Pediatric dental surgeries have risen alarmingly on mid-Vancouver Island. Between 2013 and 2014, the number of kids receiving this treatment jumped 42 per cent (those being the most recent figures available). Because the operation requires a general anesthetic and involves children under five, it should always be a last resort.
We’re not the worst in the country. Some areas of northern Saskatchewan have truly appalling records.
In that province’s Athabasca region, for example, 285 kids out of every 1,000 have dental surgery to repair or extract infected teeth.
That is the definition of a public-health crisis. By comparison, 30 children out of 1,000 on Central Vancouver Island require this form of treatment.
Nevertheless, this is still an unacceptably high number. Indeed, it represents the fourth-worst score in Canada among non-remote regions. (Quebec did not participate in the study, but since that province provides free dental care to children, surgery rates are probably low.)
And these are only the operations that are reported. There might be others that fall through record-keeping gaps.
Part of the immediate cause is the high level of poverty on the mid-Island. Children from less-affluent families are four times more likely to have this procedure.
Part is the relatively large aboriginal population. Kids from First Nations backgrounds are eight times more at risk. Lack of fluoridated drinking water could also be a factor.
But the more pressing question is why this situation was allowed to arise in the first place, and why it continues. It has long been known that poverty and indigenous status are strongly linked to childhood dental problems.
In addition, it is also known that kids who have dental surgery before age five are likely to require repeat treatments as they grow up. This is not, in other words, a one-shot problem.
Cost, by and large, shouldn’t be an issue. Under the B.C. Healthy Kids program, low-income youngsters receive $1,400 toward dental treatment every two years.
It’s true some dentists refuse to accept reimbursement from government sources and demand cash on the spot. That is unhelpful behaviour.
But the real problem goes much deeper. A child’s dental health isn’t always the top priority for families living at the margin.
The numbers tell the tale. In 2014, 266 children under five years old had dental surgery on the mid-Island. Yet procedures of this kind don’t become necessary overnight. They follow a long period of neglect in which kids who should have seen a dentist, didn’t.
The First Nations Health Authority runs preventive services on Vancouver Island. Travelling dental hygienists provide fluoride varnishing, sealants and temporary fillings for pre-school kids.
Efforts are also made to educate new mothers on the basics of oral health, such as proper brushing, use of fluoridated toothpaste and avoidance of sugary drinks.
But that only intensifies the mystery. Why does this problem persist?
Economics play a major role. Dentists in private practice (and those are the great majority) find it financially impractical to open offices in small communities. As a result, many villages on the mid-Island have no resident dentist. Itinerant services, however important, leave too many gaps.
And here we come to the nub of the matter. There is not a single difficulty to overcome, there are many.
Given time, the FNHA is by far the best-placed agency to break down cultural and geographic impediments. However, it is only three years old, and not yet fully up to speed.
Island Health lends a hand, but the hard truth is this: The resources committed to date are not sufficient. There are hundreds, likely thousands, of young children who have a right to expect better.
