A new report by Ontario’s Chief Medical Officer of Health, Dr. Arlene King, has highlighted some of the barriers that low income people face in receiving oral health care in our province. Dr. King found that:
- Ontario has the lowest rate of public funding for dental care in Canada.
- 71% of Ontarians visited a dentist in 2005. Among Ontarians with lower income and less education, as well as those with no insurance, only half made such a visit.
- Ontarians with lower income, less education, as well as those with no insurance and those over the age of 65, are more likely to only visit the dentist in cases of emergency.
- Among Ontarians who did not visit a dentist in the past three years, one in five cited cost as a barrier.
- Lower income Ontarians are the most likely to report mouth conditions that cause them to avoid social interactions such as conversation, laughing or smiling.
- 68% of Ontarians report having dental insurance. However, among older Ontarians and those with lower income and less education, there is a significant drop in coverage rates (36%, 40%, and 41% respectively).
These findings are troubling because poor oral health can lead to serious and ongoing chronic conditions, such as diabetes and lung disease in addition to intense oral pain, and these poor health outcomes are disproportionately felt by low income and vulnerable Ontarians. The 2007 Street Health Report found evidence of homeless people attempting to extract their own teeth because they were unable to access dental care. We have previously blogged about the importance of health equity and oral health.
Currently there are a patchwork of programs designed to increase access to oral health care for low income Ontarians and their children, including the Children in Need of Treatment program and Healthy Smiles Ontario, and some support is available to people on Ontario Works and Ontario Disability Support Program.
The report recommends that the province explore opportunities for better integration and/or alignment of low-income oral health services in Ontario, including integration and/or alignment with the rest of the health care system. We agree with this recommendation and encourage the province to conduct a Health Equity Impact Assessment to ensure that any program changes will improve the health of the most vulnerable Ontarians.