Breakups are never easy, but this one was especially painful. We’d been together 20 years. He knew my intense anxiety about going to the dentist (thanks to a traumatic incident when I was five and a mean, old small-town dentist slapped my face after I cried when he pulled out a tooth).
Dr. D., let’s call him, happens to also be movie-star handsome.
Beyond his good looks, he is gentle and kind and patient. When he said, “open wide,” I happily complied. Last month, we parted without saying goodbye.
It turns out our bond wasn’t as strong as I hoped. Blame the new (CDCP), a federal benefit first introduced by the NDP and passed by the Liberal government that will provide free dental care for basic services such as cleanings, fillings, X-rays and extractions for millions of Canadians who can’t afford the hefty cost of such care. Dr.
D. chose not to be part of the CDCP, not even for long-standing patients like me. His secretary broke the news.
When I asked her if he could give me a call so we could talk about it, she said, “He suggests you call the Ontario Dental Association (ODA) with your concerns.” Dr. D.
ghosted me — this, after 20 years of me and my kids sitting in his chair. This, after he earned tens of thousands of dollars from our family’s dental insurance plan over that time. The program is free for eligible people under 18 or 65 and older with a net family income of less than $90,000 and no access to dental insurance.
Next year it will be rolled out for eligible Canadians of any age, which means our country will have joined the likes of Norway and Sweden, who have progressive dental care policies that relieve the suffering of millions of uninsured people unable to afford the high cost of taking care of their teeth. No one in this day and age should have to worry about having to afford to pay for a filling or a tooth extraction. No one should have to go to emergency when they are in excruciating dental pain because they can’t afford a dentist.
No one should have to cover their mouth when they speak or lose out on employment opportunities because they are ashamed of how their teeth look. No kid should have to forgo teeth cleaning for years and then deal with the long-term consequences of poor oral health (including diabetes, heart disease and other chronic conditions) when they are older because their parents couldn’t afford a dentist. If you have the means to pay for your kids’ braces or your own root canal, consider yourself privileged.
Lots of Canadians, including the 50 per cent of lower-income Canadians without health benefits, can’t afford to do the same. Dental care shouldn’t be a luxury. It’s a necessity.
But apparently not all dentists think so. Minister of Health Mark Holland makes an announcement on the Canadian Dental Care Plan at a dental office in Ottawa, on Aug. 7.
About 70 per cent of dentists are now in the program. Back in June, only 50 per cent of dentists had signed up for the CDCP. The others complained the paperwork was too complicated (this, from people who have eight years of higher education?).
Last month, Health Minister Mark Holland simplified things, telling them they could submit individual claims for reimbursement without officially joining the CDCP. Now 70 per cent of dentists are in the program. So, what’s with the other 30 per cent? Some people think it comes down to money, but Dr.
Maneesh Jain, president of the ODA, says it ain’t so. “Dentists are not comfortable signing contracts that could be unilaterally changed by Health Canada,” he said in an interview, while also noting that dentists fear being audited by the government if they signed up for the program. Why would they be audited? “If they suspect fraud,” he said.
That seems like a good reason, doesn’t it? It was like pulling teeth to get him to admit that signing up for the CDCP will result in lost income for dentists. When pressed, he finally conceded, “Obviously it’s a subsidy, and so some patients are going to pay less.” There are dentists who will tell you that it is indeed about the money.
Dr. A. (he asked that his last name not be used because he does not want to be seen as publicly criticizing members of his profession) is a recently retired Ontario dentist who operated a few clinics in rural communities.
He notes that dentists who sign up for the CDCP will receive about 10 per cent less than what the dental association fee guides suggest for basic services. Some dentists — who happen to be among the highest income-earning professionals in the country with personal corporations that pay them anywhere from $200,000 to $500,000 a year (often far more than family physicians) — think that is too high a price to pay. Dr.
A put it bluntly: “I don’t think most dentists mind taking a 10-per cent cut. If a filling is normally $200, they will now get $180. The real fear is that two years from now the government might change the rules and reduce their fee to $100,” he says.
“In the end, it comes down to money.” He also suggests something more sinister may be at work — namely, that some dentists don’t want lower-income people in their chairs. “Some dentists spend $1 million or more on their upscale clinics to attract a certain clientele.
They’d rather fill their chair with people paying full price for lucrative cosmetic dentistry rather than basic stuff like fillings.” However, he also notes some dentists may stand to gain more income by seeing all those patients who never would have gone to them in the first place because they couldn’t afford it. “Eventually, the majority of dentists will accept this plan because it is a competitive market and if the dentist across street is accepting it, they will too because some money is better than no money,” he said.
(Dentistry as a profession has a long unfortunate history of being resistant to government plans for dental care. Dentists did not want to be part of Medicare in the 1960s and opted out of OHIP in the 1970s so that they would not have to accept government oversight and set fees.) When a privileged professional class chooses to resist a subsidized program because they will face a tiny loss in earnings, you have to wonder about their commitment to their existing clients who were loyal patients for years.
You have to wonder about their commitment to the health of kids and older people or anyone, for that matter, who can’t afford high dental costs. You have to wonder why they got into the profession in the first place. It’s time for that 30 per cent of withholding dentists to do their part — if they truly care about the health of Canadians then they should put their money where their mouth is.
As for me, I’m still getting over my breakup with my dentist, but I’ve found a new partner in my oral health care — Dafna Czudner, a regulated dental hygienist who operates Healing Roots on Dundurn Street in Hamilton. A couple of weeks ago, I went for a cleaning (I paid $150 compared to my dentist’s usual $270) and, yes, she is part of the CDCP. “I am excited that the public has this program in place,” says Czudner.
“This is a big opportunity for hygienists like myself to help more patients.” All dentists would do well to take a cue from her..
