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UBC Theses and Dissertations

Community dental clinics in British Columbia Wallace, Bruce Barclay

Abstract

Objectives: Oral health inequities are prevalent but little is known on how to respond. In British Columbia (B.C.) there has been a rapid expansion of local responses to the inequities as communities and dental professionals cooperate to operate community dental clinics (CDCs). The purpose of this research has been to explore how the clinics evolved and how they operate from the perspective of participants in B.C. Methods: Three studies were conducted: #1 to understand the problems of access to dentistry using a case study that included 60 interviews with low-income people (N=41), dentists (N=6), and other healthcare or social service-providers (N=13); #2 to investigate the expansion of CDCs in B.C. by interviewing 63 people who helped to establish or operate the clinics; and #3 to study five clinics through aaggregated data from treatment, procedural, and financial data combined with explanatory information from interviews with eight staff members. Results: I identified two models of CDCs emerging in B.C,: volunteer-charitable (VC) clinics offering free services primarily to relieve pain; and, not-for-profit (NFP) clinics operating mostly full-time within community health centres employing paid staff to provide a wide range of basic dental treatments. Not all clinics are providing equitable standards of care to underserved populations, and they all operate with major concerns about financial sustainability. The NFP model seems to improve access to underserved populations by integrating primary or basic dental services with other health care and community social services. Conclusions: Expansion of CDCs in B.C. has been rapid to meet a growing societal concern. They all operate with some success on the principles of health-equity but with concerns for the limits of charity, the sustainability of NFP operations, and their overall limited capacity to address the level of unmet needs. However, the NFP model within the context of CDCs seems to be most effective.

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Attribution-NonCommercial-NoDerivatives 4.0 International