Cost, lack of insurance keeping Canadians from seeing the dentist: StatCan

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Canadians avoiding dentist due to cost, lack of insurance: StatCan
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With the federal government’s early steps for a dental care plan expected to be announced before the end of the year, new data from Statistics Canada suggests more than one in three Canadians had not visited a dentist over the span of 12 months between 2021 and 2022 — and almost one-quarter say this was due to cost.

The data is based off the Canadian Community Health Survey, released Monday, which collected data from Canadians 12 and older living in the provinces between Feb. 9 to Dec. 31, 2022.

In an interview, Statistics Canada dissemination manager for the CCHS Shawn Brule said about 60,000 Canadians were asked and that the 12-month period in which they avoided the dentist could have been between February 2021 and 2022, or as late as between December 2021 and 2022.

In fact, more than one-third of Canadians reported not having any dental insurance, making it difficult for them to get the care they need.

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Canadian Dental Association President Dr. Heather Carr says the numbers are concerning in part due to oral care being linked to a person’s overall health.

“The best way to prevent dental disease and pain is early detection so you can get in while it’s easy to fix,” Carr, who is also a practicing dentist, said. “So if you’re not able to go, that can lead to some pretty serious consequences.”

Brule said that the data released in the survey may be able to set the stage for the national dental care plan.

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“This data is a good snapshot at a point in time before that program (the Canadian Dental Care Plan) has rolled out so that we can look at who’s going by different characteristics, who’s not going and who’s reporting not going because of cost,” Brule said.

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The plan, which the federal government announced in its 2023 budget, is expected to be rolled out in an initial stage with Canadians under 18, persons with disabilities and seniors covered. Christopher Aoun, press secretary for Health Minister Mark Holland, told Global News the plan is for the CDCP to be fully rolled out by 2025 to ensure up to nine million uninsured Canadians are covered.

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“Given its scale and scope, we are taking the time necessary to finalize all elements of the plan before releasing more details so that it is communicated clearly to Canadians,” Aoun wrote.

Brule also noted differences in some of the data, including that while it showed one-third did not visit a dentist at all due to cost, there was also one-fourth or 24 per cent who said they avoided visiting due to not having dental insurance or being unable to pay out of pocket.

However, he said that this number differs because this group of Canadians may have still visited during the course of 12 months, but then avoided a follow-up appointment such as a procedure or filling due to the cost they would face as a result.

According to Carr, a lack of dental insurance is a “huge issue” and while it may seem positive that 65.4 per cent of Canadians are able to access dental care with many able to do so thanks to insurance, there’s still more than 30 per cent who cannot.

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She said if the government’s plan is directed properly towards individuals most in need, such as lower incomes and those with reasons they’re unable to get said care, it could be a huge help.

“I think any prevention type programs would be good because if people are aware a big part of having healthy teeth is preventing the disease and knowing how to take care of your teeth, diet and all of these are tied into lower income as well,” she said.

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The CCHS also looked at public versus private dental insurance, showing 76 per cent that have private insurance — such as those provided by a person’s place of employment or a post-secondary school — saw a dental care professional, while 62 per cent of those with a government-paid plan did the same.

According to Statistics Canada, just under 55 per cent of Canadians have a private dental-care plan, while 4.4 per cent have public, with another 34.7 per cent stating they do not have any insurance. About 4.7 per cent say they don’t know if they even have insurance.

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The survey also gathered cost-related avoidance data for various equity-seeking groups, noting that age, employment rates, income, as well as race all saw varying degrees of who went to the dentist and their insurance access.

When it came to cost, the data also showed a higher proportion of West Asian, Arab, Latin American, Black, Chinese, South Asian and Filipino reported cost as a barrier — ranging from 27 per cent to 38 per cent — compared to just 22 per cent of the non-racialized, non-Indigenous population.

Cost was also a barrier for about 22 per cent of First Nations people living off-reserve, though it notes 24 per cent of the non-Indigenous population was the same.

Gender and sexual orientation also saw differences when it came to cost, with 34 per cent of transgender and non-binary persons reporting cost issues, about 10 per cent higher than cisgender persons. Meanwhile, between 30 to 37 per cent of bisexual, gay or lesbian and those who classify as another sexual orientation reported avoiding the dentist due to the price tag, compared with 24 per cent of heterosexual people.

While Brule could not say exactly why these Canadians may be be facing these barriers, he said it was important for the CCHS survey to report on them.

“At the very least we can start to tell more stories about the differences these populations face,” he said. “We want to make sure these numbers are available as a starting point to detect these differences and spur on further analysis to assess what other mitigating factors are there that could be leading to the difference.”

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Carr added she suspects the discrepancies may be related to access to care issues. If people in a lower-income job, or perhaps don’t have family support, it can be more difficult to have access to assistance.

“I think that it goes back to having a system that will allow individuals who aren’t getting the access to have access and be able to get the treatment they require,” she said.

Just under 50 per cent of  Canadians in what Statistics Canada classifies as the lowest income group reported seeing a dentist, while 73 per cent in the highest income group saw a dental professional. There was also a lower number of people in Newfoundland and Labrador, New Brunswick, Saskatchewan and Quebec having had a recent visit — with the number ranging from 55 to 62 per cent — compared to those in other provinces.

Just 60 per cent of adults aged 65 and older got their teeth checked, compared to 79 per cent of those 12 to 17 years.

Brule could not speak to aspects of policy as Statistics Canada cannot comment on policy implications, but he said the data provided could be used as the federal government’s dental plan is rolled out in terms of tracking whether it leads to a decline in cost-related avoidance of dental care and if it spurs an increase in seeing a dentist.

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