Assessing the relationship between dental appearance and the potential for discrimination in Ontario, Canada

Poor oral health is influenced by a variety of individual and structural factors. It disproportionately impacts socially marginalized people, and has implications for how one is perceived by others. This study assesses the degree to which residents of Canada\u27s most populated province, Ontario, recognize income-related oral health inequalities and the degree to which Ontarians blame the poor for these differences in health, thus providing an indirect assessment of the potential for prejudicial treatment of the poor for having bad teeth. Data were used from a provincially representative survey conducted in Ontario, Canada in 2010 (n=2006). The survey asked participants questions about fifteen specific conditions (e.g. dental decay, heart disease, cancer) for which inequalities have been described in Ontario, and whether participants agreed or disagreed with various statements asserting blame for differences in health between social groups. Binary logistic regression was used to determine whether assertions of blame for differences in health are related to perceptions of oral health conditions. Oral health conditions are more commonly perceived as a problem of the poor when compared to other diseases and conditions. Among those who recognize that oral conditions more commonly affect the poor, particular socioeconomic and demographic characteristics predict the blaming of the poor for these differences in health, including sex, age, education, income, and political voting intention. Social and economic gradients exist in the recognition of, and blame for, oral health conditions among the poor, suggesting a potential for discrimination amongst socially marginalized groups relative to dental appearance. Expanding and improving programs that are targeted at improving the oral and dental health of the poor may create a context that mitigates discrimination

Oral health inequality in Canada, the United States and United Kingdom

The objective of this study was to quantify the magnitude of absolute and relative oral health inequality in countries with similar socio-political environments, but differing oral health care systems such as Canada, the United States (US), and the United Kingdom (UK), in the first decade of the new millennium. Clinical oral health data were obtained from the Canadian Health Measures Survey 2007–2009, the National Health and Nutrition Examination Survey 2007–2008, and the Adult Dental Health Survey 2009, for Canada, the US and UK, respectively. The slope index of inequality (SII) and relative index of inequality (RII) were used to quantify absolute and relative inequality, respectively. There was significant oral health inequality in all three countries. Among dentate individuals, inequality in untreated decay was highest among Americans (SII:28.2; RII:4.7), followed by Canada (SII:21.0; RII:3.09) and lowest in the UK (SII:15.8; RII:1.75). Inequality for filled teeth was negligible in all three countries. For edentulism, inequality was highest in Canada (SII: 30.3; RII: 13.2), followed by the UK (SII: 10.2; RII: 11.5) and lowest in the US (SII: 10.3; and RII: 9.26). Lower oral health inequality in the UK speaks to the more equitable nature of its oral health care system, while a highly privatized dental care environment in Canada and the US may explain the higher inequality in these countries. However, despite an almost equal utilization of restorative dental care, there remained a higher concentration of unmet needs among the poor in all three countries

Correction to: Providing dental insurance can positively impact oral health outcomes in Ontario (BMC Health Services Research, (2020), 20, 1, (124), 10.1186/s12913-020-4967-3)

Following publication of the original article [1], the authors would like to add some information in the Competing interests section. The updated content in the Competing interests is shown below: Carlos Quiñonez receives consulting income for dental care related issues from Green Shield Canada. All other authors declare no competing interests. The original article has been corrected

Changes in Social Inequality in Smoking-attributable Adult Male Mortality between 1986 and 2001 in Four Developed Countries

Social inequalities exist in smoking-attributable mortality rates of males. Change in these social inequalities in the past two decades in developed countries remains uncertain. This study was conducted in Canada, France, Poland, and Switzerland to quantify differences in smoking-attributable mortality rates, at ages 35-69 years, among different social strata in recent years and to examine the changes in social inequalities in these rates between 1986 and 2001. Analyses included 377,878 deaths from a total population of 13,482,210 males of these four countries. Smoking-attributable mortality rates reduced in all strata over the comparative time periods, in all countries, except France. This work specifically focuses to fill the gap in knowledge about whether tobacco control has reached the poor or lower social strata in developed countries. This study will enable follow up research including quantification of effects of the specific tobacco control policies in each country.MAS

A perspective: Challenges and opportunities of a novel national dental benefit

In Canada, the federal government launched the interim Canada Dental Benefit (CDB) on December 1, 2022, to support access to dental care for children <12 years. The interim benefit shows government's assurance to develop a long-term national dental care program. The benefit will be a cash transfer through Canada's revenue services agency, ranging from $260 to$650 annually. This perspective examines the federal initiative and reflects on its strengths and challenges to learn lessons, which can support the long-term solution that is being currently planned. This article outlines a number of positive aspects as well as challenges from the perspectives of varied stakeholders; the feasibility of the application process; remaining potential gaps due to restricted eligibility criteria; possible effects of unrestricted oral health care services and reimbursement rates; valuing of patient autonomy; guidelines for the expansion of the program to other populations; and remaining barriers to oral health care access are analyzed. The CDB is cause for excitement for the Canadian population because it is an opportunity to reduce affordability barriers to accessing dental care. That said, it is important to discuss anticipated challenges and indirect consequences, particularly through the lens of equity, to support the new CDB and the proposed national dental care program in achieving the much-awaited goal of putting the mouth back into the body

The Role of Dental Treatment in Welfare-to-Work

Background: Social assistance recipients in Canada receive limited dental care in order to meet health needs and to promote the move from welfare-to-work. Policy advocates argue for the expansion of such services for similar reasons. However, the hypothesis that dental care can improve the chances of employment has been rarely tested. This project was designed to provide policy makers better understanding about the relationship between dental treatment and employment outcomes among social assistance recipients of Ontario, Canada. Methods: First, we conducted a systematic review of the relevant existing literature. Then we designed a retrospective cohort study using large administrative data (total n = 8742) from five Ontario regions and from the province’s social assistance ministry. We also conducted an exploratory pilot study of a convenience sample of assistance recipients (n = 30) using a pre- and post-dental treatment survey. Results: Systematic review revealed minimal and weak evidence concerning the idea that dental services can improve employment outcomes. Our retrospective cohort study showed no significant difference in employment outcomes between treatment and no-treatment group (adjusted odds ratio = 0.93; 95% CI: 0.83-1.03). However, over the one year, people who received treatment (124% increase) had significantly better trajectory (p=0.0014) of leaving assistance as compared to their counterparts (83% increase). Our pilot study revealed that both oral health related quality of life (OHRQoL) and job-seeking self-efficacy (JSS) improved significantly after receiving dental care and there was a significant correlation between these two outcomes. Conclusion: Our research suggests that at one year, dental treatment does not appear to be significantly associated with leaving social assistance for employment. However, people who received dental treatment appeared to be particularly disadvantaged and dental treatment may have helped to level them up in terms of employment outcomes over time. Also, our results indicate that OHRQoL and JSS are correlated.Ph.D

Deconstructing the Seven Cs of Social Media: A Summative Perspective

One of the defining technological forces which are reshaping world today is the easy accessibility to the Internet. The Internet has changed the way people communicate with each other. Social media whose development was first marshaled by Web 2.0, has revolutionized the entire world of communication. The most intriguing fact is that the world of social media is constantly changing. The platforms which are topping the charts today may not be tomorrow. Also, it can be observed that the power has shifted from the hands of marketers to the hands of users which in turn have empowered users. The objective of the present study is to explore the different facets of social media in detail. These facets form the base for the world of social media and can be referred to as the 7 Cs of social media. These seven Cs are - content, community, conversation, capital (social), culture, collaboration, and conversion respectively. With an enhanced understanding of all these Cs of social media, the study proposes a conceptual model depicting the relationship between these seven Cs and social media. Companies should analyze each of these Cs in detail and design their social media strategies accordingly. This will not only assure the efficient and effective use of social media but also will help managers to decide where and how to allot firm resources in a better fashion.</p

Reviewing Teledentistry Usage in Canada during COVID-19 to Determine Possible Future Opportunities

During the COVID-19 pandemic, the limited in-person availability of oral health care providers resulted in an unprecedented utilization of the teledentistry tool. This paper reviews how Canadian organizations supported teledentistry and what can be expected about its usage in the post-pandemic era. An environmental scan across relevant Canadian federal, provincial, and territorial organizations was conducted to review pertinent publicly available documents, including dental regulators&rsquo; or associations&rsquo; COVID-19 guidance documents, government documents, and media articles. Almost all jurisdictions promoted teledentistry for triaging dental emergencies and screening patients for COVID-19 symptoms but not even half of them have developed guidelines in terms of modalities of usage, handling of personal information, informed consent process, or maintaining standards of practice. During the COVID-19 recovery phase, these advances across Canada will support in developing a comprehensive guidance for teledentistry and possibly specific codes for its utilization. This can create a niche for teledentistry as an adjunct to the main stream dental care delivery where some visits can always be accommodated virtually, reducing disparities in oral healthcare between rural and urban communities. Ultimately, this can potentially make oral health care delivery more effective, efficient, and environmentally friendly in Canada

An observational study to assess changes in social inequality in smoking-attributable upper aero digestive tract cancer mortality among Canadian males between 1986 and 2001

Abstract Background Tobacco and low socioeconomic status have been acknowledged as potential risk factors for upper aero-digestive tract (UADT) cancers in North America. In context of reducing adult male smoking prevalence (by over 50%), in the past few decades in Canada, this study tried to document changes in smoking-attributable UADT cancer mortality rates, among Canadian males of different social strata, between 1986 and 2001. Methods The contribution of smoking to UADT cancer mortality was estimated indirectly by using lung cancer mortality as an indicator of the accumulated mortality from smoking in a population. This method was applied to UADT cancer death rates of 35–69 year old socially stratified males. Data, stratified by neighborhood income quintile, could be obtained from Statistics Canada, for four census years, 1986, 1991, 1996, and 2001. Results A total of 2704 male deaths were analyzed. Between 1986 and 2001, UADT cancer deaths reduced by 30% (32 to 22 per 100,000) but the proportion of these deaths attributable to smoking reduced much more, by 41% (22 to 13 per 100,000). In the span of fifteen years, absolute social inequality (measured by rate difference between the highest and the lowest stratum) in smoking-attributable male UADT cancer mortality in Canada reduced by 47% and relative social inequality (measured by rate ratios) reduced by 9%. Conclusion The present analyses reveal that between 1986 and 2001, smoking-attributable UADT cancer mortality rates among adult males (35–69 years) in Canada reduced in all social strata and the social inequalities in these rates have narrowed. Analysis of more current data will be of interest to confirm these trends