Pandemic dental delays in the N.W.T. have turned some tooth issues into emergencies

Some people in the Northwest Territories are still struggling to access dental care almost three years after service to communities was suspended for the pandemic. 

During the COVID-19 pandemic, dental visits to some Beaufort Delta communities stopped for close to two years. While dental travel was paused, Indigenous Services Canada expanded eligibility for medical travel for dental problems to include non-urgent dental needs like cleanings and cavity fillings, but it was a complicated and often slow process.

Dr. Chan Chin is a dentist with Western Arctic Dental Clinic in Inuvik, which usually provides dental services throughout the region. He said they started getting back to those communities in September of 2022, and have been overwhelmed by the need.

"We basically are just seeing all the emergencies, all the complicated restoration that hasn't been done for two years," he said. 

"All the toothaches, all the teeth that need to be extracted have increased. Probably a lot of what we could have prevented, because of that stop of two years, became an emergency." 

A year and a half to fill 2 cavities

In 2021, Andrea Keogak noticed that her four-year-old daughter Hailey had two large cavities.

When she went to her local health centre in Sachs Harbour to ask for a referral to Inuvik to get them filled, she said the nurse originally refused, saying cavities weren't serious enough to qualify for medical travel.

Keogak says the nurse told her, "When she's having trouble eating, she can come back and see me."

Keogak said she had to send a letter to the Beaufort Delta Health Authority to get the referral for her daughter.

Reached for comment, David Maguire, spokesperson for the Northwest Territories Health and Social Services Authority, said he was unable to comment on the specific case. He said only that the authority "has worked with NIHB to provide communications to staff across the system to clarify the process for accessing dental care and services for those in remote communities that do not have a resident dentist."

Even after Keogak was able to get a referral for her daughter, the problems continued. 

At first, she was told that the cavities could be filled in late 2021 when a specialist in general anesthesia would be in Inuvik. 

When she didn't hear from the dental clinic, she followed up with the dentist in Inuvik only to find that they lost her daughter's referral to the specialist. So seven months after getting the initial referral, the pair went back to Inuvik to get temporary fillings and a new referral.

'It's very frustrating'

In the end, Hailey didn't get her teeth fixed permanently until January of 2023, a year and a half after she'd initially asked to see the dentist. 

Hailey needed to get silver caps because of the severity of the damage, something Keogak believes wouldn't have been needed if Hailey had gotten treatment sooner.

"It's very frustrating because you don't want to see your child hurt, you don't want to see them in pain or anything over something that could have been a half-hour visit," she said. 

"If she would have had regular checkups they would have caught the cavity before it got to where they had to drill holes in her."

Keogak had a similar experience herself. In April of 2021, she started getting tooth pain, but when she went to the health centre, she was given pain medication instead of a referral to a dentist. 

It wasn't until an abscess in her mouth burst in June of that year that she was able to get a referral to see the dentist in Inuvik. At her appointment that fall, she was referred to a dentist's office in Edmonton, where she eventually underwent a root canal. 

Since then, the dentist has visited Sachs Harbour once, and she was able to get an appointment, but she is still behind on her dental care. 

"It's frustrating because it's something that I shouldn't really have to worry about," she said. "If I were in any other place like Inuvik or Yellowknife or the city I would have access to dental care at any time."

Addressing the backlog

At the outset of the COVID-19 pandemic, all dental clinics in the Northwest Territories were temporarily closed for several months. 

When clinics reopened in June, it was with stringent new requirements for ventilation. 

Upgrading the ventilation systems for local health centres so dental visits could resume required flying in experts from outside the territory, adding air purification units to treatment rooms, and in some cases, extensive renovations. 

Dentists started visiting some remote communities in June of 2021. But for other communities, including ones in the Beaufort Delta, it's taken even longer. 

People in Jean Marie River, Nahanni Butte, Wrigley, Wekweètì, and Whatì are still waiting, according to the Department of Health and Social Services.

Dental visits to remote N.W.T. communities are funded by Indigenous Services Canada and administered by the Government of Northwest Territories. 

Asked what the government is doing to address the backlog for dental care, Health spokesperson Jeremy Bird said the department has asked Indigenous Services Canada to increase the number of community visits. 

He says the government "will continue to advocate for more dental services for N.W.T. residents." 

Bird pointed to tenders out for four new dental contractors to service the Deh Cho, Beaufort Delta, Sahtu, and Tłı̨chǫ regions. He expects the new contracts to be in place by April. 

Asked for comment, Indigenous Services Canada said "discussions are underway" to renew the federal contribution agreement. "This will include reviewing the number of service days allocated for dental providers to travel into communities."

Meanwhile, Dr. Chin says that he would like to see a collaborative approach to the problem.

"I think it would be good to have all the dental clinics in the Northwest Territories and all the people who are taking care of the funding … the people who are working related to dental services … to come together and find a solution, long-term, for everybody."