April 17, 1998

Free dental clinic finds rising infection and decay among poor

If you thought tooth decay was yesterday's disease, think again. At last month's Open Wide free dental clinic, campus dentists saw more decay than ever, especially in children, says Dr. Kent Gibb, co-ordinator of the University of Alberta's effort in the province-wide clinic. He says dentists were overwhelmed by the amount of work required.

"We are seeing lots and lots of decay among the working poor, there's no question about it, says Gibb. And they seem to be getting worse off all the time. And yet, when you look at most middle income people and higher, most of the kids have no cavities and maybe one filling."

Associate Dean of Oral Health Sciences Dr. Wayne Raborn agreed there were a number of children in dire straits.

The Open Wide clinic is held every year in Alberta for those who can't afford to pay for dental care. Dentists across the province volunteer time to participate, using donated supplies. About 4,300 people dropped in on the clinic this year, 820 of them here on campus.

We were working hard, says Gibb. Some of these people had so much to do that we couldn't get it completed. We did not fulfil their needs by any means, and had to say, 'we can do one procedure on you, whether it be a filling or an extraction or a cleaning or something like that.' He says the cost of such a procedure, were a client to pay for it, would typically run between $80 and $100.

Gibb says it's difficult to attribute the rise in infection and decay to any one cause; the clinic may simply be getting better at targeting those in need through publicity campaigns. However government restructuring of the health system over the past three years, which has left chaos in its wake, may be at least partly to blame, says Raborn.

"Here in Edmonton the dental program was totally decimated by the Capital Health Authority, he said. A lot of dollars that were used for treatment intervention have been used for other things. Most of those dollars were focused on children of the working poor, on inner city and immigrant populations."

He says screening programs to identify children who need treatment in high-risk schools have been eliminated, as have subsidized clinics to carry out the necessary work.

Perhaps we need to rethink getting some treatment dollars back out there to those kids who really need the help. Gibb says the government should consider a dental plan for kids up to the age of eight, to help them get started once restructuring is completed.

Another reason for deteriorating oral health, however, may be a newly emerging sense of complacency, Raborn says, since the damage seemed to have tapered off over the last couple of years. This is my own theory, but we may be seeing a rebound phenomenon, especially among children, because it's easy to pick up any newspaper or magazine and see that dental decay is a disease that's been beaten. But there's nothing further from the truth. Maybe people are not as careful.

Open Wide clinics also see a high number of immigrant clients, many of whom are bringing years of oral neglect with them from their homelands, says William Long, president of the Alberta Dental Association. In Calgary there are clinics available for low-income clients up to the age of 16, he says, but many new Canadians might not be aware of them. They may not be fully utilized because it can be difficult to convince that client group that they should have good dental health.

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