Dental Schools Are Committed to Increasing Access to Care

April 29, 2010

Dr. Harinder Sandhu

Dr. David Mock

Examining how dental educators can support
efforts to improve access to oral health
care for special needs and geriatric patients
was a primary topic of discussion at the
Association of Canadian Faculties of Dentistry
(ACFD) Biennial Conference, held in June 2009.
Presentations at this event, co-hosted by the
University of Toronto (UofT) faculty of dentistry
and the Schulich School of Medicine & Dentistry
of the University of Western Ontario (UWO),
made it clear that while there are some existing
programs that educate dentists, raise awareness
and provide treatment for these high-risk populations,
far more work needs to be done.

Four speakers at the ACFD conference—
Drs. Ross Anderson, Barry Waldman, Ronald
Ettinger and Michael Sigal—are featured in this
edition of JCDA. Each author addresses specific
challenges facing the profession on the issue of
access to care for persons with special needs.

Of particular significance to Canadian dentistry,
Dr. Sigal notes that among the approximately
4.4 million persons with disabilities in
Canada, dental care remains one of the most required
health services yet it is also the hardest to
find. He attributes this situation in part to a lack
of educational training and to dentists’ preference
for referring patients with disabilities to
hospital clinics for care—a significant problem
since most hospital clinics have extremely long
waiting lists, especially for cases that require
general anesthesia.

Dr. Sigal knows these challenges firsthand
through his work at Mount Sinai Hospital in
Toronto, where he helped establish a program
that provides dental treatment for persons with
disabilities and special needs. This clinic, the
largest of its kind in Canada, has seen its patient
population double in the last decade, a clear
indication that there is a need for more oral care
services for this group.

Schulich Dentistry and the UofT dental faculty
are committed to increasing the availability
and accessibility of oral health care for persons
with special needs. Both faculties intend to support
initiatives that provide these patients with
a dental home.

To find successful models to emulate, we
can look to how dentistry has worked with the
Ontario government in finding ways to provide
care for low-income families. In 2009, the
government expanded its dental program for
children in need to include youths up to age
18 while also allotting increased funds toward
prevention and treatment services for some low-income
families, delivered through its public
health units.

Provincial funding also helped UofT establish
a Pediatric Surgicentre in 2008, to provide
oral care to children requiring general anesthesia.
The centre’s one active unit was quickly
booked to capacity, and despite still having
wait times, it has relieved some of the pressure
from local hospital operating rooms. Schulich
Dentistry is hoping to establish a comparable
centre that would serve the UWO community.

We believe Canadian dental schools can rise
to the challenge of finding new ways to provide
oral health care for vulnerable populations.
A great example of dental students mobilizing
in this area is the Oral Health Total Health program—
a student-run, non-profit organization
established by UofT dental students with a mission
to increase advocacy and education efforts
in treating people with special needs. An Oral
Health, Total Health
chapter was recently established
at Schulich Dentistry and the students’
hope to expand the program to every Canadian
dental school.

Although the oral health care requirements of special needs patients are being addressed,
more work needs to be done to meet comprehensive
standards of care. We hope that all Canadian
dental schools can increase their efforts to fill
the gaps in service for high-risk populations.
The ACFD is embarking on a 5-year strategic
plan designed to increase collaboration between
the 10 dental schools in Canada, and providing
access to oral health care is one of the strategic
priorities. We invite CDA, provincial dental associations
and individual dentists to become
partners in these collaborative efforts.

Dr. Sandhu is director, Schulich Dentistry

Dr. Mock is dean, faculty of dentistry, University of Toronto