One of the more frequent questions I am asked by my patients is “Why is dental treatment not covered under OHIP? After all,” they ask, “dental health is a part of overall health, isn’t it?” It is a reasonable question to ask; to answer it, however, requires a bit of a historical perspective. There are, in fact, three aspects to the answer – biological, political and economic.
From the standpoint of biological science and health care, the profession of dentistry has transformed significantly over the past 150 years. What was once looked upon historically as more of a mechanical skill has evolved into a recognized health care profession. Scientific understanding of the correlation between oral health and systemic health has also strengthened, particularly in the last 20 years.
From a political standpoint, the introduction of publicly funded health care to Ontario in the mid-1960s was somewhat controversial, and was introduced as a pilot project. At its inception, there was discussion about gradually introducing other allied health professions under the OHIP umbrella, including dentistry, optometry and chiropractic.
Whether or not this was a legitimate notion or political posturing is open to speculation. However, within the first five years of the introduction of OHIP, some political economists, both within and outside of government, had begun to predict that the system as introduced was not sustainable over the long term.
As we all know, the more recent history of OHIP over the past 20 years is one characterized by de-listing of procedures, not adding covered services. The economic reality is that the money for government-funded dental care simply is not there. During the last two provincial election campaigns, the political shift has been toward some sort of government-sponsored basic dental care for low income families. All three of the major political parties have had this concept, in one form or another, as part of their election platforms. However, with our current economic climate, the current provincial government has been unable to move this from a political discussion to a reality.
It should be noted that there are already in existence a number of programs, funded by both provincial and municipal governments, that meet some basic dental needs for those on social assistance and with disabilities.
However, there are also many low income Ontario families who unfortunately fall through this social safety net. As a result, there is a wide disparity in the level of oral health among the citizens of this province. Hopefully, as Ontario’s economic outlook improves, there will be the collective political will to improve the level of dental health for all Ontarians.