The Canadian Dental Care Plan: Bridging Gaps or Upholding Them?

AI generated Canada map with tooths and bridge in color

Written by

Jasmine Babra (MHSc in Health Equity and Sustainability)

 

 

Introduction

It is no secret that Canada is admired for its public healthcare system (Saif Goubran et al., 2024), where inclusivity and equity are reflected in the universal coverage of essential healthcare services. However, one striking gap remains: access to dental care.

Oral healthcare needs have seemingly fallen through the cracks in the country (Saif Goubran et al., 2024). As many have noted, access to basic dental care has become unaffordable for many Canadians (Schroth et al., 2024). The prevalence of unmet needs in this area, as evident in rates of untreated dental caries and dental pain, significantly exceeds that of general health indicators for the Canadian population (Allison, 2023). These dental care inequities disproportionately affect underserved and historically disadvantaged populations, with higher rates of caries and poor oral health predominantly affecting low-income households, Indigenous communities, newcomer populations and residents of rural and remote areas (Saif Goubran et al., 2024). For instance, low-income and uninsured families are three to four times more likely to not obtain dental care than their counterparts (Saif Goubran et al., 2024). As well, Indigenous communities are found to face higher rates of poverty and food insecurity, reducing their ability to access dental care more than their non-Indigenous counterparts (Kyoon-Achan et al., 2021). Thus, there is an urgent need for the delivery of an equitable solution.

Unmet dental healthcare needs in Canada have led to the introduction of the Canadian Dental Care Plan (CDCP), a policy aimed at expanding access to dental care for vulnerable populations (Schroth et al., 2024). While it is a remarkable initiative, clear barriers remain that hinder the successful implementation of this plan (Allison, 2023). This arises from the plan’s lack of accountability towards factors including geographical disparities, limited public awareness and income-based inequalities.

 

Canadian Dental Care Plan

Before discussing these barriers, it is essential to outline the plan's scope briefly. This plan is designed for Canadian residents who lack dental insurance and face significant challenges accessing dental care (Saif Goubran et al., 2024). The benefits of the plan are provided to families whose adjusted net income is <$90,000 per year and to those who have filed a tax return with the Canada Revenue Agency (Saif Goubran et al., 2024). In 2022, the plan was implemented for children under 12 whose families had met the requirements (Schroth et al., 2024). By the end of 2023, coverage was expanded to include children up to 18 years of age, seniors, and individuals with special needs (Schroth et al., 2024). In 2025, larger expansions are anticipated (Schroth et al., 2024), underscoring the equity-based coverage this plan aims to achieve.

 

Geography

Canada’s diverse geography poses a predominant challenge to the CDCP’s goals of levelling inequities in access to oral healthcare. Those residing in rural and remote areas face unique challenges due to transportation barriers, including reduced proximity and availability of dental clinics (Allison, 2023). The CDCP does not address geographic barriers to care access (Allison, 2023). 

This concern is primarily felt in Northern Canada, where lower participation in the CDCP has already been observed among residents of the territories (Saif Goubran et al., 2024). A contributing factor to such low rates is a specific requirement of the CDCP, which requires individuals to note the dental practice they intend to attend for their future scheduled appointments (Saif Goubran et al., 2024). Given the documented shortage of healthcare providers in many remote communities, this is an extremely challenging situation (Saif Goubran et al., 2024). Researchers have noted that this requirement discourages individuals from applying for the CDCP, as they do not have a provider to note in their application (Saif Goubran et al., 2024).

 

Lack of Public Awareness and Oral Health Literacy 

The CDCP also faces significant barriers through concerns of the lack of public awareness and low oral health literacy amongst economically disadvantaged and racialized populations (Schroth et al., 2024). This manifests itself in that many Canadians who are eligible for the plan are unaware of its implementation. In contrast, others face difficulty in understanding the application process and the plan’s overall benefits (Schroth et al., 2024). 

A significant correlation to this lack of awareness, resides in the low oral health literacy of underserved communities (Schroth et al., 2024). Often, underserved communities lack access to oral hygiene programs, resulting in decreased overall oral health awareness (Saif Goubran et al., 2024). This has caused many underserved communities to refrain in seeing the value in accessing dental care, resulting in their low engagement with the CDCP (Saif Goubran et al., 2024). This is, therefore, an essential barrier for the CDCP to address. One that can be addressed with multi-sectoral collaboration, where policymakers, oral health care professionals and community members come together and devise the implementation of inclusive and educational oral health programs (Schroth et al., 2024). Through doing so, remarkable changes can be fostered in terms of awareness and accessibility.

 

Income Related Disparities

While the CDCP focuses primarily on income, it neglects to consider certain income-related disparities. This can be exemplified by the plan’s condition to have qualifications through the Canada Revenue Agency (CRA) (Allison, 2023). As the plan targets marginalized populations, this condition immediately presents a barrier for low-income groups, who often refrain from submitting documentation to the CRA for a variety of reasons (Allison, 2023). This then perpetuates a lack of access for key target populations of the plan, discouraging the plan’s goal of improving coverage (Allison, 2023).

Another income-related disparity not considered by the plan resides in its eligibility criteria. The CDCP only considers those who lack dental insurance and excludes those from low-income populations who have employment-based or private insurance plans (Schroth et al., 2024). While the prevalence of a pre-existing insurance plan may not raise concern, certain plans are not as robust as others in the aid they provide (Schroth et al., 2024). Critics have noted that many individuals are left underinsured and cannot access dental care with the limited coverage they have (Schroth et al., 2024).

 

Conclusion

Oral health care is vital towards the development of one’s quality of life (Gondro et al., 2024). It is a form of care that is directly related to one’s psychological, social and physical wellbeing (Mehra et al., 2019). Without optimal maintenance, poor oral health can result in adverse health outcomes, where the risk of chronic disease development become largely apparent (Mehra et al., 2019). Hence, it is of the utmost importance to access oral health care services. This highlights the urgent need to rectify prevalent inequities involved with oral health care accessibility.

Accordingly, the CDCP represents a much-needed advancement towards the reduction of these inequities (Allison, 2023). However, there remains considerable areas for improvement towards the gaps in accessibility in need of remediation (Allison, 2023). With strong advocacy and collaboration amongst the Canadian government and oral health professionals, positive changes can be developed (Schroth et al., 2024). This will allow Canada to achieve its goal of equity-oriented, accessible and holistic care for all.

 

 

 

 

 

 

References

Allison, P. (2023). Les inégalités en santé buccodentaire et en soins dentaires au Canada et le Régime canadien de soins dentaires. Canadian Journal of Public Health, 114(4), 530–533. https://doi.org/10.17269/s41997-023-00800-6

Gondro, J. V., Murphy, K., Clark, J., & Fortin, Y. (2024). Factors associated with the use of oral health care services among seniors in Canada. PubMed, 35(6), 16–28. https://doi.org/10.25318/82-003-x202400600002-eng

Mehra, V. M., Costanian, C., Khanna, S., & Tamim, H. (2019). Dental care use by immigrant Canadians in Ontario: a cross-sectional analysis of the 2014 Canadian Community Health Survey (CCHS). BMC Oral Health, 19(1). https://doi.org/10.1186/s12903-019-0773-x

Kyoon-Achan, G., Schroth, R. J., DeMaré, D., Sturym, M., Edwards, J. M., Sanguins, J., Campbell, R., Chartrand, F., Bertone, M., & Moffatt, M. E. K. (2021). First Nations and Metis peoples’ access and equity challenges with early childhood oral health: a qualitative study. International Journal for Equity in Health, 20(1). https://doi.org/10.1186/s12939-021-01476-5

Saif Goubran, Cruz, Menon, A., Olatosi, O. O., & Schroth, R. J. (2024). Uptake of the Interim Canada Dental Benefit: an investigation of data from the first 18 months of the program. Frontiers in Oral Health, 5. https://doi.org/10.3389/froh.2024.1481423

Schroth, R. J., Cruz, Menon, A., Olatosi, O. O., Victor, Yerex, K., Khalida Hai-Santiago, & DeMaré, D. (2024). An investigation of data from the first year of the interim Canada Dental Benefit for children <12 years of age. Frontiers in Oral Health, 4. https://doi.org/10.3389/froh.2023.1328491

 

Image credit: GPT AI generated