There is growing expectation that the Ontario taxpayer will support a public dental plan in medium term. From most accounts, it will involve a 20% copay, and an annual cap of perhaps $400 for a single or up to $700 for a family of four. The coverage will be fillings, cleanings and perhaps some topical fluoride.

Does this make sense to the stakeholders: the taxpayer, the dental professional, the patient and the government?

I am reminded of similar (mis)adventures by other governments to support dental care. Look to the ongoing misery of the UK National Health Service, for example, which has found there isn’t enough money in the world to support a national dental plan. Look to the griping which goes on in the US Medicaid dental program where neither the patient, the dentist nor the governments are satisfied about the outcomes and costs of these programs.

So if experience elsewhere shouts caution, what makes sense for expanding coverage for an aging, and increasingly un-insured Ontario?

The answer depends  on whether you consider poor oral health to be an acute one-time condition or to be a chronic disease.

If tooth decay and gum disease are acute, then throw  money at a dental program for a couple of years.

But if tooth decay and gum disease are medical conditions which grow with age and with other chronic conditions such as diabetes, mood disorders, hypertension and arthritis, then be very careful on what is offered in any dental plan initiative.

The point is that for sure tooth decay and gum disease are chronic disorders which stem from a bacterial imbalance in the dental plaque. This imbalance is unchanged by fillings, cleanings or fluoride.

Seems like we need a rethink of the proposed Ontario dental plan before it actually begins!


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