As the province develops its first oral health strategy, new numbers show that fewer and fewer Nova Scotians are taking advantage of existing oral health services for children.
The Department of Health and Wellness expanded dental coverage for children 14 and under last year, but that program is being accessed three per cent less often than before, and the province has no data to explain the gap.
More residents could be billing their dental care to private insurance companies, said acting deputy minister Jeannine Lagassé, but there’s no way to verify that.
“We could always do better at advertising our programs with stakeholders and users.”
The update came at a standing committee on health meeting on Tuesday, where a group of dental hygienists renewed their push for oral health care reforms that would help them serve more patients.
In Nova Scotia, dental hygienists can’t bill MSI — the province’s health care insurance — for any services that aren’t supervised by a dentist. That means independent dental hygienists can’t serve children whose treatments are covered by the government, and can’t provide billable services on site in communities, unless a dentist is there.
That’s a particular issue for vulnerable populations, who may face additional challenges in accessing care, such as cost, transportation, language or cultural barriers.
“They may not feel comfortable going into a general practice setting for fear of being charged at the end of the appointment for services over and above what the fee guide for MSI programs offer,” explained Francine Leach, a dental hygienist at the North End Community Health Centre.
The non-profit health centre relies on volunteer dentists, she added, and at least once a week there’s no dentist on site — meaning she can’t bill MSI for any treatment she provides.
Dental hygienists in the province have been asking for an expansion in their billing abilities for years, but with the new oral health strategy still years away from completion, there’s no legislative change in sight.
At the standing committee meeting on Tuesday, the department confirmed it has no deadline in mind for completing the strategy, and it has hired only one consultant — part-time — to provide clinical expertise in that process.
“I have a feeling that the amount of consultation, data-gathering and inclusiveness for something as large as an oral health strategy… it’s going to take more than a part-time position to finish the strategy in a timely fashion and to roll it out,” said Patricia Grant, former registrar for the College of Dental Hygienists of Nova Scotia.
“It is concerning that I asked about timelines, I was not given any timelines for completion of a strategy or what it will actually entail,” said NDP MLA Susan Leblanc.
Lagassé reassured committee members that the department has a team working on the oral health strategy, and is taking the time to review its programs before beginning to develop it.
That review included last year’s expansion to dental coverage for kids, allowing anyone 14 and under to get molar sealants and annual fluoride treatments, free of charge.
“We feel like we’re continuing work as we go along and we’re going to work diligently to try and get it done as quickly as possible,” she said.
The Opposition Tories have called for the appointment of a chief dental officer to oversee the province’s oral health policies, while NDP has introduced legislation that would create a universal school-based dental care program for all public school students.
There are more than 745 dental hygienists in Nova Scotia, and the province spends roughly $10 million per year on dental care programs.