“Dental cost reform may pave way for more dental access,” Dr Mark Walker

A country-wide dental cost reform may be on its way if Quebecers get their way. In early April, the Quebec-based Journal de Montreal released a report finding dental fees in La Belle province were the most expensive in the country and noting that costs related to dental care rose 13 per cent over the last five years.

The price for Quebec’s citizens to see a dentist are said to be at least 10 percent higher than elsewhere in Canada. As a result of the exorbitant dental costs, as many as 2 million Quebecers can’t afford to visit the dentist regularly, leaving the province with the dubious designation of having the worst teeth in the country.

The paper also polled 50 dental clinics in the province, finding the cost for a simple cleaning was as high as $195 in Montreal, which is higher than the Quebec Association of Dental Surgeons’ recommended price point.

The new findings come on the heels of last month’s report that found 42 percent of Quebec children start kindergarten with at least one cavity, a number that is alarming to the province’s Order of Dental Hygienists. Diane Duval, the head of the order, told CJAD that “it’s not normal,” and, “a big clean-up of the industry is needed.”

Quebec isn’t the only province in need of dental reform. Last year, Albertans were calling for an overhaul as well, after it was reported that dental fees in that province climbed by almost 60 percent over the last decade.

“We have seen a 56 percent increase overall,” says Joan Weir of the Canadian Life and Health Insurance Association. “That is on the median fee, there will be some higher and some lower.”

The rate for a dental visit in Alberta increased roughly 5.6 percent annually, which is more than twice the increase seen in B.C. (2.6 percent) and Ontario (2.4 percent).

While Ontario isn’t facing the same rampant pricing issues, dental access for low-income Ontarians has proven to be the province’s primary dental health issue. Earlier this year, the country’s most populous province integrated six oral-health benefits for check-ups, cleanings, fillings, X-rays, scaling and urgent dental care into a single program called Healthy Smiles Ontario (HSO). The program is aimed at providing children 18 and under in low-income families with publicly-funded dental care.

While many hail the initiative as a key step to fighting dental health issues for children and young adults, others want the program expanded.

“What we need is to extend (HSO) to also provide dental care for institutionalized seniors, low-income adults and seniors and anyone who is the working poor or the retired poor,” said Heather Murray, oral-health program manager for the Simcoe Muskoka District Health Unit. “It would be consistent with the goal of the poverty-reduction strategy.”

As any oral health professional will tell you, preventative treatments are less costly than more serious dental procedures that are often a result of lack of access to dental care.

Dutton, Ontario dentist Mark Walker believes enhanced access will help reduce health care costs over the long-term. “Every year, hundreds of thousands of people visit emergency rooms across the country for easily preventable dental issues,” notes Dr Mark Walker. “If we were able to provide more access to basic dental care, that number would drop drastically,”

Dr Mark Walker also pointed out that better funding tools need to be implemented, especially in Ontario to aid dentists in providing basic care. The current program model allows for 30 percent remuneration rate, while overhead costs account for closer to 60 percent, meaning dentists often lose money treating low-income patients.

This results in patients being unable to find a dentist who will treat them, creating undue stigma and embarrassment.

“When someone on a dental program for the poor goes to the emergency room at a hospital they are treated in Canada just like the Bay Street executive,” said Dr Mark Walker. “This should be the same at the dental office.”

Experts have been calling for the addition of dental care into Canada’s universal healthcare for decades now. In 2014, a report was released that found as many as 6 million Canadians could not afford to visit a dentist regularly.