KINGSTON — When her husband lost his job in May, the first thing 31-year-old Zoë Bradley did was call her dentist to cancel her appointment. Bradley, who works full-time at a salon in Kingston’s west end, had been relying on her husband’s benefits package to reimburse her for twice-yearly cleanings.
“This job I’m in now, nobody has benefits,” says Bradley. “It’s a full-time, salaried job. But benefits just aren’t part of the package.”
The couple’s expenses are growing: they just bought a house and are raising their 10-month-old son. Paying for dental care out of pocket can seem unmanageable, she says: “If I have benefits, I will go the dentist. If I don’t have benefits, I won’t go.”
That reasoning may sound familiar to the one-third of paid employees in Ontario who don’t have medical or dental benefits through their employer. While the Ontario government covers dental services for children from low-income households and is set to roll out a dental program for low-income seniors this summer, experts say that millennial and Gen-X professionals are being left behind.
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“The nature of work has changed so much over the last few decades. There seems to be more contract work, more gig work,” says Lori Kleinsmith, a health promoter at the Bridges Community Health Centre, in Port Colborne. A 2018 study by BMO Wealth Management backs this up: it concludes that the Canadian labour force is increasingly dominated by temporary positions that don’t provide medical benefits. Kleinsmith sees this every day. “People want a job, but they also want benefits,” she says. “It’s a significant issue for them. Some are going many years without any preventive work because they can’t afford to go to the dentist.”
The College of Dental Hygienists estimates that between 2 million and 3 million Ontarians have not seen a dentist in the past year, “mainly due to cost.” And, according to a report released in March by the Ontario Oral Health Alliance, an advocacy group, many of those people wind up seeking treatment in emergency rooms or physicians’ offices. The report notes that this is not only ineffective (given that physicians are not trained to deal with diseases affecting teeth and gums); it also represents a $38 million annual financial burden to the province.
Kleinsmith is part of a group of health-care workers urging the provincial and federal governments to “fill the gaps” by including dental care in general health-care programs. Canadians largely back the idea: a recent Ipsos poll conducted for Global News found that 86 per cent of Canadians would support publicly funded dental care for people without insurance coverage.
“The support is really high,” says Kleinsmith. “There just doesn’t seem to be that traction at the political level.”
Political parties are paying attention, however. During last year’s provincial-election campaign, the three major parties all made dental-care pledges: the Tories promised dental care for low-income seniors; the Liberals promised a rebate program for those not already covered; and the NDP promised a $1.2 billion dental-care program that they said would cover “every worker” in Ontario, including people in part-time and casual work.
Kleinsmith says that Ontario could learn from governments in the United Kingdom and France, where basic dental care is universal. “But, right now, in Ontario, there’s no mandate for that kind of big change,” she says. “And, unfortunately, there’s no huge public outcry wondering, ‘Why are so many workplaces not providing benefits?’”
According to a report published last May by the C.D. Howe Institute, the situation for Ontario’s millennials might get worse: “The number of Canadians unable to access dental care is likely to grow rapidly in the next decade as the baby-boom generation retires and loses insurance coverage, and the number of Canadians working in the gig economy, where benefits such as employer-sponsored health insurance are rare, rises.”
Tiffany Brick, an athletic therapist who co-owns the Annex Spa in downtown Kingston, has seen, as a patient and an employer, just how costly dental work can be. A few years ago, she was walking into a gas station when a customer suddenly flung the door open, hitting her in the face and dislodging her two front teeth. Her dentist gave her a few options, but ultimately — despite being uninsured — she chose what she calls the “Rolls-Royce of dental surgeries”: implants.
“I ended up paying upwards of $10,000,” she says. “I had some money that I put towards it, then the rest was a monthly payment plan through the oral surgeon. You sit down like you’re getting a mortgage.”
Brick, who employs 17 people at her spa, says she’s proud to offer her employees some dental insurance. “It’s kind of a perk with regards to our employment situation. It’s not something we had in the first five or six years of business,” she says. The plan covers regular dental cleanings and provides a small amount of money for procedures, although it wouldn’t cover the total cost of an expensive surgery.
Bradley, meanwhile, is taking matters into her own hands. “I am one of the few people in the world who actually flosses every day,” she says. “The cleaning — I just do it because they say I should do it every six months. It’s not something I would prioritize.”
She’ll be able to re-schedule soon: her husband was hired at the end of May to a new job. “It’s only part-time, to start, but he will get benefits. We just have to wait six months for them to kick in.”
Correction: An earlier version of this article referred to the Ontario Oral Health Alliance as a dental-industry group; it is, in fact, an oral-health advocacy group. TVO.org regrets the error.