Oral Health

Oral Health ?

More Than Just Cavities

A Report by Ontario's Chief Medical Officer of Health

April 2012

Table of Contents

Executive Summary................................................................................................................ 4 Introduction............................................................................................................................ 6 Oral Health and Health Care in Canada.................................................................................... 8 The Importance of Prevention ................................................................................................ 8 Prevention ? The Economic Argument.................................................................................. 10 Oral Health, the Ontario Picture ........................................................................................... 12 Oral Health Inequities in Ontario .......................................................................................... 17 Conclusions........................................................................................................................... 20 Report Recommendations.................................................................................................... 21 Glossary................................................................................................................................ 22 References............................................................................................................................ 23

Executive Summary

I have written this report to raise awareness of the importance of oral health and equitable access to oral health services. Many Ontarians are not aware of the connection to overall health. In addition, many Ontarians do not have access to affordable dental care. The issues that concern me the most are: ? lack of awareness and knowledge among both the public and health care professionals of the

importance of oral health and its links to overall health; ? risks associated with poor oral health, including its links to other diseases and serious health conditions; ? lack of understanding that better access to preventive oral health services could result in savings to the

health care system; ? current publicly funded programs, while admirable in many respects, amount to a patchwork of services

that are complex for clients to navigate, and difficult to assess in terms of health outcomes achieved and return on investment; and, ? low-income Ontarians, including children and seniors, do not have adequate access to preventive oral health services or treatment when and where they need it. In Ontario we have made significant strides in providing dental services to people who struggle to pay from their own pockets. But current efforts are not enough. Opportunities exist for improved alignment and integration of publicly funded programs. Better monitoring and evaluation must also be done. I am hopeful that this report will bring more attention to the importance of dental health, and prompt a review of the effectiveness and efficiency of current publicly funded programs, within the current fiscal framework. I am also hopeful that an increased focus on these issues will result in improved access to oral health services for Ontarians, particularly low-income families and children, seniors and First Nations communities.

Arlene King, MD, MHSc, FRCPC Chief Medical Officer of Health

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Report Recommendations

I have made four recommendations for action and review by an expert advisory committee.

Recommendation 1

Conduct a review of current policies and mechanisms to ensure that all Ontarians have access to optimally fluoridated drinking water.

Recommendation 2

Conduct a review of how publicly funded oral health programs and services for Ontarians are monitored and evaluated. The review should include the quality, availability and appropriateness of current data and identification of missing data in order to improve programs and services.

Recommendation 3

Explore opportunities for better integration and/or alignment of low-income oral health services in Ontario, including integration and/or alignment with the rest of the health care system. This relates predominantly to the client journey, including making it easier for the client to access the care that is needed, when it is needed.

Recommendation 4

Explore opportunities to improve access to oral health services as well as awareness of oral health services available to First Nations people in Ontario, with a focus on better integration and/or alignment of the variety of available dental programs.

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