The goal of the new federal dental care program is to help those who cannot afford to pay out-of-pocket for much needed services. But a narrow focus on dental treatments will not be enough. Oral health is crucial to the general health and well-being of people of all ages. That’s why oral health promotion and disease prevention need to be an essential part of public programs.
To be effective the new program must offer a reasonable array of preventive services and interventions. It must also recognize all regulated oral health professionals as eligible service providers, including dental hygienists, who are the sixth-largest group of regulated health care providers in this country. These two important criteria have been overlooked in the current patchwork of provincial and territorial programs.
In advocacy conversations with elected officials and policy staff, representatives from the Canadian Dental Hygienists Association (CDHA) have noted a lack of understanding about the importance of preventive dental hygiene services and treatments. Dental hygienists routinely offer expectant parents, youth, adults, seniors and care-givers individualized guidance on at-home oral health practices as well as lifestyle changes that support oral health and wellness.
Studies have shown that poor oral health is associated with serious systemic health conditions. These include diabetes, respiratory diseases and cardiovascular diseases, as well as adverse pregnancy outcomes. Dental hygienists advise their clients on the risks associated with smoking, alcohol and substance use and sugar consumption, all of which can contribute to the incidence of tooth decay, periodontal diseases (gingivitis and periodontitis) and many systemic diseases.
Dental hygienists also provide comprehensive and systematic assessments of the head, neck and soft tissues of the mouth. These thorough examinations are particularly important as they can lead to early detection of cancer and prompt referral to other health professionals.
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Trends in Canadian cancer statistics suggest that in 2022 there will be approximately 7,500 new cases of head and neck cancer, a category that includes oral cavity cancer. Given that many Canadians lack a dedicated family physician, a qualified oral health professional may ultimately be the first to detect cancer early and refer the client accordingly.
Finally, preventive dental hygiene services address the most prevalent chronic oral disease in children and adults. Cost-effective and minimally invasive clinical interventions that prevent tooth decay include the application of fluorides, dental sealants and temporary fillings.
Dental hygienists have developed innovative ways to deliver services in mobile clinics, and in places like schools, public health agencies, community centres, long-term care homes and private homes. They also travel to rural and remote communities to provide care.
We frequently hear from dental hygienists, particularly those who work independently of a dentist (permitted in most Canadian jurisdictions), that without their care, many families would be forced to seek urgent treatment in hospital, or worse yet, not seek treatment at all.
Oral health promotion, disease prevention and early treatment of diseases make sense. There have been consistent and growing calls from the health sector overall for a greater orientation towards prevention. This is why dental hygienists should be part of the federal dental care program.
Though passing of the proposed legislation for the first stage of the government’s plan is pending, more details about the administration and delivery of the long-term program are still under development.
With full implementation of the federal program set for 2025, dental hygienists will continue to advocate not only for prevention and increased access to oral care within this and other publicly funded dental care programs. They play an important role in improving people’s lives in Canada.