Canada's War on Poverty: Why is he out of work?

Jason Jones is a natural for a sales job. Trouble is, many people can't see past his mouth. Painful rot forced him to pull almost all of his teeth. This is the state of dental care for our working poor -

Decayed to the bone, his nerves exposed, the years of endless pain led Jones to seek the removal of his teeth, using his wife's entire savings to pay the oral surgeon's $600 fee.

The reason Jones lost his teeth is simple: he is poor. There is no public dental insurance for the working poor in Ontario, and only partial coverage for those on social assistance, meaning the government will pay for a few emergencies, such as tooth extraction, but not to prevent them from rotting in the first place.

Two months after the surgery, Jones's appearance is startling – he has the wide eyes of youth and the gaunt jaw of an elderly man. And worse, he is still in pain. The surgeon left in his two bottom front teeth, saying they would be anchors for his false teeth, but they are rotten and feel like shards of broken glass poking into his gums.

A dentist at a low-cost clinic quoted him $2,150 for the final two extractions, tooth posts and dentures, far out of his price range, but he is hoping to find a new job and save enough money.

For now, he is learning to eat only soft foods. "I maybe eat one meal a day. I can eat chicken, if I cook it just right. I chew it with my fingers in a way. Sandwiches, I can eat. Peanut butter and jam sandwiches. I can chew them with my tongue," he says.

The lack of dental coverage means those with little money have been shut out of the preventive care that leads to healthy teeth. No one knows how many go without dental benefits but nearly 900,000 Ontarians survive on low incomes, meaning they are either on social assistance or working in low-paying jobs.

Medically, dental disease is associated with diabetes, heart conditions, infections and diminished health. Economically, it lessens the odds of finding a job, or job advancement.

Medical practitioners who work with the poor say the impact is extreme. Minor tooth problems turn into decay, which can develop into abscesses and require extraction. One doctor described a beautiful woman with a low income with gaping holes in her teeth. A nurse said patients with minor dental problems will watch their teeth blacken in a decade if they do not receive treatment.

Toronto Public Health operates 13 free dental clinics for low-income children and seniors, and there are several other clinics that offer lower fee services to residents of all ages. But, the city's chief dentist, Dr. Hazel Stewart, says waiting lists are months long and for most working poor adults, affordable dental care is unattainable.

"I get calls from people who are trying to go for a job interview. They say, `Can you help me? Because my front teeth need to be fixed and I know I am not going to get the job looking like this.' Really, there is no place for me to send people like that," Stewart said.

Dr. Stephen Abrams, a Toronto dentist and spokesperson for the Ontario Dental Association, says low-income adults in Ontario have very few options. "You are really in a very difficult situation."

"Tooth decay is an infectious disease and it needs to be treated just as one would treat other diseases," he said.

Dental care was not included in the Canada Health Act, the legislation that determines which medical treatments provincial insurance like OHIP must cover. The federal Act only requires that provinces pay for dental care that requires treatment in hospital.

In Ontario, social assistance programs like Ontario Works and the Ontario Disability Support Program provide limited dental care. Children whose families are on social assistance receive basic preventative dental care until they are 18 as long as they remain in school. Adults on Ontario Works, formerly called welfare, are only entitled to emergency care. In Toronto, that includes extractions and root canals of the front teeth. There is no preventative care.

For children whose parents are on low incomes, but not receiving social assistance, there are 13 clinics across the city that provide basic dental care.

Low-income seniors also receive treatment at these clinics. Every year, there are 20,000 visits from children and youth, and 7,000 from seniors. Additionally, there are six community or university clinics that offer either free services to street youth, or lower cost services to adults.

Dr. Michael Cusato has a private dental practice but volunteers at the Urban Dental Clinic at Scarborough Hospital on Lawrence Ave., a clinic for low-income residents who need mostly emergency care. Demand for the volunteer dentists who staff the clinic is so high that there is a waiting time of several months.

"A lot of time is spent putting out fires," Cusato said. "There is a need for the preventative aspect, where they can come in and get their teeth cleaned, because a lot of gum diseases and things like that need regular care."

Some clinics, like the one offered by George Brown College, provide low-cost cleanings, but few offer more than emergency care that Dr. Cusato provides. Outside of Toronto, the need is even higher. Advocates say that without a provincially mandated dental plan, the services will continue to be hit and miss.

Organizations like the ODA and the Toronto Dental Health Coalition have separately lobbied the Ontario government, asking it to provide basic dental care to low-income residents, and to improve coverage for adults on social assistance. Little has changed, although people returning to work after being on social assistance are now entitled to keep their medical and dental benefits for six months. So people like Jones, who has spent his adult life working in full-time, low-income jobs and cannot afford any dental fees, are simply out of luck.

From the time he was a child in North Bay, Jones had trouble with his teeth. He has a tiny mouth and his teeth grew in twisted and crowded. In his sleep, he ground them down, digging holes through the enamel. His mother was on social assistance, so he received basic dental care. He was given a mouth guard to stop the grinding, but wore it out in a few weeks. Over time, he had some fillings and a few teeth pulled in an attempt to make room in his crowded mouth.

There was no money for braces, so his teeth remained crooked, the cause, dentists have since told him, for the incessant grinding. Over the years, as his teeth rotted, his nerve endings became exposed. His teeth grew painful to touch and difficult to clean.

When he was 23, Jones and his live-in partner, Candice, moved to Toronto. For one year, she worked in a daycare centre, and Jones had access to her company benefits. He immediately saw a dentist, who used up Jones' annual limit trying to clean his teeth and give him fillings. It was too late. The pain from the cleaning, Jones said, brought tears to his eyes and his teeth were so decayed that the fillings fell out.

In job interviews, potential employers stared at him. His personality veers towards gregarious, making him a natural for sales, but the jobs he found were out of the public eye. He worked full-time in machine shops, running the punch press.

"I was really good at what I did, I was really fast," Jones said. When the pain was most acute, it forced him to slow down, and, combined with an injured arm, it diminished his production of parts. He quit some jobs, and was fired from others.

In the summer, Jones said, he went to see a pain specialist, Dr. Peter Charlebois, who practises at a clinic at Kennedy Rd. and Eglinton Ave. in Toronto. Charlebois was appalled at the state of his teeth, and his inability to pay for proper care.

"This is Canada," Charlebois said. "I cannot believe that this is happening in a country as wealthy as this."

The doctor sent him to a nearby dentist, who said the only solution was to have his teeth pulled. Jones was referred to an oral surgeon, who operated in Scarborough Grace Hospital in December.

For most Canadians, dental coverage is accessible through work or other private benefit plans.

For those who have it, it can mean visits to an oral hygienist for cleaning and other preventative treatments every three or four months.

Advocates, from those who represent poverty health coalitions to the Ontario Dental Association, have for years lobbied the province to increase dental care for the poor.

A few weeks ago, Abrams said the ODA met with officials from the community and social services ministry (which oversees the dental care offered by the Ontario Works and the Ontario Disability Support Program).

The association wants the ministry, along with the ministry of health, to increase funding so dental services can be offered in private clinics, the dental schools at the University of Western Ontario and the University of Toronto, and community health clinics. Prevention of tooth decay is a cornerstone of the ODA's proposal, he said.

"It needs a will on the part of the government to recognize that these are important services," Abrams said.

Provincially, little has improved. Federally, in 2004, a Chief Dental Officer, Dr. Peter Cooney was appointed, with a mandate that will, in part, examine dental care information collected by the Canada Health Measures Survey.

Toronto's chief dentist, Dr. Stewart, who was part of the Toronto Oral Health Coalition, said the appointment of her federal counterpart is a good first step but in the interim, wants the province to provide more care in community clinics.

"It is very difficult to tell someone who is in pain, or has a swollen face, that you have to wait three months before you see the dentist," Stewart said.

"Dentistry is pretty expensive. It wasn't written into the (Canada Health) Act and looking back, that doesn't make sense because, for example, an abscess in any place in your body should be looked after.

"There is no reason why you shouldn't, at the very least, have access to the relief of pain and the condition that is causing the pain. That is very basic, in any health system," Stewart said.

For Jones, it will be months before he can afford dentures. He is on unemployment insurance, looking for a new job and awaiting the birth of his first child.

Once, people stared at him because of his teeth. Now they stare because of the emptiness in his face.

"They say, Oh my God,' what happened to you?' I tell them, `It's a very long story. Goes back to the time I was a kid.'"

"The reason Jones lost his teeth is simple: he is poor. There is no public dental insurance for the working poor"

I didn't get a vacation last year because the government didn't give me one!! Woe is me!

This is Socialism in action. It can never be proven to fail, because its intentions are more important than its results. For its proponents, the answer is, and always will be: more money. Freedom of choice and independent decision-making are denied, and the most vulnerable are made to suffer while the elite get to opt out of a system they've inflicted on everyone else. It is a vision of HillaryCare in the USA, and a cautionary tale for those who care to pay attention.

The reason Jones lost his teeth is simple: he is poor

Nonsense. Plenty of poor people have their teeth. I say he didn't brush.

The Dentists are angling for their place under the Canada Health Act. I'm moved to tears.

"Show me just what Mohammed brought that was new, and there you will find things only evil and inhuman, such as his command to spread by the sword the faith he preached." - Manuel II Palelologus

A lot of private insurance plans simply don't offer stand-alone dental insurance. It's very expensive, either through insurance or for the patient paying out of pocket at the dentist's office.

Also dental care is very infrequent. Other than getting yearly cleanings, which can easily be paid for out of pocket, some people can go years without the need for dental work. That's another reason why people don't buy dental insurance.

I oppose universal health insurance, but I am open to states using a portion of the sales tax to encourage private insurance plans to offer stand-alone dental insurance for people, which would be at reduced rates as everyone is paying the sales tax anyway.

using his wife's entire savings to pay the oral surgeon's $600 fee.

Her entire life savings is 600 Canadian Dollars?

I say he didn't brush.That was my first thought too.

I am approaching 70 and I have all but two of my original teeth. The reason? I have always kept my teeth clean (brushing and flossing) and I have had regular dental check-ups, paid out of pocket.

How can one feel sorry for a joker like this?

looking for a new job and awaiting the birth of his first child.

Did not see this before. He is unemployed, has acute dental problems and he and his wife are going to have a baby. How could the writer not note that the guy is dumb as a rock?

Toothbrush, toothpaste and dental floss. Lay out, what, $10 for this stuff and by and large, you can get by. Yes, having cleanings by the hygienist and exams by the dentist are important, but you still have to do the maintenance.

And as broke as he is, he's choosing to have a child. They're not married, of course, and he's out of work, but why let little issues like those stop them? < shaking head in disgust>

This is Socialism in action. It can never be proven to fail, because its intentions are more important than its results.

It's just like the global warming issue. If we were to do everything they want us to do to "stop" it and it still got warmer, they would say it just proves we need to do even more. If it somehow does get cooler, then they would say they were right even if they can't prove what was done had anything to do with the cooling.

Socialist thinking is dangerous, especially when applied to children in public schools. It affects the collective mind to the point that I wonder if freedom can survive.

It affects the collective mind to the point that I wonder if freedom can survive.

The reason that Socialism is so dangerous is because there is no such thing as a "collective mind" - there are only individual minds and consciousnesses whose duty it is to make decisions that define the quality of the lives that they control. Socialism denies the validity of individual perception and decision-making ability, and substitutes for personal choice the powers of the all-knowing State.

God gave us our own minds and how we choose to use them is up to us. When others insist that they know better than we how to choose - we need to fight back, because when we do not object, our freedoms vanish like dew on the warm grass.

Throughtout mankind history and in the third world most don't brush. Someone's teeth rotting out at 21 is either chewing tobacco or meth in most cases.

Brush Your Teeth,
Round and Round,
Circles Small,
Gums and All.

Moving Your ToothBrush the Round and Round Way,
Will Keep Your Gums Healthy From Soft Tooth Decay,
So Clean Very Carefully 3 Times A Day,

Go Round And Round,
Yeah!! (HotRod Harry raspy voice)
Round and Round.

" It's very expensive, either through insurance or for the patient paying out of pocket at the dentist's office."

In the US, I've found dental expenses to be a reasonable amount of money. It's the physicians that nail me to the wall and big pharma that finishes me off.

It was surprising to hear Medicare doesn't include dental. But maybe that why dental is still affordable, I don't know.

Rubbish. Lack of preventive dentistry might be partially responsible for losing a couple of teeth early -- but Clyde here is a slow learner. Never brushed, never flossed, never changed his habits to save the rest of his teeth.

And by the looks of his chin stubble, he only shaves once a week. Probably bathes once a week (except in winter when he does without). Clyde never pays attention to personal hygiene.

He's a natural born salesman, they say? Salesmen all lie through their teeth. Clyde has a problem with that!

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