Economic considerations in geriatric oral health care: the Canadian experience

Two different provincial programs for geriatric oral health care are described. Their relevance to the United States requires an understanding of the universal, national hospital (1961), and medical (1971) care programs of Canada and the different sociopolitical philosophy of its people. Ontario's new geriatric preventive dentistry program provides free preventive dental services to elderly residents of collective living centers by province-wide dental public health staff. Although it covers only 7% of Ontario's older population in these centers, initiatives are underway to include other elderly persons and to provide cost subsidization for referred treatment, if required. Since 1973, Alberta has provided, through dentists and denturists in private practice, comprehensive free dental benefits to all residents over 64 years of age. About 38% of eligibles now use the plan annually. Cost escalation per dentist user has been quite modest but less so for denturist users. The future of these two models and the problems associated with them are discussed.