Dental care access too unequal, say pediatricians

Canadian children need better access to dental care regardless of where they live or their family's income, say pediatricians concerned about tooth decay.

Children with rotting baby teeth or "early childhood caries" can suffer poor growth, behavioural problems, poor learning, and sleep loss, the Canadian Pediatric Society said in a report Friday.

The problem often requires surgery under general anesthesia and is the most common surgical procedure performed in preschoolers at most pediatric hospitals in the country, the group said.

Diet, bacteria, social factors like income, prolonged bottle feeding and drinking too much juice all contribute but the decaycan be prevented, the pediatricians said.

"Publicly funded provincial/territorial dental plans for Canadian children are limited and show significant variability in their coverage," wrote Dr. Anne Rowan-Legg, a member of the group's community pediatrics committee.

"There is sound evidence that preventive dental visits improve oral health and reduce later costs, and good evidence that fluoridation therapy decreases the rate of dental caries, particularly in high-risk populations."

Yet Canada ranks second last among members of the Organization for Economic Co-operation and Development in public financing of dental care, the pediatricians noted.

Within the country, children and youth from low-income families in most provinces are eligible for basic dental coverage up to age 18, but inNova Scotia, the coverage ends at age 10. The programs also tend to focus on treatment instead of preventative care.

The society recommendations for provincial, territorial and federal governments include:

• Ensure all children are afforded equal access to basic treatment and preventive oral care, regardless of where they live or their family's socioeconomic status.
• Support fluoride supplementation.
• Child health-care providers receive training and education in oral health, with an emphasis on early risk assessment.