Too soon to applaud federal dental care plan

Xray of teeth

December 20 2023

The National Union of Public and General Employees (NUPGE) believes that dental care should be part of our public health care system and be brought under the Canada Health Act (CHA) as a medically necessary service. While the federal government’s announcement of a Canadian Dental Care Plan (CDCP) is positive, there is no justification for not including dental services under our public health care system. On the contrary, there is a growing body of evidence showing that lack of dental care has major impacts on overall health.

This program will provide dental care for millions of Canadians currently not covered. This is essential. But this program should be the first step toward a universal, comprehensive and public dental care program. Without a roadmap to bringing dental care under the Canada Health Act, the CDCP will remain a fill-in-the-gaps program, as was promised under the Confidence and Supply Agreement struck between the NDP and the Liberals. Overall, this program will do much good, but it is also clearly a missed opportunity to correct a past failure.

Canadians at risk without dental care

The history of how Canada left dental care out of our public health care system is important and informs what is happening today. There are clear links between dental health and a range of diseases, including periodontitis affecting arthritis, kidney disease, Alzheimer’s disease, obesity, inflammatory cancers and heart disease. Canada is one of the worst countries in the OECD at providing dental care for its citizens.

Billions of dollars are being spent today to treat the fallout from people not having access to timely dental care. The human costs are far greater than the financial costs to our health care system, because people without dental care also pay a high price related to their overall health and well-being, their confidence, self-esteem, and even job prospects.

Powerful lobby against public dental care

One major question has been left unanswered. Will the NDP and Liberals commit to creating a roadmap towards a universal, public dental care program that is publicly delivered?

Creating a public option is something that the Canadian Dental Association (CDA) has been fighting against for over 60 years, since the inception of public health care, and it seems to have won for the moment. The CDA’s reaction to the CDCP is supportive and again outlines their position that the delivery of care should be primarily through the current private dental practices, supplemented by public clinics as needed.

There is another way forward

Canadians need to understand that in the long term, a fill-in-the-gaps program for dental care will end up costing more than universal dental care. While it may cost public money to set up the program, it will be a more cost effective and more comprehensive program.

This Institute for Research on Public Policy paper outlines some options for going forward toward a universal dental care plan. To achieve a universal dental care plan would require governments to consult, negotiate, and create the conditions for the transition. There are no simple solutions to moving away from for-profit dental care, but there would be many benefits.