Oral health care for children – a call for action

Question 1

What percentage of Canadian children 6-11yo have had a cavity?

Answer 1

57%

Question 2

What is early childhood caries (ECC)?

Answer 2

Presence of one or more decayed, missing (due to caries), or filled tooth surfaces in any primary tooth in a preschool-aged child

Question 3

What is the prevalence of ECC in preschool children?

Answer 3

6-8%

Question 4

What is the prevalence of ECC in Indigenous communities?

Answer 4

> 90%

Question 5

What is the most common surgical procedure performed in preschool children in most pediatric Canadian hospitals?

Answer 5

Dental surgery

Question 6

What percentage of Canadians have private dental insurance?

Answer 6

62%

Question 7

What percentage of Canadians have public insurance?

Answer 7

6%

Question 8

What percentage of Canadians have no dental insurance?

Answer 8

32%

Question 9

What are factors in ECC development?

Answer 9

1. Inappropriate infant feeding practices (i.e. frequent prolonged bottle feeding, excessive juice consumption)
2. Vertical transmission of Streptococcus mutans from caregivers

Question 10

What are measures to control ECC?

Answer 10

1. Promoting proper feeding
2. Improving diet
3. Water fluoridation
4. Increasing the use of topical fluorides
5. Dental sealant by primary health care providers
6. Use fluoride toothpaste

Question 11

What populations have higher levels of dental disease and limited or no access to oral health care?

Answer 11

1. Low-income families
2. Aboriginal children
3. New immigrants
4. Children with special health care needs

Question 12

What percentage of children <4yo with NIHB coverage have a yearly dental visit?

Answer 12

1 in 3 children

Question 13

What does the Healthy Kids program in BC cover?

Answer 13

Eligibility is children and youth 0-19yo from low income families in receipt of premium assistance through Medical Services Plan

Services covered: $1400/2y of basic dental services, $1000/y toward GA fees, emergency treatment for pain relief (>$1400 limit), no orthodontic

Question 14

What does the Dental Benefits Program for Children and Youth in Foster Care in BC cover?

Answer 14

Eligibility is children and youth in foster care covered up to $700/y

Services covered: basic, emergency and orthodontic care

Question 15

What does the Alberta Child Health program cover?

Answer 15

Eligibility: children and youth 0-18yo from low-income families

Services covered: basic coverage: dental exams, cleaning, X-rays, fillings and extractions

Question 16

What does the Family Support for Children with Disabilities in Alberta cover?

Answer 16

Eligibility: children and youth 0-18yo with a disability

Services covered: Basic dental treatment, with some orthodontic care (directly related to child’s disability and approved by a dental review committee)
– Covers portion of costs exceeding that covered by guardian’s dental insurance plan OR if guardian does not have dental insurance, costs exceeding $250 annually

Question 17

What does the Foster Care program in Alberta cover?

Answer 17

Eligibility: Children and youth zero – 18 years of age in foster care

Services Covered: Basic coverage: dental exams, cleaning, X-rays, fillings and extractions

Question 18

What does the Assured Income for the Severely Handicapped (AISH) in Alberta cover?

Answer 18

Eligibility: Children of parents with a disability who are unable to work

Services Covered: Basic coverage: dental exams, cleaning, X-rays, fillings and extractions

Question 19

What does the Family Health Benefits program in Saskatchewan cover?

Answer 19

Eligibility: Children and youth zero – 18 years of age from low income families

Services Covered: Basic coverage

Question 20

What does the Supplementary Health Program in Saskatchewan cover?

Answer 20

Eligibility: Foster children

Services Covered: Diagnostic, preventive, restorative, oral surgery

Question 21

What does the Public Health Services Dental Clinic (Saskatoon Health Region) in Saskatchewan cover?

Answer 21

Eligibility: Children zero – 16 years who have limited or no dental coverage

Services Covered: Preventive and treatment services

Question 22

What does the Health Services Dental Program in Manitoba cover?

Answer 22

Eligibility: Children <18 years of age who have a disability or are wards of the state covered up to $500/year

Services Covered: Basic diagnostic, preventive, restorative, endodontic, periodontal, prosthodontic, oral surgery services

Question 23

What does the SMILE plus program (Winnipeg Regional Health Authority) in Manitoba cover?

Answer 23

Eligibility: At-risk children in the Winnipeg region

Services Covered: Preventive and basic treatment services

Question 24

What does the Healthy Smile Happy Child intersectoral partnership program in Manitoba cover?

Answer 24

Eligibility: At-risk infants and preschool children and their families

Services Covered: Oral health promotion using community development approaches

Question 25

What does the Free First Visit Program (Manitoba Dental Association) in Manitoba cover?

Answer 25

Eligibility: children <36mo

Services Covered: Early dental screenings

Question 26

What does the Healthy Smiles in program in Ontario cover?

Answer 26

Eligibility: Children and youth <18 years of age are eligible if their family’s net income is

Question 27

What does the Ontario Disability Support Program (Dental Special Care Plan) in Ontario cover?

Answer 27

Eligibility: Dependent children and youth (<18 years of age) who live with a disabled parent

Services Covered: Basic diagnostic, preventive, restorative, endodontic, periodontal, prosthodontic, oral surgery services

– General anesthesia and sedation

Question 28

What does the Assistance for Severely Disabled Children (ASDC) in Ontario cover?

Answer 28

Eligibility: Children and youth (<18 years of age) living at home in a low-income family
– Child must have a severe disability

Services Covered: Basic diagnostic, preventive, restorative, endodontic, periodontal, prosthodontic, oral surgery services

Question 29

What does the Children in Need of Treatment (CINOT) program in Ontario cover?

Answer 29

Eligibility: – Children and youth (<18 years of age) requiring emergency or essential dental care
– Parents have no dental insurance OR cost of treatment would result in ‘financial hardship’ (no income verification)

Services Covered: – Includes diagnostic, preventive, restorative, prosthodontic, endodontic, oral surgery, and pays for adjunct services such as general anaesthesia and conscious sedation
– Intended for one-time coverage; no ongoing care

Question 30

What does the Régie de l’assurance maladie du Québec: Children’s Dental Care Program in Quebec cover?

Answer 30

1. All children <10yo
   Services Covered: Basic diagnostic, restorative and oral surgery
   – Does not include cleaning or fluoride application
2. Children from Low Income families
   Services Covered: Basic diagnostic, restorative and oral surgery
   – >12 years of age: annual teeth cleaning
   – 12 – 15 years: annual fluoride application

Question 31

What does the Dental care for low- income families in New Brunswick cover?

Answer 31

Eligibility: Children <18 years of age from low-income families

Services Covered: Examination, basic diagnostic, extractions and some preventive treatment
– Up to a maximum of $1000/year

Question 32

What does the MSI Children’s Oral Health Program in Nova Scotia cover?

Answer 32

Eligibility: Children <10 yrs of age
– Families required to access private coverage first

Services Covered: Diagnostic (dental exam), preventive (one sealant application), and treatment services (fillings, fluoride application in some cases)
– General anesthesia covered in hospital settings only

Question 33

What does the Mentally Challenged Program in Nova Scotia cover?

Answer 33

Eligibility: – Children with disability (no age limit)
– Required to access private coverage first

Services Covered: Diagnostic, preventive, and treatment services
– General anesthesia covered in hospital settings only

Question 34

What does the Children’s Dental Care Program (Treatment Services) in PEI cover?

Answer 34

Eligibility: – Children three – 17 years of age
– Annual registration fee of $15/child to a maximum of $35/family (waived for low- income families)
– Parent pays 20% of treatment cost, unless annual income

Question 35

What does the Children’s Dental Care Program (Prevention) in PEI cover?

Answer 35

Eligibility: All school-aged children 3 – 17 years of age

Services Covered: Oral health education, screening, scaling, topical fluoride, sealants

Question 36

What does the Pediatric Specialist Services Dental Program in PEI cover?

Answer 36

Eligibility: – Children in medical and financial need
– Annual registration fee of $15/child

Services Covered: Diagnostic, treatment and some preventive services

Question 37

What does the Preventive orthodontic clinic in PEI cover?

Answer 37

Eligibility: Directed at children in low-income families

Services Covered: Minor preventive orthodontic services

Question 38

What does the Early Childhood Dental Initiative in PEI cover?

Answer 38

Eligibility: 15- and 18-month-old babies at Public Health immunization clinics

Services Covered: Screening, risk assessment by dental hygienists

Question 39

What does the Children’s Dental Health Program in Newfoundland cover?

Answer 39

Eligibility: – All children 0 – 12 years of age
– Families required to access private coverage first
– Youth 13 – 17 years of age in low-income families or on social assistance

Services Covered: Children’s component: diagnostic, preventive periodontal, restorative services (ie, exams, cleanings, fillings, fluoride application, extractations, sealants)

Social assistance component: exams, fillings, extractions and emergency treatment

Question 40

What does the NIHB program in Nunavut cover?

Answer 40

Eligibility: Registered First Nations and Inuit

Services Covered: Emergency, diagnostic, restorative, endodontic, periodontal, prosthodontic, oral surgery, orthodontic services

Question 41

What does the Children’s Dental Health Program (Yukon Health and Social Services) in Yukon cover?

Answer 41

Eligibility: Two programs:
– Preschool children
– All school-aged children from kindergarten to Grade 8 (or Grade 12) depending on the place of residence

Services Covered: – Preventive, restorative, periodontal, and oral surgery services
– Emergency (accidental) not covered in school-aged children’s plan

Question 42

When does the Canadian Dental Association recommend for timing of the first dental assessment?

Answer 42

Within six months of their first tooth appearing and no later than 1yo

Question 43

What does the AAP on Pediatric Dentistry recommend for timing of establishing a child’s dental home?

Answer 43

Within six months of their first tooth appearing and no later than 1yo

Question 44

When does the Rourke Baby Record recommend for timing of the first dental assessment?

Answer 44

9-15mo

Question 45

What are the most pressing targets for policy development?

Answer 45

1. Ensure leadership in paediatric oral health policy development at provincial/territorial and federal levels.
2. Assure provision of dental services under the Canada Health Act tenets, with special attention on marginalized populations.
3. Compile (and maintain) current data on the dental health status of children and youth.
4. Extend dental policy and programs based on evidence-based practices.
5. Ensure proper evaluation of existing programs.

Question 46

What are the CPS recommendations?

Answer 46

1. Ensure that all children in their respective jurisdictions be afforded equal access to basic treatment and preventive oral care, regardless of where they live or their family’s socioeconomic status.
2. Ensure that every child has a dental home by one year of age.
3. Support the Canadian Paediatric Society and the Canadian Dental Association recommendations on fluoride supplementation.
4. Create leadership positions to represent the specific interests of children and youth on oral health issues.
5. Develop an ongoing surveillance system to capture key data and to reflect the state of paediatric oral health.