Skip to main content Accessibility help

CAEP Dental Care Statement

  • Hasan Sheikh (a1) (a2)


Oral health is an important part of an individual's overall health; however, dental care is not included in the Canadian public healthcare system. Many Canadians struggle to access dental care, and six million Canadians avoid visiting the dentist each year due to cost.1 The most vulnerable groups include children from low-income families, low-income adults, seniors, indigenous communities, and those with disabilities.15 The lack of affordable, equitable, and accessible dental care puts undue strain on emergency departments across the country, as patients desperately seek the care of a physician when they actually need the care of a dental professional.6 Emergency physicians do not have the same expertise or equipment as dentists and, in most cases, are only able to provide temporary symptom relief. This results in an increased reliance on prescription opioids that would otherwise be unnecessary if patients could access the dental care they required.


Corresponding author

Correspondence to: Dr. Hasan Sheikh, Toronto General Hospital, 200 Elizabeth Street, Ground Floor, Room 480, Toronto, ONM5 G 2C4; Email:


Hide All
1.Canadian Academy of Health Sciences. Improving access to oral health care for vulnerable people living in Canada; 2014. Available at: (accessed June 10, 2018).
2.Birch, S, Anderson, R.Financing and delivering oral health care: what can we learn from other countries? J Can Dent Assoc 2005;71(4):5.
3.Locker, D, Maggirias, J, Quiñonez, C.Income, dental insurance coverage, and financial barriers to dental care among Canadian adults. J Public Health Dent 2011;71(4):327–34.10.1111/j.1752-7325.2011.00277.x
4.Ontario Agency for Health Protection and Promotion (Public Health Ontario). Report on access to dental care and oral health inequalities in Ontario. Toronto: Queen’s Printer for Ontario; 2012.
5.Quiñonez, C, Ieraci, L, Guttmann, A.Potentially preventable hospital use for dental conditions: implications for expanding dental coverage for low income populations. J Health Care Poor Underserved 2011;22(3):1048–58.10.1353/hpu.2011.0097
6.Quiñonez, C, Gibson, D, Jokovic, A, Locker, D.Emergency department visits for dental care of nontraumatic origin. Community Dent Oral Epidemiol 2009;37(4):366–71.10.1111/j.1600-0528.2009.00476.x
7.Quiñonez, C, Figueiredo, R, Azarpazhooh, A, Locker, D.Public preferences for seeking publicly financed dental care and professional preferences for structuring it. Community Dent Oral Epidemiol 2010;38(2):152–8.10.1111/j.1600-0528.2010.00534.x
8.Blaizot, A, Vergnes, J-N, Nuwwareh, S, Amar, J, Sixou, M.Periodontal diseases and cardiovascular events: meta-analysis of observational studies. Int Dent J 2009;59(4):197209.
9.Taylor, GW, Borgnakke, WS.Periodontal disease: associations with diabetes, glycemic control and complications. Oral Dis 2008;14(3):191203.10.1111/j.1601-0825.2008.01442.x
10.Daniel, R, Gokulanathan, S, Shanmugasundaram, N, Lakshmigandhan, M, Kavin, T.Diabetes and periodontal disease. J Pharm Bioallied Sci 2012;4(Suppl 2):S2802.10.4103/0975-7406.100251
11.Haerian-Ardakani, A, Eslami, Z, Rashidi-Meibodi, F, et al. Relationship between maternal periodontal disease and low birth weight babies. Iran J Reprod Med 2013;11(8):625–30.
12.Kellesarian, SV, Kellesarian, TV, Ros Malignaggi, V, et al. Association between periodontal disease and erectile dysfunction: a systematic review. Am J Mens Health 2018;12(2):338–46.10.1177/1557988316639050
13.Lin, T-H, Lung, C-C, Su, H-P, et al. Association between periodontal disease and osteoporosis by gender. Medicine (Baltimore); 2015. Available at: (accessed June 10, 2018).
14.Morita, T, Ogawa, Y, Takada, K, et al. Association between periodontal disease and metabolic syndrome. J Public Health Dent 2009;69(4):248–53.10.1111/j.1752-7325.2009.00130.x
15.Sfyroeras, GS, Roussas, N, Saleptsis, VG, Argyriou, C, Giannoukas, AD.Association between periodontal disease and stroke. J Vasc Surg 2012;55(4):1178–84.10.1016/j.jvs.2011.10.008
16.Moutsopoulos, NM, Madianos, PN.Low-grade inflammation in chronic infectious diseases: paradigm of periodontal infections. Ann N Y Acad Sci 2006;1088:251–64.10.1196/annals.1366.032
17.Simpson, TC, Weldon, JC, Worthington, HV, et al. Treatment of periodontal disease for glycaemic control in people with diabetes mellitus (ed. Cochrane Oral Health Group). Cochrane Database Syst Rev; 2015. Available at: (accessed June 10, 2018).
18.Yoneyama, T, Yoshida, M, Ohrui, T, et al. Oral care reduces pneumonia in older patients in nursing homes. J Am Geriatr Soc 2002;50(3):430–3.10.1046/j.1532-5415.2002.50106.x
19.D'Aiuto, F, Ready, D, Tonetti, MS.Periodontal disease and C-reactive protein-associated cardiovascular risk. J Periodontal Res 2004;39(4):236–41.
20.Hanson, GR, McMillan, S, Mower, K, et al. Comprehensive oral care improves treatment outcomes in male and female patients with high-severity and chronic substance use disorders. J Am Dent Assoc 2019;150(7):591601.10.1016/j.adaj.2019.02.016
21.Bedos, C, Levine, A, Brodeur, J-M.How people on social assistance perceive, experience, and improve oral health. J Dent Res 2009;88(7):653–7.
22.Quiñonez, C, Sherret, L, Grootendorst, P, et al. An environmental scan of provincial/territorial dental public health programs; 2007. Available at: (accessed June 14, 2018).
23.Devaux, M.Income-related inequalities and inequities in health care services utilisation in 18 selected OECD countries. Eur J Health Econ 2015;16(1):2133.
24.Canadian Dental Association. The state of oral health in Canada; 2017. Available at: (accessed July 10, 2018).
25.Canadian Institute for Health Information. National health expenditure trends, 1975 to 2017; 2017. Available at: (accessed June 10, 2018).
26.Canadian Dental Hygienists Association. Dental hygienists call for federal leadership to support taxpayers and improve oral care outcomes; 2015. Available at: (accessed June 10, 2018).
27.Brondani, M, Ahmad, SH.The 1% of emergency room visits for non-traumatic dental conditions in British Columbia: misconceptions about the numbers. Can J Public Health 2017;108(3):279.
28.Ontario Oral Health Alliance. Information on ER and DR visits for dental problems; 2017. Available at: (accessed June 10, 2018).
29.Sheikh, H. Prescription from ER doctor: expand public dental programs. Toronto Star; February 21, 2017. Available at: (accessed June 14, 2018).
30.Okunseri, C, Okunseri, E, Xiang, Q, Thorpe, JM, Szabo, A.Prescription of opioid and nonopioid analgesics for dental care in emergency departments: findings from the National Hospital Ambulatory Medical Care Survey: opioids analgesic and dental care. J Public Health Dent 2014;74(4):283–92.
31.Okunseri, C, Dionne, RA, Gordon, SM, Okunseri, E, Szabo, A.Prescription of opioid analgesics for nontraumatic dental conditions in emergency departments. Drug Alcohol Depend 2015;156:261–6.10.1016/j.drugalcdep.2015.09.023
32.Janakiram, C, Chalmers, NI, Fontelo, P, et al. Sex and race or ethnicity disparities in opioid prescriptions for dental diagnoses among patients receiving Medicaid. J Am Dent Assoc 2018;149(4):246–55.
33.Canadian Association of Public Health Dentistry Position Development Committee. A brief analysis of position statements on oral health and access to care; 2006. Available at: (accessed June 14, 2018).
34.Canadian Dental Hygienists Association. Access angst: a CDHA position paper on access to oral health services; 2003. Available at: (accessed June 14, 2018).
35.Canadian Dental Association. Position paper on access to oral health care for Canadians; 2010. Available at: (accessed June 10, 2018).


Type Description Title
Supplementary materials

Sheikh supplementary material
Sheikh supplementary material

 Word (54 KB)
54 KB

CAEP Dental Care Statement

  • Hasan Sheikh (a1) (a2)


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed