The Green party and NDP have unveiled promises that could give more people access to dental care, though there are differences between the two proposals.

The Green party platform, released this week, said “Greens will guarantee... dental coverage for low-income Canadians.”

And the New Democratic Party platform released earlier in the summer pledged “A New Democrat government will work together with provincial partners, health professionals and dentists to develop a roadmap to including dental care in the Canada Health Act.”

The NDP’s stated goal is universal coverage for all Canadians. But it says the first step would be taken in 2020 with a national dental plan for uninsured Canadians in households making up to $90,000 a year.

Advocates have long argued that dental care should be part of the health-care system.

Nearly a decade ago, the Canadian Dental Association called for a national action plan to reduce the barriers people face getting dental care. The goals included “Creating new minimum mandatory standards for Canadian dental public health programs with the resources to meet these standards.”

According to a 2015 article in the University of British Columbia Medical Journal, about one in three Canadians lacks dental coverage and a similar number never see a dentist.

Grey Showler, a registered nurse by training, is the president of the British Columbia Association of Community Health Centres and the director of health and support services for the Victoria Cool Aid Society, which runs a busy dental clinic.

The clinic provides services to people on income assistance, who have limited coverage through the provincial government, and provides care to others at a 20-per-cent discount to rates recommended by the BC Dental Association in its fee guide. It’s the only clinic of its kind on Vancouver Island.

“We’re seeing people that are working poor, seniors, veterans, newcomers that aren’t able to access care at for-profit dental clinics,” Showler said. There’s huge demand, he said, noting it takes six months to get a routine appointment and longer for some procedures. “We run at 100 per cent.”

It makes no sense to leave dental care out of the public health-care system, said Showler. “Dental care is part of health care,” he said. “There’s an expression, ‘put the mouth back in the body.’”

Everything a person eats goes through their mouth, so its condition greatly affects whether they can eat without experiencing pain, their nutrition and their overall health, he said. The social stigma of an unhealthy mouth can also affect an individual. “If you have poor oral health, it’s pretty front and centre,” Showler said.

“We think dental care should be a publicly insured benefit like any other part of health care and income shouldn’t be a barrier to accessing care,” he said. “It really has a profound impact on people’s lives.”

The NDP platform proposes a universal plan, extending to all Canadians like other health services, regardless of ability to pay.

The Greens, on the other hand, advocate providing dental care to people with low incomes, though the platform doesn’t specify a cut-off. Nobody from the party was available for an interview on the topic. The party released a statement saying its policy would promote equity by ensuring low-income Canadians can visit a dentist regularly.

Green Leader Elizabeth May criticized the NDP’s universal plan during the Maclean’s-Citytv leaders’ debate as too expensive, saying that when her party checked the cost on a similar proposal four years ago the estimate was $30 billion a year. (The Greens have since said the current estimate is $40 billion.)

“We realized we couldn’t afford it,” May said, adding it was unclear how an NDP government would pay for it.

During the debate, Singh rejected the claim.

“We know that dental care is something essential,” he said. “We believe we can’t afford not to invest in dental care right now. There’s far too many Canadians that can’t afford their dental care and they end up in hospitals and they don’t get their initial problem treated because there is no dental coverage.”

The NDP platform doesn’t actually promise to include dental care as part of the health-care system, instead promising to “develop a roadmap” to get there.

“We want to make sure that people believe us when we say we’re going to get something done,” Singh told The Tyee during an August interview. “We’ve seen a lot of cynicism come out when a lot of fake words were said by Mr. Trudeau that didn’t result in any concrete action.”

An NDP government would focus first on introducing a national pharmacare program, he said. “We’re confident that once we show that we can deliver the pharmacare, we can get the buy in for the next step of our expansion of the health-care system to cover people from head to toe.”

On Wednesday, the party provided more details with Singh promising a national dental care plan starting in 2020 that would cover uninsured Canadians with household incomes up to $90,000 a year. The plan would make dental care free for households with income under $70,000 and require co-payments from those with higher incomes.

The party estimated 4.3 million Canadians would be covered and Singh has said it would cost about $860 million a year once fully in place.

In August, Singh told The Tyee that deciding what should be part of universal dental care would require work, noting that countries in Europe have plans in place. “We want to look at what’s the best out there and what’s the best plan we can provide that covers people the way they need to be covered.”

A 2012 report for the Australian government found that five countries in the Organisation for Economic Co-operation and Development covered the full cost of dental health services: Austria, Mexico, Poland, Spain and Turkey. It also cited a Council of European Dentists’ report that found Denmark, Finland, Greece, Italy and the United Kingdom had programs that could be considered universal.

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Other countries have at least some coverage for dental care, with several providing coverage for children up to the age of 18 or 21.

An emailed statement from the Liberal party responding to questions about dental care said, “It is more important than ever that our health-care systems adapt to deliver better care and better outcomes at a cost that is affordable.”

It detailed money the government has contributed for home care and mental health, as well as increased transfers to provinces and territories for health spending and steps to reduce the cost of drugs.

A Conservative party media contact failed to respond to requests for comment.

During the Maclean’s-Citytv leaders’ debate, Conservative Leader Andrew Scheer said expanding health care will make life more difficult for people living in poverty.

“You cannot increase health-care services when you’re paying more and more money to pay the service charges on the debt,” he said. “That is what all these plans will lead to: higher and higher taxes which take money out of the economy, which means that there’s less economic growth, which means there’s fewer opportunities for people trying to lift themselves out of poverty.”

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Hazel Stewart, the former director of dental and oral health services for Toronto wrote in a recent Toronto Star opinion piece that failing to fund dental care is also expensive.

“Scientific evidence suggests that having an unhealthy mouth could be contributing to chronic diseases of the heart, lung and stomach as well as being a risk factor for diabetes,” she said. “The effects of chronic poor oral health can be physically debilitating and socially incapacitating. It can affect a person’s ability to eat healthy foods, to sleep, to work and to maintain social connections.”

“While previous governments have shied away from implementing universal dental care because of the cost, the reality is that we’re paying more to treat the health consequences of dental neglect than we would if we invested in primary dental care.”

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