Oral Health for a Lifetime


Dr. Ronald G. Smith

Access to care has been a prominent issue in dentistry throughout my career. Although the vast majority of Canadians enjoy access to high-quality oral health care, some groups in our society are unable to see a dentist on a regular basis, including seniors, low-income populations, people with special needs, children and Aboriginal peoples. I believe the time has come for dentistry to make a concerted effort to ensure that these groups receive proper oral care.

CDA has pledged to make improved access to care the primary goal of its advocacy efforts. In particular, we will focus on helping children in need and seniors, especially the frail elderly living in long-term care (LTC) facilities. The CDA Board recognized the need to focus on these groups and tasked the Committee on Clinical and Scientific Affairs (CCSA) to review and analyze the situation across Canada. The CCSA produced 2 detailed reports that compile information on existing programs in the provinces and also identify service gaps.

The CCSA report on seniors' oral care documents the challenges that many dentists experience firsthand. As anyone with a relative living in LTC knows, the myriad of physical and mental health problems affecting seniors can make even daily living a challenge. If you visit the dining room at these facilities, you can see how the food choices of some residents are severely limited by their inability to chew properly. The lack of a nutritional diet can have a significant impact on the continued health and well-being of these individuals.

I find it disheartening that some new LTC facilities are designed with services such as a hair salons, but with no accommodations for dental care. To help remedy the situation, CDA is calling for the creation of national and provincial standards to ensure minimum daily oral health care in LTC facilities and annual access to professional care. The goal is for all incoming residents to undergo oral health screening as part of the routine collection of health information at these institutions. This would give the staff a baseline measure of oral health and also identify residents who may be experiencing a dental problem.

Moving to the other end of the life spectrum, the profession is also focusing on access to care for children. Overall, dentistry has made great progress over the last few decades, as evidenced by the results of the recent Canadian Health Measures Survey, which showed that the percentage of children between ages 6 to 11 with 1 or more decayed, missing or filled permanent teeth has dropped to less than 25% compared to almost 75% in 1972. However, there are still young children in segments of our society who are experiencing rampant caries at an early age.

Educating parents on proper oral health habits and promoting better nutrition and diet will go a long way to improve our children's oral health. The profession has also increased its efforts to encourage all parents to bring their infant children for a dental visit in the first year. Along these lines, JCDA.ca has posted an audiovisual presentation from Dr. Felicity Hardwick that guides dentists through the steps of a successful first visit for young children.

Oral health care should be a priority for a lifetime. CDA will continue to increase awareness on access to care and look for incremental and practical solutions to this issue. To reinforce our advocacy message, we visited Parliament Hill in November to meet with federal politicians and policy-makers. I also encourage you to take a moment to read the position statements on access to care and residents in LTC facilities adopted by CDA in 2010.

If the profession can show progress in improving access to oral care for children in need and seniors living in LTC facilities, we can transfer these solutions to other groups who also require our attention. We need to come together to articulate the oral health needs of those who often cannot speak for themselves.

Ronald G. Smith, DDS