A snapshot of oral health in Canada

In 2010, Health Canada published a report on the dental health of Canadians, based on the Canadian Health Measures Survey (CHMS) conducted by Statistics Canada. The results showed that 75% of Canadians visit a dental clinic annually and 86% do so at least once every 2 years. This is a significant improvement from the early 1970s, when barely half of the population consulted a dentist on an annual basis.

Collectively, Canadians have experienced significant decreases in levels of dental decay over the past 40 years. According to Health Canada's Report on the Findings of the Oral Health Component of the Canadian Health Measures Survey:

• The percentage of the population that consults a dentist per year increased from 49.5% to 74.5%,
• The percentage of children with at least one decayed tooth decreased from 74% to 23.6%,
• The percentage of adolescents with at least one decayed tooth decreased from 96.6% to 58.8%,
• The average number of decayed, missing or filled teeth (per child) decreased from 6 to 2.5,
• The percentage of adults with no natural teeth decreased from 23.6% to 6.4%.

Overall, the survey indicates that Canadians have very good levels of oral health. The following are a few of the survey's high-level findings:

Access to dental care

• Roughly 80% of Canadians have a dentist,
• Approximately 85.7% of Canadians visit a dentist within a 2-year period,
• 32% of Canadians have no dental insurance,
• 53% of adults between 60 and 79 years of age have no dental insurance and 50% of Canadians in the lower-income bracket have no dental insurance.

Clinical oral health indicators in Canada

• 84% of Canadians report their oral health as good or excellent,
• 6.4% of Canadians have no teeth (are edentulous),
• 5.5% of Canadians have untreated coronal cavities,
• Most Canadians (73%) brush twice or more a day and over a quarter (28%) floss 5 times a week.

Need for care

• 34% of dentate Canadians 6-79 years of age had some sort of treatment need identified,
• 47% of lower-income Canadians had a need identified, compared to 26% of the higher-income group,
• Approximately 2 out of 3 Canadians have no dental needs,
• 1 out of 3 Canadians has a need and only 1 out of 6 says they cannot address this need because of financial reasons,
• Overall, Canadians from lower-income families were found to have two times worse outcomes compared to higher income families in many measures.

Economic burden of oral health disease

• The percentage of Canadians who have experienced time-lost from normal activities for oral health reasons is 39.1%,
• It is estimated that 2.26 million school-days are lost annually due to dental visits or dental sick-days,
• It is estimated that 4.15 million working-days for adults are lost annually due to dental visits or dental sick-days,
• Overall, an average of 3.54 hours per year is lost per person due to dental disease in Canada, including professional treatment.

Spotlight on Inuit oral health

The Inuit Oral Health Survey (IOHS), conducted in 2008-2009, found that compared to non-Indigenous Canadians, more Inuit reported poor oral health and higher frequency of food avoidance and oral pain. Fewer than half made a visit for dental care, even though very few reported that costs were a factor in avoiding a visit or accepting recommended treatment.

The prevalence of coronal caries was very high among Inuit. More than 85% of preschoolers had dental caries with a mean of 8.22 deciduous (baby) teeth affected. By adolescence, 97.7% had been affected and among the oldest adults, the disease had affected the entire population. Counts of decayed, missing or filled permanent teeth increased at every age, from 2 (aged 6-11 years), to 9.5 (for adolescents), to 15 (aged 20-39 years) and over 19 (for older adults). The prevalence and mean DMFT counts exceeded similar counts for non-Indigenous Canadians by a significant margin. Much of the disease remained untreated and there were more extractions among the Inuit. Among Inuit adolescents, there were 20.3 extractions per 100 teeth filled, much higher than findings for non-Indigenous adolescents, who had only one tooth extracted per 100 filled.

While Canada's oral health care measures are generally above average compared with countries around the world, there are inequities in oral care. In particular, Canadian families and individuals with lower incomes and of lower socio-economic status, those without dental insurance, older Canadians and Indigenous Canadians experience worse overall oral health outcomes than the general population.