Street dentistry: A commentary on Canada's new dental coverage and expansion opportunities for dental schools, health agencies, and not-for-profit

Abstract

Like other nations, such as Sweden and Brazil, that have publicly funded dental care, the Canadian federal government announced the Canadian Dental Care Plan (CDCP) in 2023.¹ For example, in both Sweden and Brazil, there have been “improvements in oral health, especially among young groups [… and] a decline in disparities in utilization [among all age groups]”.² This is particularly important because the earlier an oral health care program is initiated, the higher the likelihood it will promote sustained oral health improvements into adulthood.³ The CDCP will cost the government $13 billion in five years and $4.4 billion on an annual basis via an insurance regime providing primary oral care for uninsured citizens with an income below $90,000 per household.¹ It is estimated that the CDCP will provide coverage to more than 9 million Canadians, first opening to seniors in 2024 and the insurance process fully operationalized to all eligible Canadians in 2025.¹

The coverage offered under the CDCP plan will be comprehensive for millions of Canadians who have not visited a dental office for years. For example, the program will cover scaling, polishing, sealants, varnish, radiographs, restorations, crowns, dentures (complete or partial), endodontics, periodontics, and oral surgery.¹ This is particularly important because many chronic illnesses have been linked to dental health neglect. For example, poor oral health has been linked to diabetes (type 2), pneumonia, heart disease, stroke, and Alzheimer's disease.⁴ Moreover, previous research has highlighted the association between access to oral care and better diet, mental health, self-esteem, and improved grades in school.⁴ This is particularly important for underserved, homeless, and at-risk inner-city populations who have been disproportionately affected by many healthcare disparities. In effect, the concept of outreach health care in the inner cities has been established for decades in many North American urban centers where free health care has been tailored to homeless and at-risk groups.⁵ Therefore, this commentary highlights not only street medicine but the potential for ‘street dentistry’ in the context of the federal government's expansion of dental care for low-to-middle-income Canadians.

Previous research has urged the governments to provide publicly funded dental care for many uninsured Canadians based on human rights principles due to the severe consequences of lack of access to oral care.⁴ Finally, Canada is increasing its public share in dentistry in line with other nations, such as Sweden and Brazil, providing oral care via publicly funded programs. While Street medicine has been practiced for decades, the concept of ‘street dentistry’ could offer new potential for closing the gap in oral care accessibility for many underserved, at-risk, and vulnerable Canadians. Street dentistry could also provide innovative ways for non-profit companies, local health agencies, and dental schools to expand oral health to inner-city urban neighborhoods in vans and mobile clinics already utilized in some limited settings. Finally, street dentistry programs could enhance oral health students' education, training, and comprehensive understanding in an increasingly shrinking pool of patients for dental schools in the future. While this new Canadian program may increase the potential of this type of dental delivery system, in the United States, it is already widely used by many dental schools, including New York University, Columbia, and the University of California, Los Angeles, as well as many not-for-profit organizations, hospital dental programs and city and state departments of health.

Not applicable.

The authors declare no conflict of interest.