in British Columbia The Canadian Dental Association defines oral health as a state of the oral and related tissues and structures that contribute positively to physical mental and social wellbeing and to the enjoyment of lifes possibilities by allowing the individual to speak eat and soci ID: 779069
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Slide1
Waiting for Pain
The politics of oral health in British Columbia
Slide2The Canadian Dental Association defines oral health as “a state of the oral and related tissues and structures that contribute positively to physical, mental and social well-being and to the enjoyment of life's possibilities, by allowing the individual to speak, eat and socialize unhindered by pain, discomfort or embarrassment.”
What is Oral Health?
Slide3What are the most common oral diseases?
Dental caries, also known as tooth decay or cavity A disease where bacterial by-products damage hard tooth structures, causing holes in the teeth.
Untreated, caries lead to pain, tooth loss, infection, and, in severe cases, death. Caries are one of the most common diseases in the world.
Slide4What are the most common oral diseases?
Gingivitis
: irritation of the gums caused by bacterial plaque between gums and the teeth, and calculus (tartar) on the teeth.
Irritation & inflammation causes deep pockets between the teeth and gums and loss of bone around teeth, known as
periodontitis
.
The loss of bone from
periodontitis
can cause teeth to become loose and fall out or need to be extracted because of acute infection.
Proper maintenance above and below the gum line to remove plaque and tartar helps remove the cause of inflammation and helps prevent infection & tooth loss.
Slide5Ten oral health problems your dentist can see that you can't:
Deterioration in fillings, crowns and other restorations.
Root cavities — decay on roots of teeth exposed by receding gums.
Periodontal pockets caused by gum disease.
New decay under the gum line.
Cavities under existing fillings.
Hairline tooth fractures.
Impacted wisdom teeth.
Early signs of gum disease.
Early signs of oral cancer.
Signs of other problems that could affect your general health
Slide6The Mouth is a Window...
Average number of filled or decayed teeth per adult = 15.8 (out of 28-32 teeth)Untreated tooth decay averages 20% across class (concentrated in working class)
20 % young adults would benefit from orthodontic treatments98% of the middle and upper classes have their natural teeth while 25% of those with low income are edentate (have no teeth)
Slide7The Mouth is a Window to Class
Many Barriers Exist to Accessing Dental Care:
63% of Canadians have some private dental coverageThe poor are concentrated in the 37 % that lack insurance – only 1 in 4 has any insurance versus 3 in 4 in higher income earning bracketsThose without insurance lack funds for dental care
Many workers are unable to take time
Majority of services are in English w/o translation
Many dental clinics are inaccessible to the disabled
Lack of transportation and childcare
Maintaining good oral health isn’t a choice – it is a luxury!
Slide8The Mouth is a Window to Class
In 2005 63.7% of Canadians consulted a dentist:12 – 19 years = 78.6%75 years + = 40.8%
Total dental expenditures in 2006 were almost 10 B with only 5% as public expenditures – the Federal and Provincial programs are completely inadequate or non-existent
Slide9The Poor are “Waiting for Pain”
Working class people wait until there is trouble to access dental care, with the result that we’re more likely to suffer:
Loss of teeth
Chronic infections
Chronic pain and all it’s many complications
Heart disease
Diabetes
Stroke
Preterm and low birth-weight babies
Slide10We Should ALL Smile with Dignity!
Poor oral and dental health impacts our:
Self-esteem and sense of self-worth
Employment
Access to education
Nutrition and the pleasure of eating
Emotional expression
Communication and relationships
Participation in community activities
Quality of life
Human dignity
Slide11Oral Health is a Human Right!
“Just as we cannot separate the jaw from the body, we cannot separate oral health care from health care. And yet, throughout the year, citizens, policy makers, and governments engage in critical debates about universal health care in Canada, and absolutely ignore oral health.”
Bruce Wallace, VIPIRG Research Coordinator
Slide12Dental Access Funds
Dental access funds are one way communities addressed access Administered by a Health Unit, Community Health Clinic, or charitable organizationHas increased access in some communities, and has encouraged some dentists to offer reduced rates or some pro bono work… however:Disempowering as charitable, patients must have a referral and / or be means tested to receive funds
Funds available are very small – inadequate to cover all needed treatmentVery few are able to be served this way – long wait lists
Slide13Volunteer Charitable Clinics
“Mandated to relieve pain with a focus on extractions”A few clinics offer limited cleanings or restorative workMajority clinics target the homeless, those struggling with addictions, and those with mental health issues
Volunteer dental staff – inconsistent care resultsCharity model which can be very disempowering for people
Hours very limited – patients turned away every day
Oral health MUST INCLUDE PREVENTATIVE SERVICES!
Extractions can negatively impact ability to chew as well as having cosmetic implications
Substandard services for the poor is fundamentally unjust
Slide14Social Enterprise & Subsidized ClinicsOffer lower cost dental, 10 – 100% below standard fee guide
Those with insurance fund those who don’t have insuranceClinics still rely on fee for service from patientsFull services available, not just extractionsVery limited capacity to meet the need for low cost dentistry
10-30% reduction of fees is not nearly enough to make preventative and restorative work affordable for many low income peopleSometimes recommended treatment plans are not ideal b/c dentist knows patient is low income
Very long wait lists to get an appointment unless very urgent
Slide15Teaching Clinics Resembles social enterprise clinic – reduced fees 60% BCDA guide feesOffer orthodontics to children assessed to be in need but still this work is >$1000 (60% reduction from private fees)
Not easy to access as on campus (at UBC)Long wait times at the clinicsStudents doing the work
Some dental hygienist programs offer discounted cleaningsMany of the same disadvantages of the subsidized clinics, and more…Not anywhere near adequate to meet the needs in BC!
Slide16Universal Dental Care for All!
Access to dental care determined by
ability to pay not by needWe are one of few industrialized nations without an oral health strategyOral health is completely excluded from our human right to universal health care
We should not accept stop-gap measures!
Structural issues undermining
equality in oral health must be
addressed!
Include basic dental care services
in our BC Medical Services Plan!
Slide17We’re tired of Waiting in Pain!
After more than two years of reaching out in the Mount Pleasant community, and many years of doing popular education and participatory action in East Van, the APH is ready to launch a campaign for universal dental care…What demands do we want to make to the Ministry of Health?
What slogans and catch phrases can we brainstorm to represent those demands?