Access to Dental Care in Canada: Organized Dentistry and the State in Two Canadian Provinces
Bibliographic record
Abstract
Although oral health in Canada has improved considerably since the 1970s, many vulnerable groups still lack proper access to dental care. Limited public funding for dental care, restricted access to private insurance, and a shortage of dental professionals in more remote parts of the country, have all contributed to historical inequality and inequity in the dental care system. Although scholarship in the field has focused substantial attention on these issues, less consideration has been given to how political forces at play influenced major policy reforms designed to improve access to basic oral care. Most notably, the political intricacies affecting the sustainability of a major dental experiment in the province of Saskatchewan—which subverted the traditional model of delivery in care in Canada—have never been analyzed through the lens of medical sociology. Through the theory of professional dominance, this thesis examines how the relationship between the dental profession and the government influenced the creation and termination of the dental therapy program in Saskatchewan, and how it foiled any initiative allowing dental therapists to work in Ontario, despite recommendations from a committee appointed by the provincial government. A scoping review examined research activity on the political influence of organized dentistry over public dental programs, and whether the professional dominance framework had been used for this purpose. A qualitative case study methodology was then adopted to examine the dental profession’s historical influence over public dental policies in Saskatchewan (1950s to 1980s), and Ontario (1960s to 1970s), through this frame. This thesis revealed that the dental professions’ political efforts, in both Saskatchewan and Ontario, were aimed at maintaining control over knowledge, and at lobbying the government for public programs focused on prevention and hygienists. This ultimately contributed to the termination of the dental therapy program in Saskatchewan and prevented the entry of dental therapists in Ontario. In applying the theory of professional dominance to dentistry, the analysis clarifies how the profession’s authority was shaped into an effective lobby that would terminate Saskatchewan’s experiment employing an alternative delivery model of oral care, and how it prevented such a model from being implemented in Ontario.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.014 |
| Science and technology studies | 0.022 | 0.005 |
| Scholarly communication | 0.006 | 0.001 |
| Open science | 0.003 | 0.005 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".