Blog Post by David Thornley, Executive Director, Guelph Community Health Centre and Member of the Poverty Task Force
Natalie (not her real name) experiences daily pain and infection from broken teeth and abscesses, due to lack of dental care. With proper treatment at an earlier stage, her cavities wouldn’t have led to broken teeth and abscesses that make it difficult to chew her food at the young age of 36. And she wouldn’t have embarrassing gaps in her smile, almost as difficult to live with as her physical pain.
Natalie is only one of many Guelph residents who don’t have dental benefits and can’t afford to pay out of their pockets for basic dental care. Wellington-Dufferin-Guelph Public Health (W-G-D Public Health) receives at least 100 calls a year from adults and seniors seeking emergency dental care, but there are no programs to help them. Many more already know there is no help and don’t even ask.
The vision of Ontario’s Community Health Centres is to ensure the best possible health and wellbeing for everyone, particularly those facing barriers to good health. But it’s hard to achieve that when so many of the people we see at the Guelph Community Health Centre (Guelph CHC) cannot afford dental care. OHIP covers health care for every part of our body except our teeth and gums.
April is Oral Health Month – a good time to highlight the changes we need in our health care system so that everyone has access to oral health care in our province.
A recent study by Public Health Ontario found that 1 in every 5 Ontarians does not visit a dentist because they cannot afford it.
So thousands of people in Ontario suffer with pain and infection from poor oral health. They have no choice but to go to the local Emergency Room of their hospital where they can get pain killers but no dental treatment for the problem.
As Natalie explains, “Abscesses, while they are in full blown pain, cannot be repaired until antibiotic treatments take the infection down. At that point, the pain is gone and I no longer qualify for treatment. I’ve had two teeth pulled by dentists under OW (Ontario Works) benefits as that was the only thing covered by OW. Both teeth could have had root canals and/or repair but these aren’t covered.”
More than 26,000 people in similar situations annually visit emergency rooms for dental problems. In the area covered by our Local Health Integration Network (Waterloo Region, Wellington County, City of Guelph and a small part of Grey-Bruce) 1,664 people sought care in our hospital ERs in 2011 for less urgent and non urgent oral health issues, the last year for which data is available. Many of their painful dental problems could have been prevented and/or more appropriately treated by a dentist.
Because the Guelph CHC and W-D-G Public Health are aware of this problem in our community, we are working with the Ontario Oral Health Alliance, a provincial coalition working to raise awareness of the need for publicly funded oral health programs for low income people in our province.
As health care workers, we see how dental problems and poor oral health affect our clients’ overall health and wellbeing. As one person told us, “My broken teeth are all molars, causing chewing to be difficult and therefore I avoid food like raw carrots, apples, and meats.” In addition to affecting people’s ability to eat healthy foods, research clearly shows the link between poor oral health and diabetes, cardiovascular disease, pneumonia, and Alzheimer’s.
We also know there are economic costs when people don’t have access to affordable dental care. According to the Canadian Health Measures Survey 2010, 4.15 million working days are lost annually due to oral health problems. Not only do working poor people lose work time and pay when dental pain prevents them from going to work, many struggle to find work in the first place if a prospective employer won’t hire someone with bad teeth.
In response to these problems, representatives of Guelph CHC and W-D-G Public Health met with Liz Sandals, our local MPP to voice our concerns and present over 700 postcards signed by our clients and community members calling for expansion of public programs to ensure emergency oral health care for low income adults.
We told her that the Ontario government took an important step in the right direction in 2010 with a commitment to invest $45 million in dental programs for low income families. But they currently cover only dental treatment for low income children. And because the income eligibility criteria were set too low, W-D-G Public Health has had to deny eligibility for over 900 children whose parents earn more than $20,000 per year (the after-tax Low Income Cut Off for a family of four living in a community the size of Guelph in 2011 is $30,871).
As a result, desperately needed dental care money has gone unspent. A recent Toronto Star article (April 1 2013) reported that, rather than reworking the rules of the new dental program to make sure more children had access, the funds are quietly being diverted to programs that promote sports, healthy communities, and anti-smoking.
Meanwhile the gap for adults needing emergency dental care still exists. As part of a campaign to change this, over 50,000 oral health postcards have been signed and delivered to MPPs across Ontario calling for affordable, accessible oral health care programs for all low income children and adults in Ontario.
We are asking the Ontario government to raise the income eligibility levels so more low income children can benefit from the Healthy Smiles Ontario program. And we’re calling on the Province to expand oral health programs to provide emergency care for low income adults, saving health care dollars by keeping people out of hospital emergency rooms.
As health professionals, we know that strategic upfront investment to improve health and wellbeing now will prevent larger amounts of money being spent on sickness care and rehabilitation in the future.
This April, please take a few minutes to add your voice to this call to our provincial politicians by visiting www.oaphd.on.ca and emailing your MPP.