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Dental care a gaping hole in our health system by Stephen Hwang

Dental care a gaping hole in our health system by Stephen Hwang

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Published by EvidenceNetwork.ca
Across Ontario, going to the dentist is financially out of reach for many people. This dilemma is well-known to physicians — many of us regularly care for patients who have terrible dental problems that we are powerless to address. We see people who have delayed seeking dental care that they can’t afford until they are in serious pain or their health is at risk. We see people who have trouble finding employment, miss school, or avoid social situations because of the condition of their teeth. We see people who avoid eating because their mouths constantly hurt.
Across Ontario, going to the dentist is financially out of reach for many people. This dilemma is well-known to physicians — many of us regularly care for patients who have terrible dental problems that we are powerless to address. We see people who have delayed seeking dental care that they can’t afford until they are in serious pain or their health is at risk. We see people who have trouble finding employment, miss school, or avoid social situations because of the condition of their teeth. We see people who avoid eating because their mouths constantly hurt.

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Published by: EvidenceNetwork.ca on Feb 26, 2014
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03/30/2015

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umanitoba.ca
http://umanitoba.ca/outreach/evidencenetwork/archives/12090
Dental care a gaping hole in our health system
 A version of this commentary appeared in the Windsor Star, Vancouver Province and Ottawa Life
 Across Ontario, going to the dentist is financially out of reach for many people. This dilemma is well-known to physicians — manyof us regularly care for patients who have terrible dental problemsthat we are powerless to address. We see people who havedelayed seeking dental care that they can’t afford until they are inserious pain or their health is at risk. We see people who havetrouble finding employment, miss school, or avoid socialsituations because of the condition of their teeth. We see peoplewho avoid eating because their mouths constantly hurt.Lack of access to oral health care is a pressing issue for a largesegment of Ontario’s population. Most often, this lack of access isdue to economic barriers. In Toronto, a new study from the Centrefor Research on Inner City Health found that low incomes are a very strong predictor of poor oral health and mouthpain. In Hamilton, a new report from the City of Hamilton’s Public Health Services found that there is a clear linkbetween poor oral health and lower income levels. According to a report from Ontario’s Chief Medical Offer of Health, 20% of Ontarians who stayed away from thedentist for a long time cited cost as a barrier. Nationally, cost has kept a full 16.5% of Canadians from seekingrecommended oral health care.For people who are homeless, the situation is particularly acute. Recently, researchers from the Centre for Researchon Inner City Health and the Faculty of Dentistry at the University of Toronto worked together to assess the oral healthof about 200 people staying at 18 homeless shelters in Toronto. We found that 97% of the people we examinedneeded some kind of dental care and 40% needed emergency treatment.Thirty-five per cent of the people we surveyed had avoided eating due to mouth pain. Many had experienced painover the last month, and most didn’t seek treatment.Dental care remains a gaping hole in our health care system for people with limited means. There are currently nocoordinated, city-wide dental care programs for women and men experiencing homelessness in Toronto, for example.More generally, children, youth and elders are covered by a patchwork of public programs that leave many fallingthrough the cracks. Adults earning wages that add up to low and middle incomes have no access to public dental care programs at all.The recent discontinuation of very basic dental care for people who are refugees has made the situation even worse. As a physician, I can tell you how much it’s needed. The overall health of people living on low incomes is deeplyimpacted by their lack of access to dental care. The current situation in which we provide health insurance to cover the treatment of every part of a person except his or her teeth makes little sense, and leaves thousands of people tosuffer from chronic pain and tooth loss.Would we tolerate a system in which we didn’t cover the treatment of eye diseases, and allowed people who didn’thave the means to pay for their own care to go blind?It’s time to address the very real pain, distress, and long-term health consequences caused by the fact that many in

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