Is private insurance enough to address barriers to accessing dental care? Findings from a Canadian population-based study

Abstract

Background In Canada, as in many other countries, insurance plays a crucial role in facilitating access to dental care. Private dental insurance, though it greatly reduces financial barriers to dental care, does not guarantee affordability, as there are issues with the quality and level of coverage of insurance plans. Individuals experiencing barriers to dental care are expected to have poorer oral health. It is important to examine access to dental care and the oral health status of individuals with private insurance. Methods Our study is a secondary data analysis of the most recent available cycle (2017-18) of the Canadian Community Health Survey (CCHS), a national cross-sectional survey. Univariate analysis was conducted to determine the characteristics of Ontarians with private insurance (n = 17,678 representing 6919,814 Ontarians)—bivariate analysis to explore their financial barriers to dental care, and how they perceive their oral health. Additionally, logistic regressions were conducted to identify relationships between covariates and each outcome variable in our study (cost barriers to dental care, visiting the dentist only for emergency, perceived their oral health as “fair to poor” and “dissatisfied and very dissatisfied” with their teeth/denture appearance). Results We found that the majority of those with private insurance did not experience cost barriers to dental care and perceived their oral health as good to excellent. However, specific populations, including those aged 20–39 years, and those earning less than $40,000, despite having private dental insurance, faced significantly more cost barriers to access to care. Additionally, those with the lowest income (earning less than $20,000) perceived their oral health as “fair to poor” more than their counterparts. Adjusted estimates revealed that respondents aged 20–39 were six times more likely to report cost barriers to dental care and ten times more likely to visit the dentist only for emergencies than those aged 12–19. Additionally, those aged 40–59 were two times more likely to report poorer oral health status compared to those aged 12–19. Conclusion Given the upcoming implementation of the Canadian Dental Care Plan, the results of this study have implications for identifying vulnerable populations who currently are ineligible for insurance coverage.