In 2022, the interim Canada Dental Benefit became available for children under the age of 12 whose parents and caregivers received the Canadian Child Benefit and were not covered by a private dental care program, and who had an adjusted annual family net income of less than $90,000. The benefit provided up to $1,300 over two years to help get kids the dental care they needed. With the introduction of the Canadian Dental Care Plan in December 2023, basic dentistry costs will now be covered for about nine million Canadians. For families with an annual income of less than $70,000, there will be no co-payments, meaning there will be no out-of-pocket expenses. Families whose annual income falls between $70,000 and $79,999 will pay 40 per cent of their dental bill, while those in the $80,000 to $89,999 income bracket will be paying 60 per cent of the billed cost.

Seniors aged 87 and above could start applying for the Canadian Dental Care Plan in December 2023, those aged 77 to 86 in January 2024, and those aged 72 to 76 in February. Starting in March, seniors aged 70 to 71 can start applying, followed by seniors aged 65 to 69 in May. Adults with a valid Disability Tax Credit certificate can begin applying in June 2024 as well as parents and caregivers with children under the age of 18. All remaining eligible Canadian residents can start applying in 2025. It is important to note that only those who have no dental health coverage through private insurers are eligible to apply. Historically, universal dental care has received even less discussion and consideration than pharmacare. The federal NDP had it as a part of their campaign platform in 2021, but the other major political parties continued ignoring it until it became a condition of the Confidence-and-Supply Agreement between the federal NDP and Liberal parties.

Canada ranks among the lowest in public spending for dental care of all OECD countries, second only to Spain. Public spending on dental care is only $24 per capita, compared to $337 spent on drugs, and $999 spent on physician services. Despite having higher needs, seniors are 40 per cent less likely to have private dental insurance compared to the general population. Additionally, approximately 42 per cent of low-income Canadians avoid seeing a dentist when they need to because of cost, compared to only 15 per cent of high-income Canadians.

Dental care becomes one of those expenses that individuals cut when finances become tight. Under the Canadian Dental Care Plan the following services will be covered:

• Preventive services, including scaling (cleaning), polishing, sealants, and fluoride.

• Diagnostic services, including examinations and X-rays.

• Restorative services, including fillings, crowns, and dentures.

• Endodontic services, including root canal treatments.

• Prosthodontic services, including complete and partial removable dentures.

• Periodontal services, including deep scaling.

• Oral surgery services, including extractions.

Although Canada has not previously offered a publicly funded dental care program, Saskatchewan has. A 1968 survey of Saskatchewan’s children found that they had poor oral health. On average, seven-year-olds had one-quarter of their primary teeth either decayed, restored, or extracted. This statistic, coupled with a significant shortage of dentists, led the provincially governing NDP to search for an alternative method of meeting the oral health needs of children.

The result, despite opposition from Saskatchewan dentists, was the creation of the Saskatchewan Health Dental Plan. Under the plan, dental nurses (later known as dental therapists) were trained and employed in school-based clinics to provide basic dental care for children. An article published in the Journal of Public Health Dentistry in 2016, titled “Saskatchewan’s School-based Dental Program Staffed by Dental Therapists: A Retrospective Case Study,” examined the program and determined that it was successful and popular with families during the 13 years from 1974 to 1987 that it operated. The services provided included diagnosis through radiographs and treatment planning, prevention through chairside and classroom oral hygiene instruction and the topical application of fluorides, restorations involving fillings and the application of stainless-steel crowns, oral surgery involving the extraction of primary and permanent teeth, pulpotomies, and emergency procedures.

The children’s SHDP, based in schools and staffed by dental therapists, was the first and only dental plan of its kind in North America. It demonstrated that school-based care by dental therapists:

• Improved access to dental care for children by providing care in their local schools, resulting in a 90 percent utilization rate.

• Reduced the incidence of dental caries through effective preventive procedures.

• Provided quality restorative care equivalent to what could be provided by dentists in private offices.

• Resulted in more cost-effective oral healthcare than traditional private dental office-based care.

• Provided dental care that was accepted and appreciated by parents.

The “bold and innovative” program despite its significant success and documented improvement to the oral health of children in the province, fell at the hands of a different government with different ideologies. In 1984, the Conservative government came to power in Saskatchewan, and by 1987 they had announced the program’s dismantling, and that all dental care would be transferred to the private sector.

Garry Ewart wrote in his 2010, University of Regina thesis titled, The Saskatchewan Children’s Dental Plan: is it Time for Renewal, “It seems that the majority of Saskatchewan citizens were very happy with this program, while a minority and the Progressive Conservative government was not. The minority decided what was best for the majority.” Although the NDP was re-elected in 1993, the nearly bankrupt public purse left by the Conservative government under Grant Devine, led to the decision to terminate all funding for the Children’s Dental Program and finalize the program’s demise.

The program’s success raises the question as to why leaders in public health policy have not been motivated to introduce school-based, dental therapist-staffed programs throughout Canada. Its demise raises the question of what will happen to the Canadian Dental Care Plan should the government in Ottawa change.

By Carol Baldwin, Local Journalism Initiative Reporter Wakaw Recorder

-Carol Baldwind