If you do not know conscious sedation, you have never had to accompany a person with a severe anxiety disorder to their dentist. These are most often young patients with anxiety disorders or having autism spectrum disorder or other types of disabilities.
This procedure, which is widely used around the world, makes it possible to administer the care required for these patients, whether it is a simple filling or a more complex operation. The most likely alternative to conscious sedation is general anesthesia.
Despite the immense benefits of this procedure for young patients, the Ministry of Health has been making intense legal efforts for the past four years to complicate its access to our patients.
Are you surprised? U.S. too.
Extra fees
The Ministry of Health’s crusade began in 2016, when medical clinics were prohibited from charging “incidental costs”. At the same time, because conscious sedation is not reimbursed by the public dental care plan, dentists have been prohibited from administering this treatment unless they assume all the costs for all the patients concerned. According to the logic of the Ministry of Health, patients should rather be referred to a hospital to receive their care if they cannot be treated in a clinic.
After having contested this decision, the dentists were temporarily successful, after an arbitration confirmed that conscious sedation does not constitute incidental costs, which is moreover universally accepted by the medical community; sedation is an expertise in its own right which needs to be recognized and remunerated.
The story should end here. But this is not the case. The rest is a deplorable story, where the Ministry of Health will multiply legal steps to reverse this decision.
Thus, by dint of relentlessness, the ministry can finally shout “Victory!” “. After years of legal recourse and having suffered a bitter setback in the Court of Quebec, the department finally obtained satisfaction before the Court of Appeal thanks to a clever subterfuge. According to the recent judgment, the arbitrator did not have the jurisdiction to determine whether or not conscious sedation was an incidental expense.
Several losers
This is the demonstration that, if ridicule does not kill, it once again prevents dentists from having recourse to this treatment and sends children on the waiting list to the hospital when they could be treated quickly in clinical.
This is how this decision made a lot of losers in the population. Starting with all the young patients who will now have to go to a hospital to receive their care, thus prolonging their pain unnecessarily, in many cases. Then there are hospital staff, who already have a lot on their hands. Dentists, who have to deal with the distress of parents on a daily basis. The taxpayers who ultimately pay the much higher bill for general anesthesia.
And all this is taking place, let us remember, at the same time as our government announces its intention to expand access to dental care throughout Quebec. The least we can say is that it got off to a bad start.
Minister, you have the power to end this senseless crusade and give young patients the treatment they deserve. Many parents have already delayed their next date in the hope of a wise decision on your part. A decision that could also really improve access to dental care for young people at zero cost to the State. Can we count on you?
Dr Carl Tremblay, president of the Association of dental surgeons of Quebec
Dr Étienne Caron, President of the Association of Pediatric Dentists of Quebec