Hon. Brent Cotter: Honourable senators, I rise to speak in support of Bill C-31. I will speak only to the component related to the dental benefit for children.

I want to thank Senator Yussuff and, before him, Senator Lankin for their leadership on this bill. I also want to thank Senator Loffreda for his detailed, thoughtful and comprehensive comments about the bill. I will speak in a somewhat more environmental way about dentistry and this bill.

At second reading of this bill in early November, I heard one of the most remarkable things I have ever heard in the Senate. Speaking about her acquisition of dental benefits, Senator Simons said:

As soon as I was hired on by the Edmonton Journal, I rushed to the dentist to make up for all those years when I had no cleaning or checkups. . . .

I am 72 years old. This is the first time in my life I have heard anyone express breathless enthusiasm about “rushing to see the dentist.” Senator Simons, with that one sentence, you could become the poster person for all the dentists and dental hygienists in the country.

When it comes to dentistry — and I say this sort of humbly — I know whereof I speak. I come from a family inundated with dental professionals. My sister is qualified as a dental nurse and dental hygienist. She studied with Senator McCallum many years ago in Regina. For years, my sister was president of the Saskatchewan Dental Hygienists’ Association. My brother-in-law is a dentist. My nieces are a dental hygienist and dental therapist, respectively. My daughter-in-law is a dentist in Germany, and my father was a dentist and professor of dentistry. They are everywhere.

Some of you have watched the “Ted Lasso” series. There is a little chant about somebody named Roy Kent in it. I’m going to leave out a word that I think we are not allowed to say here, but the phrase is: “Roy Kent! He’s here, he’s there, he’s [everywhere].” Well, the dentists in my life are everywhere.

My father was the finest person I have known in my life, with this one exception: When I was a kid, every now and then on a Saturday morning — when I wanted to be almost anywhere else — he would drag me off to his dental office for some painful treatment.

Working on your own children is probably not allowed anymore, but this was a long time ago — I believe shortly after dentistry had been invented. He used interesting — and now antiquated — pain-management techniques. One I recall is that he used to tug sharply on my cheek, so painfully that I didn’t notice the freezing needle going in. It was an interesting technique — to cause pain to distract from pain. I feel that I come by my aversion to dentistry and the dental profession honestly.

To moderate these somewhat uncharitable perspectives, I will add this comment and one story. Every dentistry professional I know has been deeply committed to their work and loved their work, knowing they were making things better for their patients. This is true for many occupations and professions — not just dentistry but carpenters, counsellors, painters, plumbers — the greatness of doing something honourable to help your customer, client or patient.

I want to share with you one example of this — a dentistry story. It is a bit gruesome, but also beautiful.

Late in his career, my father acquired a specialty in prosthodontics and maxillofacial surgery. They are big words, but the first one basically means false teeth, and the other is jaw and facial reconstruction. At the time, he was perhaps the only specialist in that area in Saskatchewan.

He was asked on one occasion to help a patient who had experienced a severe facial cancer and had to have part of his jaw and all of his nose removed to defeat the cancer. My dad was asked to do the jaw and nose reconstruction, which he did. What remained was both to rebuild the jaw and then to build the patient a new nose. It sounds gruesome, I admit.

He created that nose out of material, shaped it, firmed it up by whatever techniques, and got it in the right shape and skin tone for the patient, corresponding with the patient’s original nose. He noted in the picture he had of the patient that it wasn’t quite right.

I started laughing when I wrote this out. I apologize.

The man, it seemed, had a close relationship with alcohol and had had a very veiny nose. My father went to the art store and bought paint and a paintbrush with only one bristle and brought them home. At the kitchen table, with this man’s new nose on the table, he carefully painted veins onto the new nose. Then, to get it just right — I’m sorry to be sharing this — he pulled nose hairs from his own nose and glued them, one by one, to the man’s new nose.

That surgery saved the man’s life, but this reconstruction — nose and all — gave him back his life. It is pretty gruesome, but also pretty great.

Returning to my main point: Whether I wanted to go to the dentist or not, I got dental care — as did Senator Simons eventually, as do all of us here and our families, and as do millions of Canadians across the country, as Senator Loffreda pointed out. However, many do not.

As Senator Yussuff noted in his second-reading speech, perhaps 25% of our population does not have access to dental care. There are consequences to that lack of care. We all know what it is like to have a toothache and how pain of this sort, in such a small part of our bodies, can overwhelm us and be debilitating. But there is more to it than that. Longer term health care for all of us is closely tied to dental care.

Let me give you an example. I was visiting my dentist recently — not enthusiastically — and he started to tell me about the importance of the health of my gums and that, if you don’t take good care of them, it can lead to heart disease and death. This sounded a bit extreme, kind of like a car salesman telling you that you have to buy the most expensive car on the lot or you will die in a car accident. So I looked it up and, sure enough, my dentist was right. Good dental care is fundamentally important to overall health.

Then the question is posed: Why are dental services not available to more Canadians? Access is an issue in rural and remote parts of the country, as Senator Loffreda and others have pointed out. However, the largest reason is because dental services are expensive. They are expensive to provide. For dentists, at least, the education is long, arduous and expensive. At the University of Saskatchewan, the tuition for the dentistry college is among the highest of any university program in Canada. Dentistry professionals, to be fair, earn a good living. Indeed, my father, when he was teaching dentistry, probably inadvertently contributed to this. When he was helping students in the clinic make false teeth — upper and lower sets of dentures — he used to think he was giving advice to them in terms of how to be a dentist in practice. What he used to say to them was, “After you have made the dentures, the patient is sure to ask, ‘So doc, how much?’” And he would continue, “What you say then is ‘$700,’ and then you pause, and if there is no reaction, you would say, ‘for the uppers.’”

The reality is that even now the demand for dental professionals is overwhelming. Most dentistry services operate at full capacity, and dentists can hardly find dental hygienists to support full-service dental practices. So market forces alone will not solve the problem of access. Into this context comes this bill. It’s the beginning of a regime of dental coverage that will make meaningful differences in dental care for some millions of lower- and modest-income Canadians who, mostly due to cost, are simply unable to access basic dental services. Too many families, whether in these somewhat more inflationary times or otherwise, have to choose to use their limited resources on food, rent, clothing or other needs for their families, and children’s needed dental care goes wanting. The dental insurance program, of which this bill is a start, will address the beginnings of that gap in services.

This bill is focused on dental care for children only — more coverage will follow, as we’ve heard — but for kids’ dental health and to address the cost burdens for lower- and modest-‑income Canadians, it’s a good start. All of this is great, and I support the initiative. However, as Senator Loffreda noted, there’s more to be done, and I want to highlight one aspect of it.

I would call this a knock-on consequence of the program that is unfolding, beginning with this bill. As leaders of the profession and particularly dental educators have told the finance committee, the program will require a significant increase in the supply of dental professionals in order to ensure that caregivers are available at affordable prices to meet a significant increase in demand for dental services. Indeed, that’s what we hope. At committee, Dr. Siqueira, the Dean of the College of Dentistry at the University of Saskatchewan, noted this and the way in which, for example, the University of Saskatchewan is well positioned to take on this challenge, having brought a full range of dental professionals’ education — dentists, dentistry specialists, dental hygienists and dental therapists — under one umbrella within his faculty. But it should be noted — and this is, I think, an important future point — that nearly all the educational programs that will be looked to in order to meet the needed and significant increase of dental professionals fall within provincial jurisdiction over education. It will be critical for the Government of Canada in the coming years to have a plan to work with the provinces and territories in partnered, respectful and potentially financially supportive ways to get us to that goal of affordable, good-quality dental health for all Canadians.

In the spirit of cooperative federalism that has been the way forward for most of the life of our country, I’m hopeful that such partnerships will develop and prosper and Canadians will benefit. Thank you.