The new Liberal-NDP plan for a national dental care program could reduce the “tremendous inequalities” in Canada’s oral health, argues a University of Guelph historian.
Dr. Catherine Carstairs is a professor in the Department of History within the College of Arts who examines the history of health and medicine. Her upcoming book, The Smile Gap: A History of Oral Health and Social Inequality, is the first volume to explore the cultural and social history of Canadian oral health.
The discussion of “denticare” isn’t new, she said, noting that “when medicare was first introduced in 1966, many people hoped denticare would follow. But medicare proved to be very expensive.”
After the introduction of medicare, unions began lobbying for dental insurance and private insurance companies. By 1982, about two-thirds of collective agreements in Canada included dental benefits and about 36 per cent of Canadians had coverage.
Today, about two out of three Canadians have dental insurance, although that still leaves one in three without coverage.
The growth in private coverage lessened the demand for denticare, although several provinces did step in to provide dental services to children. The most innovative program was in Saskatchewan, where dental therapists provided dental treatment in the schools. This program was cancelled in 1987.
Current oral care system laden with inequalities
There are several reasons why a denticare program is sorely needed in Canada, said Carstairs.
“One-third of Canadians do not have dental insurance and dental care can be very expensive,” she said.
Even if people on social assistance have dental benefits, they often can’t locate a dentist who will treat them. It’s a similar situation for those with disabilities or who live in rural areas, she said.
Many children require surgery for early childhood cavities. Many immigrants see their oral health decline after arriving in Canada because of lack of access to dental care. Indigenous people have the highest rates of oral health problems.
“Oral health plays a role in cardiovascular disease, diabetes, low-birth weight babies and other conditions,” Carstairs said.
Improving access to denticare through the program may help to mitigate those risks, she said, adding “there is a growing recognition that oral health is connected to overall health and well-being.”
Carstairs is available for interviews.
Dr. Catherine Carstairs