Metro Morning

How low-income people suffer without dental care

The consequences of not being able to pay for dental care or routine maintenance can be devastating.

Dental health a missing part of Canadian health care, say advocates

If the cost of accessing dental care is a barrier for overall health, and costing the system $37-million per year, say advocates. (Michael Conroy/The Associated Press)

The aim of Healthy Smiles Ontario is to help low-income parents with dental bills for their children.

The government dental program provides free care for children under 17 but currently, there is no such help for the parents themselves.

Many poverty advocates are calling on the government to expand the dental program for low-income adults. The plan is to roll adults into the plan as of 2025. But until then, the consequences of not being able to pay for dental care or routine maintenance can be devastating.

Laurie, who agreed to speak about her circumstances as long as her last name not be used, is experiencing the pain that comes with not being able to afford a dentist.

For most of her life, the 56-year-old had dental coverage through work.

But the structure of her life began to crumble when Laurie turned 45. She was working at the Ministry of Energy when that sector was restructured. The government offered many employees a buyout. Laurie left, hoping to teach English as a second language.

"But then, everything happens at the same time," she told Metro Morning.

Laurie had lived in a condo for 14 years. But it got too expensive and she had to move.

"All of it went, slowly," she said of the parts of her former life. "That's how I ended up on welfare, because I'd lost my home. And my credit rating, I'd never even used a credit card, let alone abused it. But my credit rating got ruined, which also adds to your not getting a job, apparently."

'Big smile'

Laurie has three daughters. The youngest, still in junior high, moved back in with her father. Laurie moved in with her eldest daughter, sleeping on a futon in her grandson's bedroom.

At that time, Laurie was 48. The next year, 2008, financial markets crashed, eliminating thousands of jobs. Laurie was no longer working at all.

She was dealing with dental pain, too.

"That's when my teeth started bothering me the most. Starting from 2007, I believe I've had a tooth removed, yeah, at least I really, can't even count them all now ... 1, 2, 3, 4, 5, 6, at least," she said.

Research around the world shows less money you have, the higher the risk of gum disease. With Laurie, it started with gingivitis. A common form of gum disease that gets worse if left unchecked..

But there was no way to predict the next blows. At 52, Laurie moved out of her grandson's bedroom into a shelter. That was around the same time that her youngest daughter began hearing voices, becoming paranoid. 

Laurie moved back into her ex-husband's house to look after her daughter, who was on suicide watch.

After the worst of the crisis was over, Laurie moved into another shelter.  From there into a basement apartment that didn't even have a stove or fridge — the main reason why she could afford it.

Once poverty settles in, it can mark the next generation. Having a tooth pulled is the only free dental service for people on social assistance.  When Laurie oldest daughter was having problems with one of her molars, she had it pulled.

But this year, a bright spot.  Healthy Smiles Ontario, the province's new dental program, kicked in. As of January, low-income children are covered.

Laurie brought her grandson into the dentist recently. He was thrilled to get a new mouthguard for when he plays soccer.

And Laurie's smiling again too. After years of neglect, she was seen by a dental clinic that helps people on social assistance and got a new tooth insert. 

"I was trying to practise smiling without showing my teeth. It's hard to do after a lifetime of just smiling away," she said. "I kind of had a big smile."

Mouth is part of the body

A group called the Ontario Oral Health Alliance is calling on provincial health minister Eric Hoskins to extend public dental programs for low income children to low income adults and seniors.

It's something that would help low income residents like Laurie, and something Dr. Hazel Stewart, the director of dental and oral health at Toronto Public Health, seems to agree with.

"We've got to put the mouth back in the body," she said. "It's regarded as totally different, as though it doesn't belong in the body. If you get an infection in your body, it's covered, but if it's in your mouth, you're left to fend for yourself."

She calls the lack of dental coverage a "great disparity" in the healthcare system.

"We need a Tommy Douglas for dental care," she said.

Dental care for low-income adults will be available in 2025, provided the government doesn't reverse course on the recent decision. But, as Steward and others point out, "2025 is a long time to wait."

There are free clinics and community groups fundraising to help those struggling with finances pay for dental care, but overall advocates are asking for systemic change in dental coverage.

According to the more than 2.3 million people in the province cannot afford dental care, according to the Ontario Oral Health Alliance. They say, each year, there are about 59,000 visits to Ontario's hospital Emergency Departments and 218,000 visits to doctors for dental pain and infection.



Mary Wiens

Journalist/ Producer | Metro Morning

Mary Wiens is a veteran broadcaster and a regular on Metro Morning. Her wide-ranging beat includes stories that are sometimes tragic, often funny, occasionally profound and always human. Work that is often honoured with RTDNA awards (The Association of Electronic Journalists). One of her favourite places - Yonge Street. "It's the heart and soul of Toronto," says Wiens. "Toronto's Main Street!"