Professor Diana Lin
The Inclusion of Oral Assesments into British Columbia’s Medical Service Plan
Dental care is not included in the Ministry service plan. With the only minor exception for emergency dental care provided at hospitals and residents 19 years old or younger who are a part of a low to moderate income family.
To integrate oral health, specifically oral assessments which includes intra/extra oral exam, dental exam, and periodontal exam into the MSP. A written letter to BC’s health minister will be sent to bring awareness to the issue.
As health care professionals, it is important to view health in a holistic sense. The mind, body, and mouth are all interrelated and understanding the association and relevance of each aspect can help improve overall health. Oral health should be equally important as systemic health and our health care should reflect that. People go to their doctors to get their yearly blood work done to prevent diseases, maintain health, and ensure the health of the individual. because they want to know that everything is healthy. Likewise, an oral assessment is a baseline indicator to whether the mouth is healthy or unhealthy. Integrating oral health into the MSP, coincides with the Ottawa Charter of reorienting health services so that different health care professions work together to satisfy the need of a person as a whole.
Promoting the oral and overall health of British Columbians by including an oral assessment and dental hygiene diagnosis as a service covered by the province’s medical service plan (MSP).
From a social marketing perspective, a Facebook page was created: “Support the Inclusion of Oral Assessments into BC’s Medical Service Plan”.
This Facebook page can be incorporated into the CDHA facebook page to bring about awareness and promotion of this advocacy issue. Fellow dental hygienists can gain insight and have the opportunity to get involved in this cause advocacy issue. We would then expand out and gain support from other health professions on the shared value of obtaining health for the population. These health professions would include, but not exclusive to: dentists, nurses, and physicians.
3 Points to Support Key Message
1. With oral assessments (i.e. extraoral/intraoral exam, periodontal exam, dental exam, and dental hygiene diagnosis) covered under British Columbia’s Medical Service Plan (MSP), individuals will gain awareness and knowledge regarding their current oral condition. This will provide them with the opportunity to understand the importance between oral and systemic health. Bridging the medical and dental fields will ensure that individuals do not see the mouth and the body as mutually exclusive entities.
2. Adding oral assessments to the MSP will ensure that all British Columbians have access to receiving initial oral assessments, regardless of their socioeconomic status. Underserved populations that may not be able to afford any type of dental care due to financial constraints will have access and exposure to a dental environment, where their needs will be addressed. They will learn the importance of preventitive oral health services - regular cleanings, effective and frequent personal self care (PSC). Ultimately, it can lead to the maintenance of health.
3. Since many medical conditions and diseases manifest in the oral cavity (i.e. HIV/AIDS, oral cancer, vitamin deficiencies), accessible oral assessments may result in a sooner diagnosis and have a significant impact on overall health. In addition, oral lesions with no systemic health correlation is still of an importance. Although oral cancer is not the most common type of cancer, the prognosis is often poor. The majority of precancerous lesions will not progress into cancer. However, when the disease progresses, 1 in 2 patients will die within 5 years. Those who do survive will have a decreased quality of life due to disfiguration, and difficulty with talking and eating.
The following groups would be supportive of our advocacy plan due to the similar mission statements and common values.
This association functions to support their members.
In a position paper published in May 2010, “Access to oral Health Care for Canadians “indicates the need to find a solution of the large oral care disparity. CDA advocates for the development of a national action plan to reduce the barriers to access to dental care.
Canadian Association of Public Health Dentistry
Advocates for dental coverage to be incorporated in Canada’s public health care. “All Canadians should have access to preventive and restorative oral health care, regardless of their employment, health, gender, race, marital status, place of residence, age, or socio-economic status.”
Federal Provincial and Territorial Dental Working Group
This group work towards enhancing the effectiveness of public dental programs. In doing so, improve the oral health of Canadians.
Canadian Coalition for Public Health in 21st Century (CCPH21)
CCPH21 is a national network of non-profit organizations, professional associations, health charities and academic researchers. Has 35 members (one being CDHA). CCPH21 advocates for establishment and funding of the public health agency of Canada
Canadian Public Health Association (CPHA)
CPHA is a non-governmental organization that focuses exclusively on public health. CPHA believes all Canadians should receive universal and equitable health care. Their mission statement advocates for the “improvement and maintenance of personal and community health”. These goals would be achieved through public health principles such as “disease prevention, health promotion and protection and healthy public policy”.
BC Healthy Living Alliance (BCHLA)
BCHLA supports and works towards health-promotion policies, environments, programs and services for residents of BC.
The Association of Advocates for Care Reform (ACR)
With the growing geriatric population, we would find support from ACR. ACR advocate for health care reforms in BC specifically residential care.
There is no discrepancy between a low-income family and a high-income family in terms of premiums they have to pay for MSP. Incorporating an oral assessment may increase the premium costs. Some tax payers who do not see the importance of oral health may oppose to this addition onto MSP. Another opposition may come from the finance minster and treasury board. This is due to the tight budget B.C. is on for health care; there is a reduction of $250M received from Ottawa. This is due to the healthcare funding received from Ottawa not taking into account the health costs associated with an aging population. Thus, the increase amount the tax payers have to pay and limited federal funding may serve as a barrier.
Plan for Advocacy
We plan to place our cause advocacy into action through communicating to British Columbia’s health minister, fellow dental hygienists, and other health professionals.
We will be writing a letter to Michael De Jong and utilizing Facebook to connect with fellow dental hygienists, and other health professionals.
Facebook page is available at:
Dear Honorable Michael De Jong,
As future dental hygienists and health care professionals, we believe that it is of utmost importance that healthcare in British Columbia should be accessible and equitable to all residents here in B.C. This view is aligned with several Canadian government reports such as the Romanow Report, the Ottawa Charter, and the Canada Health Act.
Currently, dentistry is part of the private health care sector and there is not much emphasis on its importance to overall health. It is evident that there is a health disparity and needs to be addressed.
We believe that by including oral assessments, which includes intra and extra oral exam, dental exam, periodontal exam and a dental hygiene diagnosis, patients are able to get a baseline of their current oral health conditions. They will then be more aware and knowledgeable when it comes to their oral health. This oral assessment can be looked as an equivalent to a person’s yearly blood work. Blood work reveals an individual’s health status, like their cholesterol level, platelet counts, blood cell counts and other conditions that may manifest in the blood and this is the same regarding an oral assessment. Individuals will be informed if they have gum disease, any abnormal lesions, and be given any information relating to their oral health status. These individuals are then able to make their own decisions as to whether or not they would like to pursue treatment with the proper diagnosis presented to them.
Incorporating oral assessments in the ministry service plan (MSP) will ensure that all British Columbians have access to receiving initial oral assessments, regardless of their socioeconomic status. Underserved populations that may not be able to afford any type of dental care due to financial constraints will have free access and exposure to a dental environment, where their needs will be addressed. Moreover, we believe the delivery of healthcare should encompass a holistic approach. Not only does oral health affects the quality of life for an individual but it plays a role in the overall health as well. The mouth and the body are not different entities and are not mutually exclusive from one another. It has been well established in research that there is a bi-directional relationship between conditions in the mouth and systemic conditions such as non-insulin dependent diabetes mellitus.
Furthermore, if this policy change were to be made it would be aligned with Ottawa Charter’s on health promotion. By including oral assessments in the MSP, a supportive environment for health promotion and health improvements in the population can be achieved. Health can be further maintained through empowering the population with the knowledge that they have control over their own oral health. Thus, the population will actively participate in the maintenance of their oral health.
We understand that there has been a reduction in health care funding for the province of British Columbia and adding an oral health aspect to the MSP might be a difficult task. But incorporating an oral health component can increase the benefits to the public in the long run. Promoting health and prevention of disease should be a key element to our health care and oral assessments are ways to prevent oral diseases.
Since the public is gradually becoming more aware of their oral health and its relation to overall health, the MSP should gradually reflect its importance as well. We know that this will be a long and ongoing process but we would greatly appreciate your time and reflection on this issue. We feel that this would greatly improve the health of the individual as a whole and the people of British Columbia.
Anna, Arielle, Nancy
UBC Dental Hygiene 2012
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