The Political Eeconomy of Dentistry in Canada

• Main Author: Quiñonez, Carlos
• Other Authors: Locker, David
• Language: en_ca
• Published: 2009
• Subjects: Dentistry; Political economy; Sociology of professions; Survey; 0567
• Online Access: http://hdl.handle.net/1807/17818

Publicly financed dental care has recently increased its profile as a health policy issue in Canada. The media have championed the challenges experienced by low-income groups in accessing dental care. Governments across the country have responded with targeted funds. Social concern has even promoted the Canadian Medical Association to call for the inclusion of dental care within Medicare, and in changing a policy position that is over one hundred years old, the Canadian Dental Association now recommends that governments establish a dental safety net for all disadvantaged Canadians. In this environment, important questions have emerged: Why did Canada never incorporate dental care into Medicare? How have governments been involved in dental care? What are governments doing now? What are the disparities in oral health and dental care? What gaps exist in the system? What does the profession think? What does the public think? Through a document review, administrative survey, expenditure trend analysis, and public and professional opinion surveys, this dissertation answered these questions with the aim of clarifying the many issues that surround publicly financed dental care in Canada. It appears that dental care was not included in Medicare due to material and ideological reasons; namely decreases in dental caries and human resource limitations, the belief in viable options to large-scale service delivery, and the belief that maintaining one’s oral health and the ability to seek out dental care are individual responsibilities, not social ones. As such, there has developed in policy and programming a predilection to support dental care for children, for social assistance recipients, for seniors, and for select marginalised groups, or those groups where personal responsibility is not totalising. There is also a bias, developed over the last thirty years, towards structuring publicly financed dental care in private ways. This has resulted in a system that has certain biases, inconsistencies, and gaps, such that it cannot clearly and fully respond to current disparities. It is in the conciliation of public and private approaches to care that publicly financed dental care can achieve a stable footing and a clear direction forward.