Survey Reveals Shortcomings of Public Dental Insurance

The article¹ in JCDA summarizing the highlights of the Oral Health Component of the Canadian Health Measures Survey was informative and well presented. The introduction by Dr. Peter Cooney, Chief Dental Officer for Health Canada, was also to the point: “The release of these results now means that all of us involved in dental health in Canada have a new task of reviewing the data to see what we have been doing right in dental health, areas for improvement, and how we can work together to address the issues that have been raised.”

In my view, the most serious issue raised in the article was that the population group with the worst dental health was not the uninsured poor, but rather those with public dental insurance. This goes against all reasonable expectations and is a situation that our profession and Dr. Cooney, as Canada’s Chief Dental Officer, cannot allow to continue. Among Canadians reporting mouth pain, 18% were publicly insured, the highest of any group presented, even higher than the lower income group, 50% of whom had no dental insurance. Any dentist knows that if a patient’s dental health is bad enough to actually cause pain, it is usually pretty awful. How can this occur in a population with dental insurance?

From the results reported in the article, it is clear that data must be available to compare the dental health of Canadians with private dental insurance to Canadians with public dental insurance. I hope that Dr. Cooney will meet his own challenge of working together and provide the profession, through publications such as JCDA, with the results of such comparisons. Because Dr. Cooney is probably in a better position than any other Canadian dentist to be effective, I also hope that he will pledge to do everything possible to rectify this discrepancy.

I believe that one of the issues underlying this problem is access to dental care. This is an area where effective action can be taken almost immediately. For example, to be compensated for giving dental care to patients under the Non-Insured Health Benefits program, dentists are required to sign an agreement that their own lawyers advise them not to sign. It is impossible to imagine that Dr. Cooney couldn’t persuade the party requiring this agreement to change its wording, such that a lawyer could advise a dentist to sign the agreement.

Solid information is invaluable in uncovering deficiencies, and Dr. Cooney should be congratulated not only for making these data available but also for his desire to identify areas for improvement and to work together to address the issues raised.

Dr. Jay Winburn
Brandon, Manitoba

Editor’s note: The Office of the Chief Dental Officer is not responsible for the Non-Insured Health Benefits (NIHB) program. NIHB is administered separately by Health Canada.