New Manitoba senator says federal dental program for First Nations, Inuit communities isn't working

Manitoba's newest senator says dental disease is a real issue on First Nations and a federal program isn't helping.

Sen. Mary Jane McCallum, who was appointed last December, spoke up at her first Senate committee meeting this week.

Auditor General Michael Ferguson outlined his assessment of the Children's Oral Health Initiative — a federal program which focuses on the prevention of dental disease and promoting good oral health practices in First Nations and Inuit communities — at the meeting on Canada's relationship with First Nations, Inuit and Métis people. 

"The state of dental disease [on First Nations] is more than twice the [national] level," McCallum told the meeting.

Before she was appointed to the Senate, McCallum managed community health and dental programs in her home community of Brochet, Man., and provided dental services throughout the North through the federal First Nations and Inuit Health Branch.

"When I go into a community I have 25 [appointment] slots to give to First Nations," McCallum said. "And sometimes there's 200-300 people that come in."

The care we deliver is all emergency work. There's no comprehensive work, so when you look at First Nations improving their oral health … it contributes to systemic health.- Sen. Mary Jane McCallum

McCallum said in some regions of northern Manitoba, four dentists would rotate through, which means there is no continuity of care and little trust between dentist and patient.

McCallum said at one point, she was the sole part-time dentist for 12,000 people.

"The care we deliver is all emergency work. There's no comprehensive work, so when you look at First Nations improving their oral health … it contributes to systemic health," McCallum told the meeting.

"When you look at delivering care from emergency care, we've trained people to access care only when they're in pain."

She said conditions in some communities mean oral care becomes a low priority when other basic services aren't provided.

"When you have houses that don't even have closets, you can't take a glass to put your toothbrushes in. Where do you store the toothbrushes? So they're all over the house, they're thrown in the toilet by the younger kids. The students will say to me, 'Oh my little brother threw it in the toilet.' And the mother is like, 'Who cares about the toothbrush?' … They're not even having their basic needs met," McCallum said.

When it comes to the Children's Oral Health Initiative program, McCallum worries dentists who go into First Nations communities may focus more on procedures such as root canals and surgeries that provide them with a higher rate of pay for dentists than those that focus on general oral health.

"So if I'm providing appropriate care to the people which is restorative, my per diem comes down," McCallum said.

She also expressed concern that there is a sense that the COHI program is working to improve dental health among First Nations' children.

"I look at the COHI program, and I work in an area where it's been there for 10 years. There is an increase in general anesthetic, which means that the COHI program isn't working," McCallum said.

Ferguson said when it comes to systemic and socioeconomic issues in First Nations in Canada, there has been little improvement in the six years he has been auditor general. 

In an emailed statement, a spokesperson for Health Canada and the Public Health Agency of Canada noted that the 2017 federal budget included an additional $45.4 million over five years to expand the Children's Oral Health Initiative. 

"We strongly believe that the oral health services provided to First Nations are making a difference," the statement from spokesperson Maryse Durette said.

"Indigenous Services Canada is engaging with national and regional First Nations and Inuit partners to better understand their oral health needs and plan for the implementation of these investments, so that more First Nations and Inuit have access to these services."