“If people’s oral hygiene isn’t good it doesn’t matter what you do”
Nunavut spends up to 13 times more per person on dental care every year than any other jurisdiction in Canada—that is, roughly $5,000 for every man, woman and child compared $378 per capita nationally—but Inuit in the territory still suffer from poor oral health.
That’s something the Government of Nunavut, which spends between $15 and $20 million a year on providing dental services and travel, would like to improve.
So, see your dentist regularly and brush your teeth is the GN’s message to Nunavummiut during April, oral health month.
And, if you have children under seven years old, you should register them in the children’s oral health program, aimed at promoting good oral health and preventing dental illness, which also offers food coupon incentives for participants.
But encouraging Nunavummiut to see dentists is just one of the big challenges facing oral health in Nunavut.
More prevention rather than more treatment is what Nunavut needs to improve the peoples’ oral health, according to Dr. Ron Kelly, Nunavut’s chief dentist.
Nunavut has the lowest per capita rate of dentists in Canada after Newfoundland-Labrador, says the 2017 State of Oral Health in Canada report.
And, of course, Kelly agrees that it would good if more dentistry services could be provided in Nunavut, but numbers of dentists aren’t the key to good teeth.
“We need better oral care,” he said. “If people’s oral hygiene isn’t good, it doesn’t matter what you do for them. In the end it won’t help.”
As for the state of oral health in Nunavut, “it’s not as good generally as it is in the rest of the country,” Kelly said.
This is a kind appraisal in a territory where at age 40, one in five Inuit have no teeth and many youth suffer from decayed and missing teeth.
The Canadian Dental Association said in 2016 oral health of Inuit requires “serious attention,” calling for “fundamental change” to Health Canada’s Non-Insured Health Benefits program.
The association said the program, which covers the cost for dental treatment for Inuit, is under-funded, with medical travel taking up the budget, instead of treatment for Inuit oral health.
For example, to keep costs down, second molars are no longer eligible for crown therapy under the NIHB, leaving no other funded option but extraction.
But often teeth are not salvageable, Kelly said.
“There’s nothing you can do that prolong their existence,” so it doesn’t make sense to spend money on crowns, he said.
Kelly said the NIHB program “adequate,” noting that it has no ceiling on treatment costs, although, as is the case with many private insurance companies, the NIHB requires approval for specialized treatments.
The oral health program for children holds promise for improving oral health for the future, he said.
Right now, more Nunavut preschoolers undergo dental surgery under general anesthetic than anywhere else in Canada because their baby teeth are rotten, but that should improve, Kelly said, thanks to the oral health program which helps teach good oral hygiene awareness.
“You’ll start to see a decline in the rate of decay you find and the need for treatment under general anesthetic is going to decline as well.”
For now, geography and logistics remain the biggest challenges facing the delivery of dental services in Nunavut.
Apart from Iqaluit, where there are two resident dentists, dentists have to fly into Nunavut, which means they can’t always make it to more isolated communities due to poor weather.
And then there’s the dental equipment to consider.
“If equipment breaks down in Resolute Bay, we can’t get their tomorrow to fix it,” Kelly said. “If you’re in Ottawa, you make a call and someone will be there the same day but [in Nunavut] it can take ages for us to get someone.”