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Office of the Chief Dental Officer Projects

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The Office of the Chief Dental Officer (OCDO) is involved in the following projects:

Oral Health Status Data Collection

a) Oral Health and the Canadian Health Measures Survey (CHMS)

The results from the oral health component of the CHMS are now available. The Oral Health Statistics 2007- 2009 factsheet, presents an overview of the results.

More detailed results can be obtained from writing the Office of the Chief Dental Officer or by visiting the Next link will take you to another Web site Federal Provincial Territorial Dental Working Group Website.

The first cycle of the Next link will take you to another Web site Canadian Health Measures Survey (CHMS) collected key information about the health of Canadians in two phases:

1. The first phase collected information through a household questionnaire focusing on:

  • nutrition,
  • smoking habits,
  • alcohol use,
  • medical history,
  • oral health,
  • current health status, etc., as well as,
  • demographic and socio-economic variables.

The portion of the household questionnaire related to oral health included questions on the general health of the mouth, the comfort or avoidance with eating certain types of foods, the presence of any pain in the mouth, oral health habits (including brushing, flossing and visits to a dental professional), and also questions on insurance and costs associated with visiting a dental professional. To view the questions related to oral heath, access the CHMS Next link will take you to another Web site household questionnaire (PDF Version - 1,334 K) and proceed to page 72.

2. The second phase collected direct measurements, in a clinical setting, including:

  • blood pressure,
  • height and weight,
  • blood and urine sampling,
  • clinical oral examination and physical fitness testing.

The oral health component of the clinical questionnaire consisted of questions that helped to guide the oral health examination including, a count of teeth, an assessment of the gums, recording the presence of gingivitis, and of any debris or calculus on the teeth. The clinical assessment also included an examination of each tooth (e.g., whether a tooth is decayed, missing, filled and/or treated), a count of the number of silver fillings and whether there was any damage done to the teeth. To view these questions, access the CHMS Next link will take you to another Web site Clinic Questionnaire (PDF Version - 1,204 K) and proceed to page 63.

For further information, please contact the Office of the Chief Dental Officer.

b) First Nations and Inuit Health Oral Health Status

The Office of the Chief Dental Officer has worked with First Nations and Inuit organizations to conduct a national oral health survey in First Nation and Inuit communities. The design of the survey included questions from the oral health module of the Canadian Health Measures Survey to allow for comparisons to the national picture, plus additional questions that are specific to the needs of a First Nation and Inuit population.

The OCDO has published the results of the Inuit Oral Health Survey. The Technical report is now available on the Health Canada Web site, as well as the Summary report.

c) Oral Health Status of the Homeless in Toronto

The OCDO is planning a study to assess the oral health status of the homeless in Toronto. The study is currently being planned, in consultation with the Toronto Oral Health coalition. Partners on the project include the University of Toronto (U of T) and George Brown College. The oral health questions and examination in the Canadian Health Measures Survey (CHMS) will be used to provide comparable data to the national population data.

d) The Oral Health of our Aging Population study

The OCDO is supporting researchers from Dalhousie University with a study to assess the oral health status of adults aged 45 years and older in Nova Scotia. The survey is cross-sectional and includes a qualitative and a clinical component.

Federal, Provincial, Territorial Dental Working Group

The Next link will take you to another Web site Federal-Provincial-Territorial Dental Working Group is a forum of oral health professionals consisting of representatives from each of the provinces and territories. This working group's efforts are aimed at facilitating exchanges of information and expertise, while respecting each partner's jurisdictional responsibility for such things as delivery of health services and policy development or strategy development.

The working group has one face to face meeting per year and has at least two teleconferences per year. The Office of the Chief Dental Officer provides the Secretariat for this committee.

The FPTDWG is now connected to the Public Health Network through the agenda of the Chronic Disease and Injury Prevention and Control Expert Group (CDIPCEG).

Federal Dental Care Advisory Committee (FDCAC)

The FDCAC is a committee of oral health professionals who provide advice to the Office of the Chief Dental Officer and to the six Federal Departments that directly provide dental case services to clients. The advice the committee provides to the Chief Dental Officer and to each of the federal departments is unbiased, based on current science in the dental field and takes the oral health needs of the federal clients of a dental program into consideration.

The Committee may have up to four scheduled meetings each year, and may be required to meet for an additional meeting depending upon the needs of the federal departments.  The Secretariat for this committee is provided by the Office of the Chief Dental Officer.

Working with First Nations and Inuit Health Branch's Children's Oral Health Initiative (COHI)

The Children's Oral Health Initiative (COHI) was developed by First Nations and Inuit Health Branch's (FNIHB) Dental Division as a means to address the disparity between the oral health of First Nations and Inuit and that of the mainstream Canadian population. The Office of the Chief Dental Officer (OCDO) is providing consultation services to FNIHB Dental Division with the implementation of this initiative.

Working with Non-Insured Health Benefits (NIHB) on improvements to the dental schedule

The Office of the Chief Dental Officer (OCDO) continues to work with the Non-Insured Health Benefits (NIHB) program to reduce the administrative requirements with the processing of dental benefits.  This will improve program use by dental providers, and will ultimately improve the client population's access to dental providers.

Updating the report on Dental Care Programs in Canada - Historical Development, Current Status and Future Directions or the "Stamm Report"

This report outlined and described the historical development of dental care programs in Canada. The original report, released in 1983, has not been updated in the last 20 years and provided the last indication of what public dental care programs exist in Canada. The Office of the Chief Dental Officer (OCDO) will undertake an environmental scan of the dental public health activities now underway in Canada and will update the report with current information.

For more information visit the Next link will take you to another Web site Canadian Association of Public Health Dentistry

Dental Public Health Expenditures in Canada, 2007/08

Governments contribute about 6% of the total oral health expenditures in Canada. This contribution comes from either federal, provincial, territorial, or municipal agencies to provide oral health services to specific populations.

The following tables describe these expenditures across Canadian jurisdictions. The column "Targeted dental public health expenditures" describes the spending by public health agencies on oral health promotion and education initiatives, or for direct delivery treatment programs aimed at at-risk populations (e.g., low-income children, long-term care residents).

The column "Targeted treatment expenditures for the socially marginalized" describes the spending by social services agencies, and is usually targeted to low-income populations receiving social funding (e.g., social assistance recipients, disability assistance recipients). This care is usually indirect, meaning that even though it is paid for by governments, it is delivered in the community through private practitioners.

"Canada Health Act expenditures" is the spending done by health ministries, usually for surgical-dental services that require hospitalization, such as for congenital anomalies (conditions requiring correction at the time of birth such as cleft lip), or serious trauma.

Dental Public Health Expenditures in Canada, 2007/2008
  Targeted dental public health expenditures ($) Targeted treatment expenditures for the socially marginalised ($) Canada Health Act expenditures ($) Total publicly financed dental care expenditures ($)

Table 1 footnotes

Table 1 footnote a

Estimate
Source: Quiñonez CR, Sherret L, Grootendorst P, Shim MS, Azarpazhooh A,Locker D. An environmental scan of provincial/territorial dental public health programs. Community Dental Health Services Research Unit, University of Toronto.

Return to table 1 footnote a referrer

British Columbia 3,500,000 44,809,000 1,539,000 49,848,000
Alberta 6,000,000Table 1 footnote a 40,000,000Table 1 footnote a 3,276,000 49,276,000
Saskatchewan 1,200,000Table 1 footnote a 7,247,000 1,511,000 9,958,000
Manitoba 1,800,000Table 1 footnote a 4,300,000 985,000 7,085,000
Ontario 33,000,000Table 1 footnote a 65,500,000Table 1 footnote a 14,230,000 112,730,000
Qubec 45,529,000 47,710,000 5,966,000 99,205,000
New Brunswick 50,000 3,400,000 505,000 3,955,000
Nova Scotia 1,000,000 9,220,000Table 1 footnote a 1,064,000 11,284,000
Prince Edward Island 2,389,000 533,000 91,000 3,013,000
Newfoundland/Labrador 0 5,740,000 313,000 6,053,000
Nunavut 1,700,000 1,700,000
Northwest Territories 1,067,000 348,000 1,415,000
Yukon 375,000 221,000Table 1 footnote a 25,000 621,000
Federal 247,687,000 247,687,000
Total   603,830,000
Federal Public Dental Health Care Expenditures, 2007/08
Federal organisation Expenditures ($)
Department of National Defence 27,000,000
Veterans Affairs Canada 18,000,000
Royal Canadian Mounted Police 8,888,000
Correctional Services Canada 2,800,000
Citizenship and Immigration Canada 999,000
Health Canada 190,000,000
Total Federal 247,687,000
Source: Public Dental Care Programming and Human Resources in Canada, 2007/2008.
Community Dental Health Services Research Unit, Faculty of Dentistry, University of Toronto

Fluoride

Experts confirm the benefits of fluoride for dental health

A global consultation on fluoride and oral health was held in Geneva on 17-19 November 2006. The consultation was jointly organized by the Next link will take you to another Web site World Dental Federation, Next link will take you to another Web site International Association for Dental Research (IADR), and the Next link will take you to another Web site World Health Organization (WHO) to discuss development of effective legislation, necessary directives and programs to ensure access to fluoride for dental health in all countries. To review a press release about the results of the consultation in either English or French, consult the Next link will take you to another Web site World Dental Federation Web site.

For more information on Health Canada's Fluoride policies, visit the "It's Your Health" article on Fluoride and Human Health

The status of water fluoridation in Canada

The U.S. Centers for Disease Control and Prevention have recognized water fluoridation as one of the ten great public health achievements of the twentieth century. In Canada, provincial and territorial governments are responsible for the safety of drinking water. The fluoridation of drinking water supplies is a decision that is made by each municipality, in collaboration with the appropriate provincial or territorial authority. The Office of the Chief Dental Officer (OCDO) has completed a second scan of the areas in Canada where the water is fluoridated. This revised information was collected from Provincial or Territorial Environment Ministries and then verified by the Dental Directors of each province and territory in 2007. Between 2005 and 2007, there was an increase from 42.6% to 45.1% of the number of people who had access to fluoridated water in Canada.

Provincial and Territorial Estimates for Community Water Fluoridation Coverage in 2007
Province/Territory Total
Population
Population
with
fluoridated
water
Population
without
fluoridated
water
Percent
with
fluoridated
water
Percent
without
fluoridated
water
British Columbia 4,113,000 152,241 3,960,759 3.7% 96.3%
Alberta 3,290,350 2,457,406 832,944 74.7% 25.3%
Saskatchewan 968,157 356,096 612,061 36.8% 63.2%
Manitoba 1,148,401 803,116 345,285 69.9% 30.1%
Ontario 12,160,282 9,229,015 2,931,267 75.9% 24.1%
Quebec 7,546,131 489,420 7,067,711 6.4% 93.7%
New Brunswick 729,498 188,607 540,891 25.9% 74.2%
Nova Scotia 913,462 519,031 394,431 56.8% 43.2%
Prince Edward,
Island
135,851 32,174 103,677 23.7% 76.3%
Newfoundland/
Labrador
505,469 7,572 497,897 1.5% 98.5%
Nunavut 29,474 0 29,474 0.0% 100.0%
Northwest
Territories
41,464 23,400 18,034 56.4% 43.6%
Yukon 30,372 0 30,372 0.0% 100.0%
Canada 31,611,911 14,258,078 17,364,803 45.1% 54.9%
 

Canada's Chief Dental Officer Weighs in on Fluoride

In light of ongoing news features, Canadians may be wondering if fluoride is, in fact, safe for use in our water supply and in dental hygiene products, such as toothpaste.

An expert panel, commissioned by Health Canada to review the scientific studies available on fluoride and its possible effects on health, made a number of recommendations to Health Canada, including:

  • to slightly decrease the amount of fluoride that can be added to municipal drinking water,
  • to encourage the availability and use of low-fluoride toothpaste by children, and
  • to suggest to makers of infant formula to reduce levels of fluoride in their products.

This Findings and Recommendations of the Fluoride Expert Panel (January 2007) report was submitted to the federal government in January of 2007, and made public in June, 2008 on Health Canada's Web site.

Letter from Canada's Chief Dental Officer - July 30th, 2008

As the Chief Dental Officer for Canada, I would like to highlight some of the many benefits of water fluoridation.

Water fluoridation is the process of adjusting the level of fluoride in the water to provide dental health benefits. Many governments and health organizations, including Health Canada, the Canadian Public Health Association, the Canadian Dental Association, the Canadian Medical Association and the World Health Organization endorse the fluoridation of drinking water to prevent tooth decay. Community water fluoridation has been identified by U.S. Centers for Disease Control as one of 10 great public health achievements of the 20th century.

Canada has one of the best systems in the world to ensure water quality. Health Canada supports water fluoridation as a public health measure to prevent dental decay. Dental disease is the number one chronic disease among children and adolescents in North America; fluoridation can therefore be an important public health measure.

An expert panel was formed to provide Health Canada with advice and recommendations on the current state of relevant science with respect to the fluoridation of water. The report from the panel reinforces Health Canada's position that water fluoridation is important from a public health perspective and that our position on water fluoridation is sound. The report's recommendations are based on the latest science.

In undertaking the study, we consulted with a number of experts including scientists from the Universities of British Columbia, Toronto, Iowa; scientists from many areas of Health Canada; and also received input from the Canadian Dental Association, the U.S. Environmental Protection Agency and public health experts from Canada and the U.S.

The safety and efficacy of water fluoridation has been frequently studied and continues to be supported by current science. Canadian and international studies agree that water that was fluoridated at optimum levels does not cause adverse health effects. For example, an adult male would need to consume at least 15,000 litres of water that is fluoridated at optimum levels continuously in one sitting to get an acute toxic (lethal) dose of fluoride.

There is also no evidence to suggest that children should avoid drinking fluoridated water at the accepted levels in Canadian drinking water supplies.

The big advantage of water fluoridation is that it benefits all residents in a community, regardless of age, socioeconomic status, education, or employment. Health Canada continues to support water fluoridation as a safe, cost effective public health measure, and encourages Canadians to review respected and credible sources of information to reach their own conclusions about water fluoridation.

International Involvement

Developing an Oral Health Strategy with the Pan American Health Organization (PAHO)

The Chief Dental Officers from countries involved with the Pan American Health Organization (PAHO) have jointly developed an Oral Health Strategy to improve the general health in the Americas through critical advancements in oral health through 2005-2015. Canada's Chief Dental Officer was appointed a member of the four country advisory group that worked on the development of the strategy.

Canada's participation in the initial drafting of the document was done with Chile, Mexico, Barbados, and PAHO representatives from Washington. The document went to all member countries for their input and comments and was further discussed at the PAHO Chief Dental Officers meeting in Montreal at the FDI in 2005. A final review of the strategic plan occurred at the 138th session of the PAHO Executive Committee in June 2006 for ratification and approval to go to the Directing Council in September 2006.

At a Directing Council meeting in September 2006, a resolution ( Next link will take you to another Web site Resolution CD 47.R12 (PDF Version - 21 K)) to approve the Oral Health Strategy was passed.

The resolution emphasized ensuring a basic level of access to oral health care, encouraging effective interventions such as fluoridation programs and establishing public policies in oral health

World Dental Federation

The Chief Dental Officer of Canada is the Chair of the International Chief Dental Officers (CDO) Public Health Section of Next link will take you to another Web site  World Dental Federation. This role involves communicating with about 194 chief dental officers from about 160 countries.

Dental Public Health Human Resources

The dental public health workforce is a key and necessary component of Canada's public health care system, often meeting the needs of those Canadians that access dental care through public financing. In an effort to learn more about their numbers and work environments, the Public Health Agency of Canada, in conjunction with the Office of the Chief Dental Officer, recently commissioned a scan of dental public health human resources across the country. Below is a summary table from this work, showing, in full-time equivalents, the number of dental public health specialists, and those dental health professionals, currently working within Canada's public health care system. This information was collected from members of the Federal, Provincial, and Territorial Dental Directors and consultants Working Group, and from provincial, territorial, municipal, and federal health jurisdictions.

Dental Public Health Human Resources in Canada, full time equivalents 2007/2008
Dental Public Health Specialist Dentists in Community Practice Dental Therapists Dental Hygienists Dental Assistants Other
47.32 66.51 152.6 453.21 236.23 148.12
Source: Public Dental Care Programming and Human Resources in Canada, 2007/2008.