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Russell Wangersky: Governments should put the money where our mouths are

Dental instruments
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Sorry, dentists — I never welcome a visit to you.

I’m prickly about sitting in the dentist’s chair — in fact, I hate it — but I go, half out of a sense of responsibility for dental appointments already made, and half because I’m afraid of what might happen if I didn’t. Constant, overriding mouth pain is a great fear of mine: actually getting to the dentist is the unfortunate trade-off that keeps that fear at bay.

Choosing to go to the dentist is not a decision everyone in this country can make. In fact, the more you need the dentist, the more likely you are not to get to see one.

A review of the availability of dental services in this country in 2015 made a stark point about who, in survey after survey, gets left behind: “These surveys have identified that most of the oral disease continues to be concentrated among disadvantaged groups, with those having the highest need often receiving the least care.”

Here it is, courtesy of the September 2014 Canadian Academy of Health Sciences report “Improving Access to Dental Care for Vulnerable People Living in Canada.” The report says that “there are significant income-related inequalities in oral health and inequity in access to oral health care (and that) those with the highest levels of oral health problems are also those with the greatest difficulty accessing oral health care.”

That’s why I read with interest about the Gathering Place and their plan to open a two-chair dentist’s office above the organization’s St. John’s, N.L., soup kitchen by the end of October. 

“We’ll be able to provide oral care, complete dental services to the most marginalized individuals in society,” Gathering Place executive director Joanne Thompson told CBC NL. “The point of offering services in this site is this is their safe place.”

I can’t agree more; in fact, I think I think it’s an idea that’s overdue right across the region.

The only thing I don’t understand is why basic dentistry hasn’t found its way under the public health-care umbrella.

The fact is that it is basic health care: if you’re suffering from the pain of constant dental infections, it’s not only damaging your ability to sleep, eat and live a normal life. It’s potentially threatening your life: low-grade infections in other parts of your body can damage everything from heart valves on down.

Provincial governments in the Atlantic provinces approach dental care in different ways, but they primarily focus on dental care for the very young — capping provincial care at ages ranging between 12 and 17 — some cohorts of the elderly, and some parts of the social assistance spectrum.

But that leaves out vast ranges of moderate- to low-income individuals who don’t have health plans, don’t have dental plans that are broad enough to fully encompass needed dental work, and can’t afford the high cost of anything more than the lowest range of services.

Like so many things, though, we’re robbing Peter to pay Paul: eventually, dental situations get bad enough that they become full-fledged health concerns, or they cause problems in other parts of the body that do have paid health care.

I don’t understand why my hands, heart and lungs are eligible for universal health care, but, for many things, my mouth does not.

I count myself among the lucky ones: able to have dental care through a plan that’s part of my employment benefits.

It doesn’t make me like the service any better.

The only thing that scares me more than my regular trip to the dentist is the idea of what could happen if I stood them up.

Russell Wangersky’s column appears in 36 SaltWire newspapers and websites in Atlantic Canada. He can be reached at [email protected] — Twitter: @wangersky.

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