With the Province considering changes to the Ontario Public Health Standards, Local 79 President Tim Maguire deputed to the City’s Board Of Health, asking the City to urge the Premier and the Minister of Health and Long-Term Care to maintain the current eligibility for preventive dental services under the OPHS.

 Dear Councillor Mihevc and Members of the Board of Health:

RE:      HL33.5 – Impact of Removing Clinical Preventive Oral Health Services from Ontario Public Health Standards

Local 79 members working at Toronto Public Health (TPH) in Dental & Oral Health Services provide critical supports for the city’s most vulnerable populations – children, youth, seniors, shelter clients, Ontario Works participants and their families. We strongly support the Medical Officer of Health’s recommendation that the Province be urged not to follow through on changes to the Ontario Public Health Standard (OPHS) that could potentially make over 15,000 children ineligible for provincially-funded oral health services, based on 2013 data in the Report.

In December 2013 the Province announced its intention to integrate provincially funded dental programs for children. More recently, the Province has indicated that they want to remove clinical preventive oral health services from the OPHS. This action by the Province would mean that as of August 2015, publicly-funded dental prevention services will only be available to children and youth in families who can establish financial eligibility under the new integrated dental program.

Dental disease is on the rise in children, and these changes will mean newcomers, children and families struggling in poverty, who are just above the eligibility line, will not receive the preventive care they need.

Currently, children with urgent dental needs are eligible for one course of dental treatment to treat existing dental problems, and restore oral health. Our members screen hundreds of thousands of children every year for urgent dental issues, such as abscesses and deep decay that can cause extreme pain and lead to further health complications. When they identify a child in urgent need of care, they help the child and their family schedule and attend an appointment with TPH’s dental team and follow-up to ensure they are maintaining good dental health.

According to the Report, “In 2013, 18,846 children received prevention services in TPH dental clinics under OPHS. Of those children, only 3,242 met Healthy Smiles Ontario (HSO) eligibility criteria. If prevention services are removed from the OPHS and the current eligibility for HSO is applied, only children eligible for the new integrated program will receive prevention services. Based on 2013 data, approximately 15,600 children in Toronto will not have access to provincially funded prevention services.”

Dental disease in children can lead to “speech problems, nutritional deficiencies, lack of sleep, behavioural problems and reduces capacity for learning as a result of pain and stigma”(Toronto Star, May 5, 2014, Students’ rotting teeth show ‘inequality of health’). Without access to preventive care many more Toronto residents will require costly dental surgeries and other health care services because of complications due to poor oral health.

In the report in front of you, the Medical Officer of Health (MOH) recommends urging the Premier and the Minister of Health and Long-Term Care to maintain the current eligibility for preventive dental services under the OPHS.

We applaud and support this recommendation, and will be joining the MOH in pressing the Province to retain coverage for vulnerable populations in need of dental care. We will also be connecting with other health and community organizations in the city that support and care for vulnerable populations to make them aware of the damage these proposed changes could bring. We ask that the Board of Health contact other Medical Officers of Health in the Province to alert them to the issue and ask them to join in urging the Province to reconsider.

The Province must strengthen, develop and increase dental disease prevention strategies, not limit and erode them. Access to dental care for low income families must be a priority.

Yours truly,

Tim Maguire
President