Anita Gordon has been living with a cracked tooth for more than five months with no relief in sight.
“I never got a call, it is just getting worse and it is a lot of pain,” she said.
“But they can’t do anything about it, they don’t have the equipment, they can’t fix it.”
The Kuujjuaq resident says she’s in agony but not crying about it — she’s one of many people in Nunavik who have to live with their dental problems.
Long Waitlists
With extremely long waitlists, a lack of infrastructure and no competitive salaries for staff, access to dental care in the Ungava Bay region is “appalling,” says Nathalie Boulanger, who works as a director with Ungava Tulattavik Health Centre.
The centre offers dental services to Nunavik beneficiaries in seven communities: Kangiqsualujjuaq, Kuujjuaq, Tasiujaq, Aupaluk, Kangirsuk, Quaqtaq and Kangiqsujuaq.
There are currently two full-time dentists serving a population of more than 6,000 people, Boulanger said, adding her organization has added dental hygienist positions to alleviate the workload in the communities.
Between May 13 and Sept. 4, she said, 159 people called to request a dental appointment. Only 16 were able to see a dentist.
This is one of the two dentist chairs in the Kuujjuaq health centre. The wait-list in the community is months long. (Photo by Cedric Gallant)
In total, more than 400 people are waiting to receive dental care in the Ungava Region, and most have been waiting for over three months.
Dentist Rami Joudi told Nunatsiaq News a months-long wait for care is common, and people who need specialized services must wait even longer.
“The situation on the field is more than frustrating,” he said in French.
Joudi has been working at Kuujjuaq’s health centre for five years.
Patients with excruciating pain prioritized
Dentists prioritize people who are in a lot of pain, those with infections, and children. Kuujjuaq has two dentist chairs, and time slots are reserved for the most urgent cases.
“It is unfortunate, the equation is how much time we can have on the chairs and how many treatments we can do in that time. At one point, we have to choose,” Joudi said.
“[This situation] is slowly deteriorating over time. We can’t catch up, all treatments are pending.”
Staffing is also a problem. Salaries for dental employees are not competitive enough to incentivize them to come to Nunavik, says Carl Tremblay, president of the Association of Dental Surgeons of Quebec, the union that represents Quebec dentists.
He said its collective agreement with the government has been out of date for more than a year and he doesn’t know when negotiations for a new one will begin.
‘Government leans towards cutting costs’
In the last round of negotiations, the union asked for dentists in remote regions to be better compensated and at the time, “the government was actually more interested in cutting incentivizing measures for dentists,” Tremblay said.
“We’re hearing through the grapevine that the government is leaning towards cutting costs,” he added.
“We are expecting our next negotiations to be difficult.”
Tremblay said dental professionals need to unite with local leaders to apply pressure on the government.
“The issue needs to be in the public eye enough for the government to feel the pressure, and understand that this is a problem they need to fix,” he said.
Space is limited in most Ungava clinics already. Nathalie Boulanger, with Ungava Tulattavik Health Centre, says Kuujjuaq would need an entire building solely dedicated to dental care for infrastructure to be adequate to the community’s needs. (Photo by Cedric Gallant)
Ungava Villages need dentist
Ideally, all Ungava villages should have their own permanent dentist and at least one dental assistant. But even if those expectations were met, the infrastructure in place cannot support it.
Dental facilities in the communities lack the space required to take care of patients and house the staff, said Boulanger, with Ungava Tulattavik Health Centre.
This creates a funnel of dental patients to Kuujjuaq, where dentists are struggling to keep up with their own wait list.
She said Kuujjuaq already needs its own building dedicated to dental services just to meet the needs of the community.
Some patients are sent south to Montreal, but that city’s Ullivik medical boarding home that serves Inuit is also overbooked.
Nunatsiaq News contacted Quebec’s Ministry of Health, but did not receive a response.
In the meantime, Gordon still suffers with her cracked tooth.
She laments that this health system was imposed upon Inuit.
“We were colonized, we were told not to complain,” she said.
“We had our own ways of dealing with things, but we have become modernized and we are entitled to basic rights like health care.
“Just because we’re isolated does not mean we are not allowed services.”
