population. Close to a third of all provincial spending already goes to health in Ontario, so adding a treatment that affects every individual is a massive increase to our biggest expense.
5) Epidemiological reasons: At the time of our public system’s development, the introduction of fluoride with the promotion of regular oral health prevention measures such as brushing or advances in dentistry, lead to a dental care and disease being less of a pubic health issue at the time for sitting governments. While most residents will agree that public dental is an important issue, until it’s pushed to the front of the campaign agenda, politicians are unlikely to cause any waves about it.
While these key points help us understand the history of our public healthcare system and why dental wasn’t a big part of it from the beginning, there still doesn’t seem to be a clear direction forward to address these key issues, particularly with the economic aspect of it being such a significant part, and most importantly, there's no clear path forward for public dental in areas of need such as dentures.
Our goal at Saberton Denture & Implant is to give the public an affordable denture option to at least provide a choice in an environment that lacks a true public dental health structure.
* Why was dental care excluded from Canadian Medicare? NCOHR Working Papers Series 2013, 1:1