Dental care goes deeper for those in poverty.

Discovery Community Dental College recently announced a one day low cost dental event for community members who do not have dental insurance. Tooth polishing, fluoride treatments and X-rays for children and adults will be provided by dental assistant students. Part of the service will be to write up treatment plans for the children and adults they see on this day. Most if not all of these treatment plans will likely not be followed.
In our community and throughout Canada in fact, access to dental care is based on the ability to pay and not the need for care. According to a 2003 Statistics Canada report, almost half of employed Canadians do not have dental benefits through work. For the self-employed, two out of three people go without.
Stats Can also reports that one in three British Columbians hasn't seen a dentist in at least a year. And one in six of us has not seen a dentist in more than three years. It just is not affordable.
While one third of people cannot afford dental care through the current private fee for service system, some can find reduced fee clinics scattered around, but there are not many and not one north of Victoria. The problem is that the demand far outstrips the number of dentists and staff willing or able to volunteer.
People on low incomes have the highest extraction rate and lowest filling rate because it is cheaper to pull it rather than restore it. For those on welfare, there is coverage, but the amounts paid by the Ministry are less than the amounts charged by dentists, so poor people are left to try to make up the difference, or not get the work done. Most don’t get the work done. And for those who have no teeth at all, estimated to be at least one if four of low income people, welfare rates do not meet the rates for dentures by any stretch of the imagination. Most are left with having to pay out more than a months’ income for the difference. Who can do that?
Those with high incomes or with insurance receive the preventative and diagnostic treatment they need. Low income people only get emergency service and even then, it often differs from the services of those who can pay for them. There is quite a bit of self care going on. This includes people pulling out their own teeth with pliers, popping infections on their gums, and living on pain killers- prescribed or not.
The Canadian Dental Association says that there is a definite link between oral diseases and diabetes, heart disease, stroke, low birth weights and pre term babies. Common sense says there is a definite link between no dental care and needless pain and suffering, barriers to employment, restricted activities in school, poor self esteem, no quality of life, terrible nutrition and poor bashing stereotypes.
An Alberta man who worked for a minimum wage with no benefits, earning basically enough to pay for rent, food and gas, needed his tooth fixed, but the cost was five hundred dollars. The situation became life threatening when the tooth became abscessed. The infection spread to his brain where doctors had to remove part of his skull to remove all the pus. In Ontario, a man went blind because he couldn't afford to treat his abscessed tooth. Then there is the case of a 17-year-old boy who died after his tooth abscessed and the infection ended up in his heart. This is not all about great smiles. Lives are being lost.
The reality is that most low income people put off getting care and ultimately end up in their hospital emergency department where they can be treated for free.
The answer is that Canada should have a universal dental care plan. If not, then do what many countries do and make dental care free for children and teenagers. Denmark, Finland, and the United Kingdom are three of them. Even for adults there is usually some form of subsidisation or insurance with co-pays and no payments are required from those in poverty.
Some may argue that dentists have a responsibility to do charitable work through their private practices, donating their services, reducing fees, waiving bills, or providing a payment plan. There are one or two dentists locally who do contribute. But I think there is just cause to ask why, if physicians and people who practice in the hospital settings get paid for their care why should people providing oral health care services have to volunteer to help the poor? I think there is just cause to ask why, when even massage therapy and acupuncture treatments are covered under B.C. Medical, is oral health seen as a marginal need?
While polishing and fluoride treatments are great, the dental needs of many people go far beneath the surface.