Category Page: Oral HP for Vulnerable Populations

With 95% of dental services in Canada being provided by private dental offices, and dental care not being included in the Canada Health Act or under Medicare, private practice settings are less conducive to ongoing access to care for these vulnerable populations. In order to improve access to care, governments, social agencies, church groups and not-for-profit organizations can establish programs in attempts to address the barriers that prohibit citizens from seeking out dental services.

Over the last three decades of the 20th century the overall dental decay rates in Canada decreased considerably. Most of these improvements occurred for middle and upper class, young, employed people. There are some of the more vulnerable segments of the population, however, who have not benefited from lower decay rates and also who face barriers to accessing dental care.

The Canadian Oral Health Strategy^[1] identifies four types of barriers to access to care: financial, geographic, social-cultural and legislative. One or more of these types of barriers can come into play in reducing access to treatment services and to oral health promotion and prevention programs for many of these individuals.

Some of the segments of the Canadian population that are more vulnerable to higher disease rates and/or reduced access to dental preventive and restorative services include:

• Low-income citizens: Low-income people have decay rates and treatment needs 2.5 to 3 times that of people with higher incomes^[2]. The Canadian Health Measures Survey (CHMS) reports that Canadians from lower income families have almost two times worse outcomes compared to higher income Canadians^[3]. In addition, the CHMS reports “Lower income families and those with no insurance report not obtaining care in the order of 3 to 4 times more than higher income Canadians”.
• Aboriginals: Dental decay rates for Aboriginal people are between 3 and 5 times greater than for the non-Aboriginal population^[4]. In addition, many Aboriginal people live in remote areas with limited access to dental services.
• Recent immigrants and refugees: Many immigrants and refugees come from countries that have high dental decay rates and little access to care. Some have never had the opportunity of accessing dental care. Language and cultural barriers, as well as low incomes result in reduced access.
• People with disabilities: Access to oral health care is a major concern for people with disabilities. Financial and geographic barriers limit access to promotion, preventive and treatment services. The British Society for Disability and Oral Health provides some guidelines and policy documents regarding the provision of oral health promotion and treatment services for groups with various disabilities^[5].
• Seniors living at home, in community care settings, or in long-term care facilities: More and more people are entering their senior years with several of their own natural teeth. A high percentage of seniors are living on low, fixed incomes, restricting their access to care. According to the CHMS, 38.6 % of seniors aged 60-79 have private dental insurance, compared to 62.6% of the general Canadian population^[2]. In addition, seniors suffer from various medical conditions and decreased mobility and they have old dental restorations that are prone to breakdown.

Subtopics

1. Strategic Planning for Oral Health
2. Dental Surveillance, Monitoring and Screening
3. Oral Health Promotion and Integration of Services
4. Oral Health Promotion for Vulnerable Populations
5. Oral Health Promotion for Infants & Preschool Children
6. Oral Health Promotion for Children and Youth