Increase in dental travel to Yellowknife unlikely to slow down anytime soon, says N.W.T. health minister

N.W.T.'s minister of health says there's no end in sight to the challenges facing the dental care system in the territory.

Over the last couple years, the volume of dental travel to Yellowknife has increased substantially, leading to shortages of accommodations for medical travel in the capital. Last month, the N.W.T. government urged people to cancel all non-urgent dental travel to Yellowknife until the end of the tourism season altogether because of a lack of beds.

Lesa Semmler said there's a reason for the increase in people travelling to Yellowknife for dental.

The health minister said the territory's contracts with dental providers to visit N.W.T.'s small communities expired at the end of the COVID-19 pandemic — and no dentists in the territory have been willing to sign new contracts. While there have been a few dental visits since the pandemic from older providers, no one is now providing that service consistently.

Adding to the problem is the closure of Western Arctic Dental Clinic in Inuvik, which served thousands of patients across the Beaufort Delta Region. The clinic has now been closed for well over a year.

As a result, Semmler said "a whole region and a lot of small communities" are now getting all of their dental care through medical travel to Yellowknife. Among them is Lawrence Norbert, an elder from Tsiigehtchic who recently travelled to the capital for a dentist appointment.

The 1-hour appointment meant spending nearly 3 days away from home – over half of which was spent travelling. He said it was a long trip.

"[It] takes about a day to recover from the travel … it's a lot more tiring, psychologically you've got to gear yourself up, and you know in your mind you are wondering why is this happening?

Territorial government response

The N.W.T. government was contracted to provide dental visits to small N.W.T. communities on behalf of Indigenous Services Canada's Non-Insured Health Benefits program. The federal program covers dental care, medical travel, prescriptions, and some other health care for most First Nations and Inuit people.

Semmler said Indigenous Services Canada has underfunded the territorial government for this work, making it hard to attract dentists.

The territory's most recent agreement with Indigenous Services Canada expired at the end of March. In an email, Indigenous Services Canada spokesperson Pascal Laplante said that the federal government won't enter into a new agreement during the election period, but "services will still be available while the new agreement is being negotiated."

When asked if the federal government was willing to provide more funding, Laplante said the federal government does not make commitments during election periods.

Perry Heath, the director of medical insurance for the N.W.T. Department of Health and Social Services, said dentists wanted to see some major changes before signing up to provide dental visits to small communities. Those changes include more flexibility in how long they visit communities, better dental equipment in communities, and an increase in their payment rates through the Non-Insured Health Benefits program.

Heath said the territorial government has applied for funding from Health Canada to upgrade dental facilities, and is hoping to get the funding this spring. 

But payments for dental visits and the number of dental days for each community is decided by Indigenous Services Canada.

"Our hands are really tied," Semmler said. 

As for the lack of dentist in Inuvik, Semmler said that's also out of the territorial government's hands.

"It's a private business," she said. "We don't have control over why they're leaving."

Heath said that until these issues with dental travel are resolved, N.W.T. residents are likely to see the same problems with a lack of medical travel accommodations whenever there is a spike in tourism in the N.W.T. capital.

"Will the pressures continue? Yes, they will," he said.

'It's a long trip'

But for N.W.T. residents, travel to Yellowknife every time they need dental care is far from an ideal solution.

Norbert said between the time and the cost of all of this medical travel, it doesn't make sense to have so many people visit Yellowknife instead of having dentists visit them.

"It just boggles the mind. All of this airfare is adding up week after week, month after month, year after year." 

Norbert wasn't impressed, either, with the responses from the territorial and federal government as to why dental visits haven't resumed – calling their answers "very bureaucratic."

He's also found himself entertaining some painful alternatives to travel.

"You just start wanting to stay home sometimes, and 'ah, you know, I think I'll just pull out my tooth.'"