Coverage of dental care by the Régie de l’assurance maladie du Québec is resurfacing. Within the profession, two discourses oppose each other. Some welcome this idea, others are reluctant and perhaps fear an upheaval in their habits in a profession that has been mainly private for so many years.
Posted at 2:00 p.m.
So what about public coverage of dental care? Although this measure would allow equitable access to oral care for all, what would be the real benefit of this measure on the state of oral health of the population?
The literature provides information on the use of dental services and socioeconomic inequalities. Despite the introduction of public dental coverage, the users benefiting the most would be the socioeconomically wealthier individuals1. Thus, these social inequalities in health would persist despite public coverage of this care.
Free access to dental care is therefore not the only determinant of the state of oral health. In Japan, where the state of dental health is good, heavily funded dental care combined with an increase in service centers has reduced the physical and financial barriers associated with this care2. However, this phenomenon has been accompanied by a collective awareness of the value of maintaining good oral health and of the health benefits resulting from these habits.
A Canadian cohort study of Manitoba First Nations reports similar findings3 : the financing of dental care is not the only determinant of the state of oral health.
No need to look very far! In Quebec, where dental care is funded for certain specific populations, the oral health status of these populations is not proportional to the funding offered. Among these vulnerable populations, social issues and different life realities have an influence at least as important as free services. We then understand that despite the absence of a financial barrier to dental care, visiting the dentist is not a priority. At the root of this gap, then, are several social determinants of health. Social realities that are true even in our major cities across the socio-economic continuum.
While the discussion of dental coverage is welcomed, this measure alone will only have a limited impact on dental health status. Simultaneously with this investment, a collective awareness of the importance of dental health within overall health is therefore necessary. To do this, a set of communication and prevention strategies must be developed, consolidated and deployed in addition to financial accessibility.
1. “Effects of Income and Dental Insurance Coverage on Need for Dental Care in Canada,” Journal of the Canadian Dental Association2014
2. “The Oral Healthcare System in Japan”, Healthcare2018
3. “Oral Health in a First Nations and a Non-Aboriginal Population in Manitoba,” International Journal of Circumpolar Health2012