WATERLOO REGION — Dental visits are too expensive for more than 100,000 Waterloo Region residents, leaving them with no choice but to postpone care until there is a crisis.
At that point, the problem is much worse and still often the only choice is to go to a doctor or an emergency service for care that is not ideal but covered.
“It’s much, much more expensive,” said researcher Steve Ayer. “And the results are worse.”
Ayer authored a recent report on oral health in the region for the Kitchener Waterloo Community Foundation, highlighting the significant difficulty and impact on low-income and marginalized residents who cannot access or afford essential dental care. .
When people have limited income but no dental insurance, basic needs like food and shelter take priority over a dental appointment. About 138,000 people in the region do not have dental insurance, 54,000 only visit a dentist for emergency care and 46,000 suffer from persistent pain in their mouths.
“Oral health often falls on the table,” said the foundation’s vice president, Lynne Short. “And that has long-term implications for residents’ quality of life.”
OHIP doesn’t cover the cost of dental care, and the patchwork of plans for low-income residents leaves most adults between the ages of 18 and 65 without coverage, including many who work but don’t receive benefits while living. The economy is shifting from full-time jobs to more temporary gigs.
“Dental care is unaffordable or inaccessible,” said Doug Rankin, a community health worker at Kitchener’s Downtown Community Health Center.
Rankin is part of the Ontario Oral Health Alliance, which is calling on all parties to close gaps in dental care to ensure equitable access for all ahead of the June 2 provincial election.
Ontario lags behind other provinces in government support for dental care, spending just $6 per person compared to a provincial average of $25 in Canada.
One in three Ontario residents do not have dental insurance and one in five cannot afford dental care. Each year, about 3 million people do not go to a dental practice because they cannot afford it.
“The need is huge,” Rankin said.
Every day, Rankin sees people downtown who can’t get dental care. Even those covered by provincial welfare or disability programs may have difficulty finding a dentist, in part because that coverage pays less than the market rate.
And the cost of dental care continues to rise. Over the past two decades, the cost has risen twice as fast as the rate of inflation – faster than other goods and services except tobacco.
Those most likely to have poor oral health and lack insurance are racialized people, newcomers, seniors, low-income and part-time workers, people with disabilities food insecure and struggling to find affordable housing, reports the alliance.
“What we’re hoping for is a more comprehensive program that covers everyone in Ontario,” Rankin said.
It should include both routine care and addressing any urgent oral health issues, he said. “It’s very important for healthy teeth and gums.”
There are efforts to fix the problem, but critics say it’s insufficient. The federal government’s April budget promises $5.3 billion over five years for a national dental program for low-income Canadians, and the Ontario NDP election platform promises free or low-cost dental care. cost to all low- and middle-income families.
The province launched a new plan at the end of 2019 that provides free routine dental care to seniors who cannot afford it. But the local program, with sites in Cambridge and Kitchener, is struggling to keep up with demand. Any new federal plan would also be overwhelmed with demand when launched.
Good oral health is essential to overall good health. Chronic diseases such as diabetes and heart disease are made worse by poor dental health, which can also seriously affect quality of life.
Beyond the discomfort of tooth pain, people who lose teeth may have difficulty eating, concentrating, and becoming depressed. The most marginalized – people who are homeless or in precarious housing – will also struggle to find work due to the stigma around missing teeth.
“They’re permanently stuck in this cycle,” Ayer said.
About 25,000 residents say they are unhappy with the appearance of their teeth or dentures – a likely low number as it would only take into account those in the general population and not marginalized residents.
“It’s definitely a problem for a lot more people than you might think,” Ayer said.
As the price of everything continues to climb, more people will struggle to make ends meet and dental care will become unaffordable for those without coverage, advocates warn. People can also suddenly find themselves out of work and without dental care.
Dental problems that go untreated can get worse when people have no way of paying for a dentist. Then the only way to find relief is to see a doctor or an emergency department. typically, the victim leaves with only painkillers and antibiotics.
“And they’re not solving the problem,” Rankin said.
Even such half-measures result in a heavy bill paid by the public coffers. Visits to the doctor or hospital for dental problems cost at least $38 million a year in avoidable health care costs. And that does not include worsening health problems caused by poor oral health which will also need to be addressed.
“Part of that is the long-term cost to the system,” Short said.