The Newfoundland and Labrador Dental Association (NLDA) says abrupt changes to the provincial government’s adult dental program are putting people’s health at risk, and the issue is much more severe than just dealing with a toothache.
NLDA president Dr. Jason Noel says changes to the program mean there may be enough money for people to have just one emergency dealt with a year, regardless of how many issues the person has and how severe they are. The money is doled out annually, so if they have four emergencies, it will take four years to have them all dealt with, he says.
That’s because according to a government news release, if a person gets through the prior approval process that allows them to have dental work done under this plan, the amount of coverage they are offered is a yearly allocation of $150 for basic dental services and $750 for dentures.
“By capping it at $150, it doesn’t really provide anything. It’s very, very limited,” Noel says. “Right now with the understanding I have and the way it’s written, if it’s an emergency situation or not, they’re capped at $150 per year. Which might cover one emergency visit and one simple extraction (a year).”
Last year, the provincial government created the adult dental program to provide enhanced diagnostic and therapeutic dental services to more than 90,000 people as part of the Newfoundland and Labrador Dental Health Plan.
At the time, the government highlighted the importance of dental health to physical and mental well-being. The new program was hailed as an example of the PCs’ devotion to a poverty reduction strategy initiative that they said would significantly improve quality of life for people in vulnerable circumstances.
Now, a little more than a year later, the Health and Community Services Minister Susan Sullivan says the costs associated with the program ballooned from the $6.7 million allocated to almost $21 million, making it unfeasible in the current climate of fiscal restraint.
Noel says the fact so many people took advantage of the program shows how much it is needed.
Sullivan acknowledges the importance of the program and says that’s why the government has gone to great lengths to continue it rather than eliminate it altogether. She says that even with these changes, the dental program is still very robust compared to the rest of Canada, where nothing like it exists.
However, with these changes in place, the program is actually not as good as what was offered before the adult dental health program was created more than a year ago, Noel says.
“Unless I’m missing something, then yes. Absolutely worse,” he says.
NLDA executive director Dr. Anthony Patey agrees.
Prior to the program being brought in, there were provisions in place to allow people on income support who had dental pain or infection to go to a dentist and have teeth removed — not just one a year, as the current changes now stipulate, but as many as necessary, Patey says.
Both Patey and Noel say the changes mean money in the program is wrongly allocated, putting emphasis on dentures, for which $750 is allowable each year, and ignoring emergencies and surgeries, for which only $150 per year is allowable.
“Denture is not a health issue. It’s a cosmetic issue,” says Patey. “Denture is important to eat meat and whatever, but nobody has ever died because they don’t have a denture. However, people have died because they’ve had infection that couldn’t be treated. And they’ve put nothing in to deal with the infection and pain side of things.”
Noel says the NLDA was blindsided Tuesday when the news release was sent to it stating the changes were effective the next day. The association was not consulted by the government about where money is needed most for the health of patients, he added.
“The problem we have is that they really haven’t consulted with us and we are on the ground … we are treating these patients.”
Sullivan says it’s true the association wasn’t consulted on the topic and wasn’t aware there were changes coming, but it was aware of budget issues within the program.
The immediate changes to the program meant that on Tuesday afternoon dentists were scrambling to reschedule patients whose coverage they were now confused about.
Noel says there was uncertainty about which patients would still be covered under the old plan, or if everybody is now placed under the new one.
Both opposition parties have examples of constituents in their districts who were as blindsided by the changes as the dental association was.
Andrew Parsons, the Liberal MHA for Burgeo-Le Poile, says a person in his riding had their dental office call Tuesday morning to confirm their appointment, only to call back that same afternoon, after the news release was sent out, to inform them they had to reschedule because they may be on the hook for the bill.
“It goes to show how poor their planning is,” Parsons says of the government bringing in a program that it had to overhaul just a year later.
NDP MHA for St. John’s Centre Gerry Rogers had a similar story to Parsons’.
“If they were budgeting the $6.7 million initially for that program, one wonders, did they not cost it out at all? Because basically what happened is that there was such a use of that program to make up for the (past) neglect,” says Rogers.
Sullivan says if people have had their X-rays and prescreening done and have had emergencies and essential surgeries already identified, they’ll still get to have them done. Everybody else will fall under the changes.
Noel says a big difference is that before, dentists could potentially operate and stop things before they became major problems, and now that ability has been taken away.
“We’re going to be facing a situation where people will not be able to be treated until it’s an absolute last resort and they’re in pain,” he says.
He predicts that now there will be a lot more people going to emergency rooms for pain and infection because they won’t be able to afford to have the dental work done. That puts extra pressures on emergency rooms, he says, but also doesn’t get to the dental issue affecting the people who end up there.
“Hospitals will manage their pain and manage the infection, but they won’t get to the root of the problem.”