Throughout Canada the majority of dental services are not covered by federal or provincial government, and are instead covered by private healthcare and/or out of pocket costs. Only 6% of dental services in Canada are funded by provincial/federal organizations (Health Canada 2010). In 2009, the Canadian Institute for Health Information (CIHI) estimated that Canadians would spend out of pocket $12.8 billion on dental care, of that $361.62 per capita (Health Canada, 2010). There are some federally financed programs available to military personal, recognized indigenous status, those receiving social assistance, some seniors, developmental disabilities, veterans, those in federal prisons, and refugees (Canadian Dental association, N.D). As well as provinces each have specific programs covering different sectors of their population. For example, the provincial government in Nova Scotia covers children for routine dental care until the age of 14. This includes routine yearly dental exams, X-rays, cleanings/oral hygiene instruction, fluoride, fillings/extractions and sealants are covered. However this program is considered to be a ‘last resort’ program and any private dental plan coverage must be used first, and then MSI will pick up any remaining balance. (Nova Scotia, 2020) Different provinces/territories have differing provincial coverage, which can be found on the Canadian Association for Public Health Dentistry.
Dental related health care (as well as other healthcare/services) in Canada is divided into 3 levels. This includes the federal government, provincial/territorial government, and municipal. The federal government is mainly responsible for legislation and guidelines related to things such as recommendations for water fluoridation, and drug approval. Provincial/Territorial level is responsible for the delivery of public and personal health services, which in the case of dental care - is mainly funded by private dental insurance plans. The Municipal level is responsible for application of programs, such as water fluoridation, and dental care to underserved areas. (Health Canada, 2010)
My personal thoughts & rant for the day (and everyday). I strongly believe that preventative dental care should be covered across Canada by MSI for all age groups. By that i do not mean everyone should be able to walk into a prosthodontists office and get a full set of crowns, implants or veneers. I believe that preventative (mainly hygiene) and diagnostic services should be covered. This could include services such as scaling, root planing, fluoride application, oral hygiene instruction, dental examinations, and x-rays coverage for all. This would ensure that everyone had the means to prevent larger dental issues from occurring. (Fixing a small cavity is a lot cheaper than a large cavity). An upstream preventative approach such as universal preventative care for dentistry would have great long term benefits for everyone involved, as well as many overall health benefits.
While I would love there to be a universal MSI coverage plan for everyone, I am grateful that Nova Scotia has a children's dental program (not every province does). I believe that even this program can help pave the way for proper future oral healthcare, both at home and at the dental office. If a child is raised until their 14 going to the dentist yearly, receiving regular preventative care and education my hope is that adequate care can continue into their adult life. Even if cost is a factor once a child is out of the MSI dental system they will at least have the knowledge and skills to have adequate home oral hygiene to help prevent more serious dental issues. However, here in Nova Scotia as well as the rest of Canada there is much room for improvement of provincially funded dental care. I am currently just a provider in the healthcare system, i hope that someday i may be involved in some of the policies surrounding dental healthcare.
Health Canada. (2010) Summary report of the findings of the oral health component of the Canadian health measures survey 2007-2009.
Canadian Dental Association. (N.D.) Laws, Regulations and Guidelines in Health Care. https://www.cda-adc.ca/en/services/internationallytrained/laws/
Nova Scotia. (2020, December 10). Nova Scotia Children's oral health program. https://novascotia.ca/dhw/children-dental/
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