Category Page: Oral Health

Oral health care in Canada is for the most part provided by the private sector on a fee-for-service basis, and therefore is paid for through dental insurances or out-of-pocket. With the exception of some oral surgical services provided in hospitals, oral health is not included in the Canada Health Act. As a result of its exclusion from Medicare, lack of access to preventive and treatment care is a major issue for a significant portion of the Canadian population.

With health being a provincial jurisdiction, there are only a few specific, publicly funded national programs provided by the Government of Canada for employees (RCMP, Canada Forces) or people who fall under federal jurisdiction (Aboriginals, Immigrants and Refugees, Veteran Affairs, Penitentiaries). Provincial or regional oral health programs vary considerably in their eligibility criteria and benefits, and there is no portability between programs.

The Oral Health Section of the Canadian Best Practices Portal is comprised of community based health promotion and disease prevention interventions that improve access to care and oral health outcomes of the population.

In addition to the PHAC-CBPI selection criteria of what constitutes a Best Practice, in the Oral Health section there are other attributes of an oral health best practice approach that must be considered. These are:

• Access to Care: The Canadian Oral Health Strategy defines four types of barriers (financial, geographic, social-cultural, and legislative) that limit or preclude access to preventive or curative oral health care for a significant percentage of the population. Community programs should be designed to address the barriers to access to care.
• Sustainability: Community oral health programs need to be politically and financially sustainable. Since programs are financed mostly from general revenues, they must be able to demonstrate accountability in terms of improving the health of the population or providing access to care to the more vulnerable populations.
• Cost-effectiveness and Efficiency: Community programs should be cost-effective and efficient through providing evidence-based services in the most cost-effective manner.
• Community Involvement: Particularly for Aboriginal programs and interventions for culturally diverse communities, involvement of the community can help to gain acceptance and overcome some of the cultural barriers that affect access to care. Community involvement helps to provide ‘ownership’ of the program which in turn improves health outcomes.

The interventions in this section are primarily Canadian. To see interventions that are best practices in the United States, see the website of the Association of State and Territorial Dental Directors. The ASTDD has a well defined methodology in their Best Practices initiative, with evidence-based resources and several examples of community programs that meet their best practices criteria.