I wish all members of the committee a good afternoon.
I'm speaking to you from to you from Charlottetown, on the unceded territory of the Abegweit Mi'kmaq first nation.
My wife and I have both practised dentistry in P.E.I. for over 30 years. I have been actively involved in organized dentistry for two decades. I currently represent CDA as president.
For 120 years CDA has represented dentists in every province and territory as the national voice of dentistry. We know that oral health is an essential component of overall health. Dentistry is an integral part of health care in Canada. There are more than 25,000 Canadian dentists. If one includes dental hygienists, dental assistants and others, the dental sector represents a workforce of roughly 100,000 workers.
The COVID-19 pandemic had an immense impact on access to dental care. Offices were shut down for months. Upon reopening, we had to put in place new and extensive infection prevention and control procedures to prevent the spread of infection. This included wearing enhanced PPE, renovating offices to better separate treatment areas and purchasing new air filtration equipment. These precautions were very effective, but have come with a significant price tag.
The post-pandemic reality has now created a further challenge, namely, hiring and retaining dental assistants. Dental assistants are the glue that hold dental offices together. It is a skilled profession, and eight provinces require licensing or registration. In fact, ESDC recently reclassified dental assisting as a skilled profession in the national occupational classification.
The last time you went to the dentist, the person who placed the rubber dams, took X-rays and walked you through your treatment plan or after-care instructions was likely a dental assistant. Crucially, they provide a necessary second set of hands to dentists during most dental procedures, from fillings to extractions to root canals.
Even before the pandemic, the number of dental assistants was an obstacle to meeting the oral health needs of Canadians. In 2019, 36% of dental offices had unfilled dental assistant positions. From 2010 to 2020, the ratio of new certified dental assistants to new dentists entering the workforce fell from over 3:1 to almost 1:1. The pandemic only exacerbated this shortage. Dentists need more formally trained licensed dental assistants to manage new health and safety guidelines, but attrition rates have worsened.
Dental offices, particularly during COVID, can be a stressful work environment, and dental assisting can be physically demanding. Furthermore, 99% of dental assistants in Canada are women, with an average age of 38. Many exit dental assisting for other professions due to, among other factors, workplace concerns such as stress and mental health, the desire for flexible hours, and, more recently, the appeal of working from home opportunities.
It is our goal to work collaboratively to address these issues that directly impact retention of dental assistants. We are hopeful that the federal government's commitments on child care will help reduce barriers to full participation of women and men in the workforce going forward.
The CDA recently partnered with the Canadian Dental Assistants Association to submit a project to ESDC's sectoral workforce solutions program. Our project, “building the professional dental assisting workforce of the future”, seeks to address the many factors impacting the attrition of dental assistants from their profession by providing mental health and wellness training for dental office staff, human resources training for dentists and office managers, and increased access to certified dental assisting programs through the development of an online-based curriculum, as well as by developing action plans addressing interprovincial labour mobility and better integration of immigrants into the dental workforce. I am happy to share further details with you, and would appreciate any support you may be able to lend.
I encourage this committee and the House of Commons health committee, which is also studying health care human resources, to consider these workforce concerns when making recommendations to government. Focusing solely on the HR needs and challenges of Canada's public health system could have a deleterious effect on health care delivered in private settings, such as dental offices. Increasing recruitment into some professions, or mandating wages for others, can intensify shortages for the rest.
I will conclude by commenting on last week's commitment by the federal government to provide greater access to dental care for low-income families. CDA supports all efforts to improve the oral health of Canadians and increase access to dental care. We have long recommended federal investment to stabilize and enhance provincial and territorial programs that provide care to those Canadians who lack access to dental care. These programs are chronically underfunded, and are almost exclusively financed by provincial and territorial governments.
Such an approach would provide better and faster access to care to the people who need it most, using existing infrastructure, as opposed to a large-scale new federal dental care program administered in Ottawa. This would also minimize disruptions for those who already have access to dental care, whether through existing programs or employer provided benefits.
We look forward to collaborating closely with the federal government going forward on better addressing the oral health needs of Canadians.
I want to thank you for this opportunity, and I'm happy, along with Dr. Aaron Burry, our interim CEO at CDA, to answer any questions you may have.
Thank you.