Gov­ern­ments should put the money where our mouths are

The Labradorian - - Editorial - Rus­sell Wanger­sky Rus­sell Wanger­sky Rus­sell Wanger­sky’s col­umn ap­pears in 36 Saltwire news­pa­pers and web­sites in At­lantic Canada. He can be reached at rus­sell.wanger­sky@thetele­gram.com — Twit­ter: @wanger­sky.

Sorry, den­tists — I never wel­come a visit to you.

I’m prickly about sit­ting in the den­tist’s chair — in fact, I hate it — but I go, half out of a sense of re­spon­si­bil­ity for den­tal ap­point­ments al­ready made, and half be­cause I’m afraid of what might hap­pen if I didn’t. Con­stant, over­rid­ing mouth pain is a great fear of mine: ac­tu­ally get­ting to the den­tist is the un­for­tu­nate trade-off that keeps that fear at bay.

Choos­ing to go to the den­tist is not a de­ci­sion ev­ery­one in this coun­try can make. In fact, the more you need the den­tist, the more likely you are not to get to see one.

A re­view of the avail­abil­ity of den­tal ser­vices in this coun­try in 2015 made a stark point about who, in sur­vey af­ter sur­vey, gets left be­hind: “These sur­veys have iden­ti­fied that most of the oral dis­ease con­tin­ues to be con­cen­trated among dis­ad­van­taged groups, with those hav­ing the high­est need of­ten re­ceiv­ing the least care.”

Here it is, cour­tesy of the Septem­ber 2014 Cana­dian Academy of Health Sciences re­port “Im­prov­ing Ac­cess to Den­tal Care for Vul­ner­a­ble Peo­ple Liv­ing in Canada.” The re­port says that “there are sig­nif­i­cant in­come-re­lated in­equal­i­ties in oral health and in­equity in ac­cess to oral health care (and that) those with the high­est lev­els of oral health prob­lems are also those with the great­est dif­fi­culty ac­cess­ing oral health care.”

That’s why I read with in­ter­est about the Gath­er­ing Place and their plan to open a twochair den­tist’s of­fice above the or­ga­ni­za­tion’s St. John’s, N.L., soup kitchen by the end of Oc­to­ber. “We’ll be able to pro­vide oral care, com­plete den­tal ser­vices to the most marginal­ized in­di­vid­u­als in so­ci­ety,” Gath­er­ing Place ex­ec­u­tive di­rec­tor Joanne Thomp­son told CBC NL. “The point of of­fer­ing ser­vices in this site is this is their safe place.”

I can’t agree more; in fact, I think I think it’s an idea that’s over­due right across the re­gion.

The only thing I don’t un­der­stand is why ba­sic den­tistry hasn’t found its way un­der the pub­lic health-care um­brella.

The fact is that it is ba­sic health care: if you’re suf­fer­ing from the pain of con­stant den­tal in­fec­tions, it’s not only dam­ag­ing your abil­ity to sleep, eat and live a nor­mal life. It’s po­ten­tially threat­en­ing your life: low-grade in­fec­tions in other parts of your body can dam­age ev­ery­thing from heart valves on down.

Provin­cial gov­ern­ments in the At­lantic prov­inces ap­proach den­tal care in dif­fer­ent ways, but they pri­mar­ily fo­cus on den­tal care for the very young — cap­ping provin­cial care at ages rang­ing be­tween 12 and 17 — some co­horts of the el­derly, and some parts of the so­cial as­sis­tance spec­trum.

But that leaves out vast ranges of mod­er­ate- to low­in­come in­di­vid­u­als who don’t have health plans, don’t have den­tal plans that are broad enough to fully en­com­pass needed den­tal work, and can’t af­ford the high cost of any­thing more than the low­est range of ser­vices.

Like so many things, though, we’re rob­bing Peter to pay Paul: even­tu­ally, den­tal sit­u­a­tions get bad enough that they be­come full-fledged health con­cerns, or they cause prob­lems in other parts of the body that do have paid health care.

I don’t un­der­stand why my hands, heart and lungs are el­i­gi­ble for universal health care, but, for many things, my mouth does not.

I count my­self among the lucky ones: able to have den­tal care through a plan that’s part of my em­ploy­ment ben­e­fits.

It doesn’t make me like the ser­vice any bet­ter.

The only thing that scares me more than my reg­u­lar trip to the den­tist is the idea of what could hap­pen if I stood them up.

Choos­ing to go to the den­tist is not a de­ci­sion ev­ery­one in this coun­try can make. In fact, the more you need the den­tist, the more likely you are not to get to see one.

Choos­ing to go to the den­tist is not a de­ci­sion ev­ery­one in this coun­try can make.

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