Martine Christiana, Quiñonez Carlos, Marchildon Gregory P
Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
J Public Health Dent. 2025 Dec;85(4):388-398. doi: 10.1111/jphd.70002. Epub 2025 Jul 17.
This paper outlines and compares the major provincial initiatives on dental care from the 1970s-with emphasis on Saskatchewan's innovative children's dental program-and their relevance to the current changes in Canadian dental policy.
Narrative review methodology. A snowball search was conducted on articles obtained through MEDLINE, Scopus, and ProQuest, followed by other databases such as Google Scholar. Primary data was collected from different sources: historical professional journals, archives, government reports, Hansard debates, and historical newspapers.
Saskatchewan and Ontario were on opposite ends of a government-sponsored dental care policy continuum during the 1970s. While Ontario never implemented a large-scale public dental plan, Saskatchewan carried out an effective province-wide children's dental plan using an alternate model of delivery, despite strong opposition from the dental profession. Dental public initiatives in other provinces lie between these two poles. While several considered employing dental therapists, they faced opposition from the dental profession, which reinforced the traditional model, despite its inability to resolve issues of access to care.
This study argues that while the current Canadian Dental Care Plan represents a major advancement towards more equality in dental care, it is unclear whether persistent issues of physical barriers to access will be fully resolved, and suggests employing an alternate model of delivery, proven to improve access to dental care in Canada. However, given organized dentistry's continuing resistance to dental therapists working largely independently, future studies should examine whether different levels of supervision and/or program format could yield greater acceptance.
本文概述并比较了20世纪70年代主要的省级牙科护理举措——重点介绍了萨斯喀彻温省创新的儿童牙科项目——以及它们与加拿大当前牙科政策变化的相关性。
采用叙述性综述方法。对通过MEDLINE、Scopus和ProQuest获取的文章进行滚雪球式搜索，随后搜索其他数据库，如谷歌学术。主要数据从不同来源收集：历史专业期刊、档案、政府报告、议会议事录辩论和历史报纸。
在20世纪70年代，萨斯喀彻温省和安大略省处于政府资助的牙科护理政策连续体的两端。安大略省从未实施大规模的公共牙科计划，而萨斯喀彻温省尽管遭到牙科行业的强烈反对，但仍采用另一种服务模式实施了一项有效的全省儿童牙科计划。其他省份的牙科公共举措介于这两个极端之间。虽然有几个省份考虑聘用牙科治疗师，但他们面临牙科行业的反对，这强化了传统模式，尽管传统模式无法解决获得护理的问题。
本研究认为，虽然当前的加拿大牙科护理计划代表了在牙科护理方面朝着更大平等迈出的重大进步，但尚不清楚获得护理的身体障碍这一持续存在的问题是否会得到充分解决，并建议采用另一种服务模式，事实证明这种模式可改善加拿大的牙科护理可及性。然而，鉴于有组织的牙科行业继续抵制牙科治疗师在很大程度上独立工作，未来的研究应考察不同程度的监督和/或项目形式是否能获得更大的接受度。
