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If the Liberal-NDP agreement to create a national dental program for low-income Canadians becomes a reality in the coming years, advocates and health care workers say it could help to prevent dental health problems from turning into life-threatening conditions – and to keep more people from using hospital emergency rooms.
Millions of families with annual incomes below $90,000 who lack dental insurance could qualify for coverage under the proposed progressive program, which is just one element of the new bipartisan plan. “supply and trust” agreement which could see the Liberals stay in power until 2025 in exchange for action on several NDP priorities.
The NDP had previously promised the program would cover a list of services, including exams, cleanings, x-rays, depositions, root canals and crowns.
“I think this will be the start of a lot of changes to make sure we now see oral health as part of our health, which it clearly is,” said Joan Rush, a disability advocate. based in Vancouver.
Statistics Canada data shows that around two-thirds of Canadians have dental insurance to cover some or all of their expenses – but that leaves one-third of the country paying out of pocket for expensive dental care and preventative care, including many seniors, people with disabilities and those experiencing homelessness.
Infections can lead to heart attacks, strokes
This is the experience of Colette Langdon. Le Barrie, Ont. resident — who uses the pronouns them/them — receives a disability pension in the province, which does not cover the full range of dental care he needs.
A root canal, for example, came with a bill for a few thousand dollars that Langdon thought was covered, but wasn’t. Their dentist ended up paying the bill, but that’s usually not the case.
“That root canal tooth? I still don’t have a crown on it,” Langdon said. “Because I can’t pay for it.”
Advocates and medical experts agree that prevention is the best approach for the health of Canadians and to avoid overburdening the medical system.
“Bacteria that infect the gums can travel throughout the body and cause heart attacks and strokes, for example,” said Jo Connelly, executive director of Toronto’s Inner City Family Health Team, who spent more than four decades working with marginalized populations.
“When you think about the cost of healthcare for people who have had a stroke at an early age, you can imagine that that alone can have all kinds of ripple effects on the healthcare system,” he said. she stated.
“All this, just because of a tooth infection”
Ottawa resident Shane Mckenzie knows all too well how a simple dental problem can become serious, requiring life-saving medical attention and a long hospital stay.
In the spring of 2016, while working in construction in northern Ontario, the 31-year-old began feeling pain in one of his molars. Although he had dental coverage, Mckenzie was not near a dentist at the time, so he waited to return to Ottawa a month later to have his tooth pulled.
“But I guess it was too late,” he recalls, “because it was infected and entered my bloodstream.”
Mckenzie developed a fever and other flu-like symptoms. In July 2016, while staying with his mother, he collapsed in the bathroom and his mother called 911, beginning what would become a years-long medical ordeal.
When Mckenzie arrived at a local hospital he was put into an induced coma and woke up about a week and a half later.
That’s when he learned the sad reality: he was suffering from sepsis, an often fatal disease that occurs when an unusual and overwhelming bodily reaction to an infection begins to damage a person’s own tissues. .
Mckenzie’s feet turned black, and half of her arms too. He ended up in an intensive care unit for a month, had to undergo dialysis to get his kidneys working, and had to undergo several surgeries to remove his damaged appendages. He then spent an entire year in his early 30s in a long-term care home that typically cares for the elderly and veterans.
“And it was all because of an infection in the tooth, and I didn’t get it out fast enough,” he said.
Speaking to CBC News from his home, Mckenzie explained that he no longer has fingers on his left hand and is now missing a large part of his right. He also needed a below the knee amputation on his right leg and is missing the toes on his left.
“When I woke up from a coma they said if you were older you might not have survived,” he recalls.
“So for older people, not having dental care is really scary to think about.”
The program could cost $1.5 billion a year
The price of the Liberal-NDP dental plan may be revealed in the federal budget due in early April, but previous NDP proposals have already been vetted and costed.
An analysis by the Parliamentary Budget Officer in 2020 estimated the cost of a similar program at $1.3 billion in the year after the plan was announced, and $4.3 billion in the plan’s first year of operation. The program would then cost about $1.5 billion a year until 2025.
Advocates point out that these investments would take some of the financial burden off emergency room teams — who often can’t even fix dental problems.
In Canada, it is estimated that one percent of all emergency department visits in any given year are made by patients with non-emergency dental conditions, such as toothaches or dental cavities.
An analysis in British Columbia of dental emergency visits published in the Canadian Journal of Public Health in 2017 suggested that a figure of 1% translates to nearly $155 million paid by taxpayers in that province alone.
“But the vast majority of these dental visits are canceled while the oral problem likely persists, so taxpayer dollars are wasted,” dentists Dr. Mario Brondani and Dr. Syed H. Ahmad wrote.
Toronto-area emergency physician Dr. Gabrie Stephen echoed the view that medical teams in hospitals are generally not equipped to deal with many cases of dental pain, even though these problems often worsen. and cause people to ask for help or fall. seriously ill, which can lead to longer and more expensive hospital stays.
In Ontario, the total cost of an average hospital stay for sepsis in adults aged 18-59 – similar to what Mckenzie experienced – can range from around $12,000 to over $25,000, according to figures provided to CBC News by the Canadian Institute for Health Information.
At the emergency room level, when patients present with initial tooth pain, “all I can really do in those situations is prescribe people antibiotics or painkillers,” Stephen said.
The “best” approach is to improve provincial programs: dental association
In a statement, the Canadian Dental Association (CDA) questioned whether the Liberal-NDP approach was the best way to improve access to dental care. CDA stressed that it will be “important to ensure that any new initiatives do not disrupt access to dental care for the vast majority of Canadians who already have dental coverage through health insurance plans.” provided by the employer.
“The best way to rapidly improve oral health and increase access to dental care is to invest in and improve existing provincial and territorial dental programs,” the CDA statement continued.
“These programs are significantly underfunded and are almost exclusively funded by provincial and territorial governments.”
There is indeed a disparate approach across the country, and not all procedures are covered equally between provinces.
Comprehensive coverage for preventative care in particular would help, according to Langdon, the Barrie resident, because avoiding the dentist can lead to other health complications.
“It would actually be a big savings in my mind for our health care system to have comprehensive dental care, to have comprehensive preventative care,” they said.