A new report from Statistics Canada, Characteristics of cost-related avoidance of oral health services among people in Canada eligible for the Canadian Dental Care Plan, is an effort to establish a baseline estimate of cost-related avoidance of oral health care prior to the introduction of the Canadian Dental Care Plan (CDCP). The analysis shows that having insurance, sufficient income and the presence of mouth pain all influence whether or not a person will seek care.
Paradoxically, having mouth pain was associated with higher levels of oral health care avoidance. The survey’s respondents, however, those eligible for the CDCP, were predominantly those with lower household incomes. The median adjusted family net income of the survey’s respondents was just $24,700, “reflecting the typical household income level in the CDCP-eligible population,” they write.
“Data from the 2023 to 2024 Canadian Oral Health Survey were used to construct a population-based cohort of CDCP-eligible individuals based on income and insurance status,” they state. The responses from 11,189 individuals found that 47 per cent avoided visits to an oral health professional and 38 per cent avoided recommended dental care in the past year because of the cost. “Establishing baseline estimates of cost-related avoidance before the CDCP became available to help pay for care is essential to gauging the success of easing financial barriers.”
The Government of Canada introduced the CDCP in December 2023 to help make oral health care more affordable for eligible residents with an annual adjusted family net income of less than $90,000. In the year leading up to the program’s launch, 50 per cent of the survey’s female cohort reported avoiding visits; 41 per cent avoided recommended dental care. Avoidance was lower among men, with 44 per cent reporting avoided visits to an oral health professional and 35 per cent reporting that they had avoided recommended dental care.
Cost-related avoidance also varies by geography. They say overall, 49 per cent of the study cohort living in urban areas avoided visits to an oral health professional, compared with 38 per cent of those living in rural areas.
“Dental insurance status and self-reported mouth problems had the largest associations with cost-related avoidance of visits to an oral health professional and recommended dental care in the past year,” they write. Specifically, they say in the full model, those without insurance had six times higher odds of avoiding visits and more than three times higher odds of avoiding recommended treatment. Those reporting mouth problems had almost five times higher odds of avoiding visits to an oral health professional because of the cost.
Those with higher incomes – above $38,800 but below $90,000 were less likely to avoid visits when compared with those earning below $38,800.
“Overall, the findings underscore the key role insurance plays in reducing out-of-pocket expense and lower financial barriers to oral health care,” they write. “The study findings suggest that while insurance plays a significant role in alleviating financial barriers to oral health care, income remains an important determinant of access.”
