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Left Behind: The People Who Lack Access to Oral Healthcare

Adapted from the Kitchener-Waterloo Community Foundations’ Report Left Behind: The State of Oral Health in Waterloo Region.

Published March 2023

Access to dental care is often overlooked and underfunded, and is deeply intertwined with complex social issues, from the rise of precarious employment to increasing food insecurity. One thing is clear – for many of the most vulnerable people in our communities, the current system has left them behind and without support.

This report highlights the importance of oral health and analyzes the state of oral health in Waterloo Region compared to other regions. It also takes a deeper look at who has dental insurance in Waterloo Region and who doesn’t, and provides recommendations for how oral health outcomes can be improved in the region. It outlines community organizations, public health efforts, and initiatives underway in Waterloo Region that are providing critical oral health programs.

The study draws on data from the 2017/2018 Canadian Community Health Survey (CCHS), which includes responses from more than 1,216 respondents from the Waterloo Region aged 12 and older

Waterloo Region is prosperous, with higher-than average median household after-tax income. Nevertheless, approximately 138,000 residents (30% of all residents) are falling through the cracks and do not have dental insurance. The problem is especially acute for racialized residents, 39% of whom lack insurance.

The implications of these problems ripple across so many domains of health. Poor oral health is linked to worse physical, mental and social outcomes, and represents a pressing and underserved health-care issue.

  • The association between oral inflammation and heart disease
  • Growing evidence that tooth pain causes depression and that depression worsens oral health
  • Employment opportunities decrease for those with worse oral health
  • Poor oral health and tooth loss can contribute to locking individuals in a cycle of homelessness
  • Low-income students have higher rates of dental pain contributing to worse academic performance
  • Renters report much worse oral health and much fewer visits to the dentist, primarily because of cost

As Waterloo Region has become an increasingly expensive housing and rental market, this (and other cost of living increases) will continue to leave residents with fewer resources for dental care and other critical health needs.

Find the full report at: www.kwcf.ca/publications

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The Integrated Circle of Care is a fluid and collaborative approach followed by workers from different agencies weaving through St. John’s Kitchen. Within this approach, staff members from each agency are aware of their specific personal roles. However, the high level of collaboration between workers means that people can approach any worker, without knowing their agency association or specific role, and still receive support – either that worker will support the person directly, or they will introduce the person to another worker who can support the person more appropriately.

This approach makes relationships more natural and support more accessible. Workers from different agencies are easily approachable, meaning that people build relationships with multiple workers. Having relationships with different workers is important to a person’s support – it makes support from a trusted source easy to find, and means that people have a choice of worker to approach in any given situation.

In order to maintain a circle of care around a person, workers from different agencies ask for consent from the person for information to be shared between workers. Continuous communication between workers helps to ensure that people do not fall into gaps between services, and also that services are not duplicated.