Northern News Services

Yellowknife (July 22/02) - NWT dentists say the federal government is turning the clock back to the Dark Ages when it comes to dental care guaranteed by treaty rights for First Nations.

Dental care for aboriginal people -- and dentists' ability to provide it -- has been a contentious issue ever since Health Canada changed its policy on non-insured benefits in 1997.

Under the current guidelines, any dental work required for an aboriginal person without dental insurance over a 12-month period costing more than $600 must be pre-authorized in Ottawa.

According to the NWT Dental Association, the dental work required is often not even reviewed by a dentist, but by a bureaucrat with limited expertise.

"Some of them that are doing the approvals are not even dentists," said the association's executive director Don Portz. "They may be therapists or hygienists are something like that, but they're not dentists and they will adjudicate some of the (work)."

What makes the whole situation infinitely worse, said Portz, is that very often, even after all the "i's" have been dotted and the "t's" crossed, payments are denied.

"We're finding in many instances recommended treatment, such as crowns, that type of thing, are very routinely denied," said Portz. "(They say) just pull the tooth because it's a lot cheaper."

Dr. Hassan Adam, a Yellowknife dentist, said many dentists, including himself, are providing expensive services free of charge, simply because they do not have the heart to pull teeth for the sake of saving money.

"Someone comes in with a broken tooth needing either a root canal or a cap, but Ottawa will say 'No, extract the tooth,' " said Adam. "Just about every dentist wouldn't sleep at night if they did that."

The dental-care situation for aboriginal people in the North was abysmal when Adam first set up practice in the early 1980s, he said.

At the time, the government would pay a dentist less than $100 for a root-canal procedure, said Adam.

It was difficult to convince dentists to practise in the North as a result, but by the mid-1980s, after much lobbying, Health Canada began to provide better fee rates and First Nations people's teeth improved as a result.

Adam said lately, however, it feels like he has stepped back in time. More and more the condition of teeth among aboriginal people appears to be on the decline.

He blames the hard line Health Canada took in 1997.

The problem for Health Canada at the time was that some dentists were over-billing the government for dental fees, Adam said.

Nonetheless, First Nations shouldn't suffer because of a few bad apples ripping off the government, said Adam.

"Kids are especially suffering a lot because of this new system," said Adam. "There's been a number of kids taken to the hospital needing 20 teeth out.

"This is what we were doing in 1980, so nothing has changed over 20 years, and the system is certainly getting worse. The quality of care is certainly much lower than what other people receive."

The situation has become so grim in other parts of the country that dentists in British Columbia threatened to opt out of treating anyone under the non-insured benefit program last month. Some Yukon dentists also threatened to do the same.

"We in fact recommended to our dentists that they do that," said Anita Caspersen of the Association of Dental Surgeons in B.C.

"We then had discussions with the First (Nations) chiefs' health committee, and agreed perhaps that the better way to do this would be to lobby government."

Lobbying efforts have apparently finally got the government to move. Meetings are scheduled for the end of August between the provinces and territories and Non-Insured Health Benefit staff over the issue.

Health Canada official Paige Raymond Kovach would not comment on the issue, but did confirm a meeting is being planned between NIHB and the NWT Dental Association.

Meanwhile, Aklavik Chief Charlie Furlong said it is high time the government involve First Nations in decisions that affect the health of First Nations people.

"I know for the people I represent there is a treaty right," said Furlong. "I don't think these policies should be put in place without first (consulting) Northwest Territories chiefs."