Disability Advocates Concerned About Eligibility for Dental Care Plan

Disability advocates are warning that the upcoming Canadian dental care plan may have eligibility gaps for those with disabilities.

The details of the plan are due to be announced later this fall, but the goal is to have kids under the age of 18, seniors, and people with disabilities covered by the program.

It has not been announced how people will be required to prove that they cannot qualify but Global News reported it is often based on the list of people who “access the disability tax credit to determine who should receive other disability-related programs, said Disability Without Poverty national director Rabia Khedr.”

The disability advocate pointed out this group of people may not be the best list to work from as it relies on people filing their taxes, which many with low incomes or lack of resources do not do.

Read more on this story from Global News.

Canada is a laggard when it comes to providing public funding for dental care, ranking close to the bottom of OECD countries. However, the federal government’s proposed Canadian Dental Care Plan could change that.

In its 2023 budget, the federal government pledged $13 billion over five years to implement the plan, which will provide dental care to Canadian families without dental insurance and whose income is less than $90,000 a year. The plan is being introduced in phases: coverage was extended first to children under 12 years old at the end of 2022; children under 18 years old, seniors and those with disabilities will receive coverage by the end of 2023; and then all families that meet the income threshold by the end of 2025.

In addition to the Canadian Dental Care Plan, the federal government has also committed to spending $250 million over three years starting in 2025-26 to establish the Oral Health Access Fund to invest in programs that address oral health gaps and access issues among vulnerable populations.

This paper calls the plan a major step forward in reforming dental care but argues that the “payer of last resort model” the government has chosen to implement falls short and will result in inefficiencies, as well as failing to ensure equitable access to primary and preventive dental care. As Canada moves forward in implementing these new programs, the federal government must consider what its goals are in reforming dental care and how it can best achieve them.

The authors identify four broad policy goals that should guide the reform: universality, fairness, accessibility, and accountability. They then assess the advantages and disadvantages of six possible options for achieving these goals:

1. a voucher or cash payment
2. a refundable tax credit
3. conditional transfers to provinces and territories, similar to those provided under the Canada Health Act
4. a program similar to the existing Non-Insured Health Benefit, through which the federal government directly provides insurance coverage to eligible First Nations and Inuit Peoples
5. conditional transfers via bilateral agreements negotiated with each province and territory
6. an arm’s-length, national agency, funded by the federal government and empowered by the provinces and territories

In late 2022, the federal government adopted Option 1, a cash benefit plan, to quickly roll out some support for children from families earning under $90,000. However, going forward, it seems to envisage Option 4 as the means to achieve dental insurance coverage for all families earning under $90,000. In what follows, we call for the government to move toward providing universal dental care coverage for a limited core of essential dental services, and argue that the best way to achieve this is through Option 6: all orders of government working together to create a national, arm’s-length agency with funding provided by the federal government.

This option would comply with Canada’s constitutional division of powers and would be the most effective and efficient way to achieve both broad access and coverage and to regulate the interface between public plans and privately financed care. Such an agency should also be charged with creating and facilitating programs to ensure actual access to dental care (as opposed to providing only surface-level insurance coverage) and with collecting data on oral health to monitor accessibility, quality of care, and use of available care, among other things.

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Dental Waterline Safety and Infection Control

How Effective Are Waterline Treatment Products?

Based on the largest dental waterline treatment study to date, which compiled data from over 22,000 consecutive waterline tests, here are some notable findings about the efficacy of waterline maintenance products:

31% of All Dental Unit Waterline Treatments Failed to Pass Water Quality Testing.*

Takeaway: Even if you think you’re using an effective treatment regimen, you can’t be certain without routinely testing lines to ensure they meet CDC/EPA safety standards of ≤500 CFU/mL.

*Represents treatments performed with all possible product combinations.

 23% of Tablet Treatments Failed Testing Without an Accompanying Shock Treatment.

Takeaway: Most practices only use continuous treatment tablets, but these products should always be paired with shock treatments for maximum efficacy.

12% of Tests Failed Even After Treatment With Both Tablets and Shock Products.

Takeaway: While a combination of shock and continuous treatment products comprises the most effective waterline maintenance with an 88% test pass rate, no solution is perfect. That’s why it’s crucial to routinely test water quality and reassess your maintenance protocol.

Source: https://blog.proedgedental.com/blog/dentalwater-treatment-product-selection-guide

Waterline Safety Essentials

Protecting your patients and practice from dental unit waterline-related hazards means using a combination of different infection control products. To help you stay stocked with the solutions you need, here’s a checklist of the essential products that support waterline safety:

Waterline Maintenance Products

• Continuous treatment (tablets, straws, or daily liquids)
• Shock treatment
• Water quality test kit

Evacuation and Isolation Solutions

• HVE tips/suctioning mirrors
• Rubber dental dams (various sizes)
• Rubber dam accessories (clamps, frames, and forceps)

Personal Protective Equipment (PPE)

• Eyewear (glasses or goggles)
• Face shields
• Masks/respirators
• Exam gloves
• Protective clothing (gowns, jackets, or lab coats)

4 Reasons to Use a Rubber Dam

Even though infection control authorities like the CDC and ADA advocate for their use during any spatter- or aerosol-generating dental procedure, most general dentists reportedly never use a rubber dental dam. If you’ve been neglecting this important tool, here are four reasons why you should reconsider:

1. Dams provide isolation and retraction.

By isolating the tooth (or teeth) you’re treating and retracting soft tissue, rubber dams protect the operative site from bacterial contamination while giving you the visibility and access you need to focus and work efficiently.

2. Dams keep the treatment site clean and dry.

The bond strength of many restorative materials, like composites and cement, becomes diminished when exposed to moisture. Dams keep moisture at bay and ultimately promote better treatment outcomes.

3. Dams protect patients from hazards.

Because dams safeguard the patient’s airway and oral mucosa, they minimize the risk of injury to soft tissue as well as aspiration of small instruments, restorative debris, and other harmful materials.

4. Dams reduce spatter and aerosol production.

Multiple studies show that dams are highly effective at reducing the spread of spatter and aerosols generated by dental treatment, and greatly mitigate the risk of operatory surface contamination and cross-transmission.