Getting dental care a major problem for a third of Torontonians, report says

A lack of insurance coverage is forcing more than a third of people in Canada's largest city to go without dental care, a new report says. 

About 35 per cent of residents don't have dental insurance, forcing many to avoid the dentist altogether due to the cost, according to the report from Green Shield Canada and the Toronto Foundation, an organization that aims to connect philanthropists with community needs. 

"One thing is clear: for many of the most vulnerable people in our communities, the current system has left them behind and without support," the report said.

The report is based on data from the 2017 and 2018 Canadian Community Health Surveys, though the foundation believes the problem has only gotten worse since then and with the aging population it will continue worsen without "timely action."

Julia Howell, the foundation's chief program officer, pointed to the growing number of people who are self-employed or working in "precarious" jobs — meaning part-time, temporary or contract positions, rather than full-time employment that carries benefits. 

"That's where the greatest growth in the labour market is," said Howell.

"We're seeing more and more people, increasingly ... that are shut out of dental care supports, and in COVID, it's gotten that much worse."

To improve access to dental care on a local level, the report's recommendations include: 

• Setting up a network of dental health professionals who would be willing to work with public health and other groups to offer low-cost or free dental care to people in need. 
• Offering more funding to existing organizations that offer this type of service. 
• Creating new Toronto Public Health dental clinics and widening eligibility for these clinics. 

Choosing between groceries and dental care

In her work as a volunteer dentist, Dr. Amanda Morel often sees patients who may be working around the clock, but who have no benefits.

"They're in the unfortunate position of [having to] make decisions between buying their groceries for the week, or paying their rent and getting a painful tooth fixed," said Morel, who is the founder of Filling the Gap Dental Outreach, which offers dental services for low-income, uninsured adults. 

"They often end up in hospital emergency rooms, and unable to really get anything other than a prescription."

Other groups who are less likely to have dental insurance include racialized people and recent immigrants, the report says. 

Older people are also struggling with access to dental coverage, the report says, in part because many lose their work-sponsored benefits after retirement. 

Beyond the impact on individuals, the report noted a lack of preventative dental care can also strain other parts of the health-care system. It cited data from the Alliance for Healthier Communities, which found that emergency room visits for dental problems cost the province about $31 million in 2015.

Poor dental health is also associated with other problems, the report said, such as heart disease and respiratory illness. 

"We have to recognize that oral health is health," said Howell. "Your mouth doesn't exist in isolation from the rest of your body."

'Dental care should not be a luxury'

The report's findings weren't all negative. It said there are a number of organizations in Toronto that offer low-cost or free dental care already, and that could scale up to help more people if they had more funding. 

Among them is the Yonge Street Mission's Evergreen Centre, where Sylverine Albertina was connected with a dentist while experiencing homelessness in her late teens.

"It really improved things tremendously," said Albertina, 26, who received composite bonding to fix chipping on her front teeth.

"I feel like psychologically having nice teeth can do a lot for a person's confidence."

Albertina thinks universal health care should include access to dentistry and that services like the one she used should be more widely available. 

"Dental care should not be a luxury, it should definitely be a necessity for everyone."