Terry McAuley recently had to make a choice: replace a mattress she’d been sleeping on for a decade or get the three fillings she desperately needed.
The 81-year-old Beach resident spent her savings on a nearly $1,000 dental bill. “The mattress is out the window for another eight months or so,” she said.
Through the anecdote, McAuley was criticizing what she says is a lack of dental-care options open to low-income retirees. She was at a dental focus group at the East End Community Health Centre on Oct. 18, an early step in the centre’s plans to lobby the province to fund a permanent dental clinic here.
“My biggest problem is that all of a sudden at 65, the Ontario population doesn’t require anything for their teeth,” she quipped sarcastically.
When Ontarians turn 65, most “exit” Ontario Works or ODSP, both of which offer some dental benefits, and begin receiving the Canadian Pension Plan or Old Age Security, the Ministry of Community and Social Services said in an email. ODSP recipients might qualify for extended health benefits—but they’d need to apply for them before leaving the program, the ministry explained.
The East End Community Health Centre meeting, attended by about 25 people, underlined such issues. McAuley’s experiences, and those of other attendees, will help health-centre staff draft a report that will be part of a submission to the province next year.
Mireille Cheung, director of primary health services for the centre, said East Toronto is the only one of the five Toronto Central Local Health Integration Network subregions that does not have a community health centre equipped with a permanent dental clinic.
“We’re feeling strongly that we need this in this area,” she said.
Jacquie Maund, policy and government relations lead at the Association of Ontario Health Centres, noted there are three public dental clinics in the East End, but she highlighted how they have trouble treating certain clients.
“The challenge is that none of these clinics can serve low-income adults/seniors (not on social assistance), as there are no public programs that fund services to this population,” she said in an email statement.
The east end centre’s oral health program coordinator Jackie, who asked not to use her surname, explained to the focus group that through Ontario Works—which provides income support, some health benefits, and employment assistance for those aged 18 to 65—it’s difficult to get anything more than tooth extractions covered.
“They may cover a filling—if you can find a dentist that will fill your teeth,” she said, adding the paperwork involved deters some dentists.
“It’s very difficult to find dentists that will accept you with ODSP,” she told the group.
Over the 2016-17 period, ODSP dental expenditures totalled $92.7 million, while dental benefits for those on Ontario Works totalled $26.2 million, according to the Ministry of Community and Social Services.
Local MPP Arthur Potts, who attended the meeting, is working with the east end centre in its funding efforts. He said he is advocating on the provincial level for basic dental care for all and specialty care for low-income patients, but also said the government was committed to a balanced budget.
“You need to have your teeth cleaned at least once a year… that way you can do an assessment, and you can stop major problems before they end up in emergency, and it’s going to cost us a lot more,” he said. “If you have to wait until you’re in crisis to get attended to, we’ve missed the battle.”
The Ministry of Health and Long-Term Care said the government has committed to expanding dental benefits to all low-income Ontarians. “Given the magnitude of this commitment, the ministry has committed to implementation by 2025,” said the ministry in an email statement.
The ministry has no plans to expand basic dental care to all and does not have an estimate for what doing so would cost the province.
The local centre currently offers workshops on dental issues and Toronto Public Health’s Mobile Dental Clinic, a clinic on wheels, visits regularly, but meeting demand is already a challenge for the centre, staff said.
At the focus group, attendees shared stories of using super glue to stick broken teeth together, self-performed tooth extractions, and resorting to substance abuse to deal with pain.
One reason Dyana Angino, 21, attended, was because of the hardships college students like herself can face in terms of affording proper dental care.
“I right now have to pay for my cleanings and my examinations myself through my part-time job, so that’s kind of putting me at a large expense because I also have to pay for transportation, books—so it’s definitely a big kind of financial barrier there,” she said.
In line with others at the meeting, she supports the idea of the province offering basic dental care coverage for all Ontarians as the Ontario Health Insurance Plan does not currently cover care provided by private dental offices.
“It could be very basic at first, maybe an examination and maybe a cleaning to start with, but definitely would help a lot,” she said.