As an archaeologist, I've excavated hundreds of skeletons and observed first-hand the effects of poor dental care. In many cases, tooth problems were likely the cause of death, not to mention chronic pain.
In our own era, it was revealed by Public Health Ontario's Report On Access To Dental Care And Oral Health Inequalities last year that 50 per cent of us had experienced "pain or discomfort" associated with dental problems, and 20 per cent of those who'd had these difficulties cited cost as the reason they didn't seek professional help.
But what if there were a service that allowed people to get the treatment they otherwise couldn't afford? And what if the government preferred to keep the existence of this service on the QT in case too many people applied for it?
Consider the experience I had recently. Some family friends who have no dental insurance faced a crisis when their 16-year-old was found to have 17 cavities, two requiring root canals - not an unusual situation for those whose finances don't allow for regular dental visits. An increasing number of people these days have no health/dental benefits through their jobs.
The dental bill would have added up to $6,000-plus - completely unaffordable - yet the kid needed relief from pain. In the end, we discovered a little-known benefit, funded by the province and administered by Toronto Public Health, called the Children In Need of Treatment (CINOT) program. It provides emergency dental care for low-income children 17 and under.
CINOT only covered about $1,800, leaving the other $4,200 to be borrowed from friends. Even with a cooperative dentist and contacts who know the municipal system, getting the maximum amount was difficult. But without this dental work, our friends' son would have lost a good number of his teeth and had visible gaps in his mouth for the rest of his life.
Ontario and the city also provide the Healthy Smiles service for children under 17 with an adjusted (for number of dependants) family net income of $20,000 per year or less. It covers simple cavity fillings, basic cleaning and tooth extractions, but not root canals that would save the teeth.
For some perspective, consider that providing full dental coverage under OHIP for everyone would cost around $4 and $5 billion, whereas the CINOT program is allocated only $45 million. Because it's complicated to access and few people know about it, CINOT doesn't even disburse its full budget. Yet there are thousands of kids under 18 in Toronto who have had little or no access to dental care.
I saw the same problem in the case of another under-advertised program. I watched a group of friends organize a benefit for someone who needed access to drugs costing upwards of $25,000 a year to limit the progression of multiple sclerosis.
They were all university-educated people, and one even had a master's in public health, but they were unaware that the province offers catastrophic drug support through the Trillium Drug Program. While it's far from universal, Trillium does help people coping with serious health problems.
It covers prescription drug costs that exceed 4 per cent of a family's post-tax income. The patient pays a deductible based on number of dependants and household income.
So, for example, a Toronto household with combined post-tax income of $40,000 would have their drug costs capped at $1,600. While that amount is still challenging, the cap ensures that people won't go bankrupt treating medical issues.
But how many people know Trillium exists, given that the province undertakes no large ad campaign? And since people don't know the program is there, many will opt not to obtain the drugs they need.
Despite the fact that provincial government spending on advertising is at an all-time high of $35 million, there's a lack of government-to-populace communication about these kinds of services. The most recent auditor general's report criticized a number of government ads for being too political. Better that some of that cash had gone to telling disadvantaged people there is some relief for them.
Government austerity obsessions are no reason to keep Trillium and dental programs under wraps. Not spending on these services only results in higher medical/dental bills for the province down the road. Some major public info campaigns are in order.
In the meantime, spread the word.