Oral health and health care occupy an unfortunately unique place in Canada’s health care landscape. Research has shown that there are associations between gum disease and conditions such as diabetes, aspiration pneumonia and cardiovascular disease. Yet, the mouth does not get the attention it deserves in terms of both educating health care providers and by not being included in Canada’s national health insurance program. Of the limited investments made by governments in oral health care, most are targeted towards low-income children and those on social assistance. Accessing oral health care can therefore be difficult, as it often depends on whether an individual has employment-based insurance or can afford to pay out-of-pocket.
According to the Canadian Institute for Health Information, in 2012, we spent over $11.7 billion on oral health care as a nation, of which almost $5 billion was from households (out-of-pocket payments) (https://www.cihi.ca/en/nhex_2014_report_en.pdf). Additionally, the Canadian Academy of Health Sciences reported that 46 per cent of adults who reported not having employment-based insurance avoided visiting an oral health care professional due to cost (http://cahs-acss.ca/wp-content/uploads/2015/07/Access_to_Oral_Care_FINAL_REPORT_EN.pdf). These trends are expected to continue, and the difficulties for those without insurance or expendable income will increase, leading them to avoid and decline recommended oral health care due to cost.
What does the picture look like for seniors? The Canadian Health Measures Survey showed that only 22 per cent of Canadians aged 60-79 do not have any of their natural teeth remaining. This reflects the success of prevention, an increased awareness of the importance of oral health, and an overall decline in tooth decay within the Canadian population (http://www.fptdwg.ca/index_htm_files/CHMS-E-summ.pdf). However, at a time when seniors are retaining more of their natural teeth, they are also less likely to be able to access oral health care due to cost, as they no longer have access to employment-based insurance or have the same level of expendable income, due to retirement.
While it is impossible to predict a person’s future oral health care costs, it may be worth having a discussion with your oral health care provider about what you might expect in the next 5, 10 or even 15 years. Understanding how you can help prevent oral disease, how your general health influences your oral health and vice versa, and the possible treatment options you will have to consider will help you make informed decisions regarding your oral and general health.
- Oral health care is not included in Canada’s national health insurance program; treatments are predominantly paid for through employment-based insurance and out-of-pocket payments.
- More people are retaining their natural teeth for longer and, as such, may need to access oral health care services more frequently as they age.
- Consider discussing long-term plans for your oral health with your provider today.
Alyssa Hayes BDent, MSc, FRCD(C)
Assistant Professor, Dental Public Health, University of Saskatchewan College of Dentistry, Canadian Association of Public Health Dentitsry (CAPHD) Past-President