Providing dental insurance can positively impact oral health outcomes in Ontario

BMC Health Serv Res. 2020 Feb 17;20(1):124. doi: 10.1186/s12913-020-4967-3.

Abstract

Background: Universal coverage for dental care is a topical policy debate across Canada, but the impact of dental insurance on improving oral health-related outcomes remains empirically unexplored in this population.

Methods: We used data on individuals 12 years of age and older from the Canadian Community Health Survey 2013-2014 to estimate the marginal effects (ME) of having dental insurance in Ontario, Canada's most populated province (n = 42,553 representing 11,682,112 Ontarians). ME were derived from multi-variable logistic regression models for dental visiting behaviour and oral health status outcomes. We also investigated the ME of insurance across income, education and age subgroups.

Results: Having dental insurance increased the proportion of participants who visited the dentist in the past year (56.6 to 79.4%, ME: 22.8, 95% confidence interval (CI): 20.9-24.7) and who reported very good or excellent oral health (48.3 to 57.9%, ME: 9.6, 95%CI: 7.6-11.5). Compared to the highest income group, having dental insurance had a greater ME for the lowest income groups for dental visiting behaviour: dental visit in the past 12 months (ME highest: 17.9; 95% CI: 15.9-19.8 vs. ME lowest: 27.2; 95% CI: 25.0-29.3) and visiting a dentist only for emergencies (ME highest: -11.5; 95% CI: - 13.2 to - 9.9 vs. ME lowest: -27.2; 95% CI: - 29.5 to - 24.8).

Conclusions: Findings suggest that dental insurance is associated with improved dental visiting behaviours and oral health status outcomes. Policymakers could consider universal dental coverage as a means to support financially vulnerable populations and to reduce oral health disparities between the rich and the poor.

Keywords: Canada; Dental care; Dental insurance; Dental outcomes; Dental utilization; Dental visits; Insurance; Oral health; Privately financed care.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Female
  • Health Surveys
  • Humans
  • Insurance, Dental / statistics & numerical data*
  • Male
  • Middle Aged
  • Ontario
  • Oral Health / statistics & numerical data*
  • Universal Health Insurance
  • Young Adult