Family Dental Health in Ontario: A snapshot of community stories Lomotey, J., Hatzipantelis, M., Janzen, R.,

1
Family Dental Health in Ontario A snapshot of
community storiesLomotey, J., Hatzipantelis, M.,
Janzen, R., Curie, C.

• Abstract
• Ontario is widely regarded as a province that
  provides its citizens with a relatively high
  quality of life and access to health services
  with state-of-the-art technology. Along with this
  notion is a commonly held perception that the
  province has a well functioning dental system
  that provides services to a majority of Ontarians
  with the exception of the very few people who
  fall between the cracks. The purpose of this
  participatory action research project was to
  assess the social inclusiveness of dental policy
  in Ontario, document family dental health needs,
  and make recommendations for policy change.
  Family dental stories suggested that a
  significant number of families in Ontario fall
  between the cracks with regards to dental
  services, particularly the working poor, low
  income families, and new immigrants. High cost of
  services, the stigma of accessing services
  through social assistance, fear of dentists, and
  cultural barriers hinder access to dental
  services. Factors found to aid access to dental
  services were financial resources, awareness and
  individual priority, and the availability of
  dentists in a community. Participants recommended
  that Ontario needs a dental policy that will
  streamline existing dental programs to promote
  equal access to services and ultimately achieve
  universal dental care.  

2
Policy Suggestions
Introduction
Findings
Personal Stories
Personal Stories

• For the working poor, for seniors, for the
  community as a whole, there is no particular
  policy --- well, I guess there is a policy
  there is a policy not to have any.
• -- Key Informant
• Preventing Poor Oral Health
• Emphasize the link between oral health and the
  broader social determinants of health
• It comes down to the biggest influencing factor
  on oral health, which in our opinion is poverty.
  
• -- Key informant
• Emphasize prevention through oral health
  education and preventive dentistry
• Support oral health education in schools
• Involve medical professionals in raising oral
  health awareness
• Organize provincial oral health awareness
  campaigns
• Enhance access to preventive dentistry services
• Enhancing Access to Services
• Develop a socially inclusive dental policy that
• Promotes access to community-based services that
  do not stigmatize users

This family dental health project was one of the
Ontario Social Inclusion Initiatives sponsored by
Health Canada to mobilize communities towards
finding solutions for problems affecting them. It
was a unique project that highlighted the dental
health experiences of families participating in
CAPC/CPNP family support programs across Ontario.

Who Has Access ?

• Our familys dental health is very good
• because we all look after our teeth when we
• are at home. The kids are always watching us
• when we brush our teeth to see and learn how
• to do it themselves.
• -- Parent / Caregiver
• We see a dentist every year but find it
• hard to find transportation. We have full dental
  coverage from Union benefits.
• -- Parent / Caregiver
• For over one year we did not have any coverage
  by an insurance plan, so we did not go to see a
  dentist. We were lucky enough not to have any
  major problems, the four of us, though we needed
  cleaning. It was a stressful time. We had debts
  and were apprehensive at the idea of spending
  lots of money at the dentist.
• -- Parent / Caregiver
• It is very hard to get in to a dentist when you
  are on social assistance I called 25 dentists
  before a dentist would take me .. It is too
  embarrassing. After the third one, I was like, do
  I really want to keep calling? I feel stupid.
  They are not taking me because I am in this
  class.
• -- Focus group participant

• My teeth are decaying.
• I have no four front teeth and one filling.
• If my teeth hurt, I scream and cry because the
  pain is so bad.
• -- parent on behalf of child Age 3
• I know this doctor that has put quite a few kids
  under anaesthesia to do major work. My
  girlfriends child had 13 fillings and a root
  canal done. She was 5 years old.
• -- Focus group participant
• It ranges right from who is going to look after
  your child while you are at the dentist because
  then you are going to have to pay for
  babysitting while you are at the dentist, your
  transportation to and from the dentist and then
  pay for the dentist.
• -- Focus group participant
• My mom pulled my teeth out at the back because
  we couldnt afford it.
• -- Child
• For someone who is living with a limited income,
  dental hygiene on a regular basis is
  unaffordable.

• People with dental plans / insurance.
• People who give priority to oral health and can
  afford to pay for services.
• People who qualify for national and provincial
  dental programs.

• The purpose of the project was
• To determine
• The social inclusiveness of current dental health
  policy
• Barriers to accessing dental health services
• The impact of lack of access on families
• To develop recommendations for a policy that is
  socially inclusive, creates oral health awareness
  and promotes access to dental health services.

Who Doesnt Have Access ?

• The working poor / low-income families
• Seniors
• People in long-term care facilities
• Small businesses employees / the self-employed
• People who are homeless
• The unemployed / underemployed
• People who have lost coverage
• New Canadians

Issues Explored

• Current dental policy
• Family dental health concerns
• Barriers and factors facilitating access to
  dental services
• Impact of lack of access to dental services
• Policy suggestions

Barriers to Access
Methodology

• High cost of dental services
• Fear of dentists from previous negative
  experiences
• The stigma of accessing services through social
  assistance
• Additional costs associated with accessing
  services (e.g., transportation)
• Cultural barriers
• Lack of / insufficient dental services
• Lack of awareness of the importance of good oral
  health

• Steering Committee
• Family members
• Community outreach workers
• Dentists
• Other dental professionals
• Civil servants
• Methods
• Key Informants (10)
• Focus Groups (5)
• Mail-in Survey (243)

Initiated by The Ontario Coalition of Community
Action Program for Children (CAPC) / Canada
Prenatal Nutrition Program (CPNP)
Sponsored by Health Canada via
the Catholic Family Counseling Centre (Waterloo
Region) Conducted by The Centre for Research
and Education in Human Services (www.crehs.on.ca)