environmental scan oral health services in british ... | p a g e environmental scan oral health...

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Environmental Scan

Oral Health Services in British Columbia for First Nations

and Aboriginal Children aged 0 – 7 years

Prepared for the Tripartite Planning Committee for First Nations

and Aboriginal Maternal and Child Health

by

Ministry of Health

Healthy Women, Children and Youth Secretariat

First Nations and Inuit Health Branch, Health Canada

Regional Health Authorities

March 16, 2012

Environmental Scan— Oral Health Services for First Nations and Aboriginal Families

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Acknowledgements

The following individuals were involved in the preparation of this report:

Marilyn Blondahl, Fraser Health Authority

Carol Charbonneau, Vancouver Coastal Health Authority

Mary Chu, Ministry of Health

Amy Gendron, Ministry of Health

Carol Gulliford, Interior Health Authority

Brenda Isaac, Health Canada, First Nations and Inuit Health Branch, Children‟s Oral Health

Initiative

Carolyn King, Fraser Health Authority

Brenda Matsen, Northern Health Authority

Esther Pace, Vancouver Island Health Authority

Carla Springinotic, Ministry of Health

Mary Lou Walker, Health Canada, First Nations and Inuit Health Branch, Children‟s Oral Health

Initiative

Renada Walstrom, Nak‟azdli Health Centre

Dr. Malcolm Williamson, Ministry of Health

Joanne Wooldridge, Vancouver Coastal Health Authority

Alma Zukanovic, Health Canada – First Nations and Inuit Health Branch, Maternal Child Health


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Table of Contents

1.0 Introduction ............................................................................................................................................. 4

2.0 Background ............................................................................................................................................. 4

3.0 Definitions............................................................................................................................................... 8

4.0 Results ..................................................................................................................................................... 8

4.1 Population Distribution ....................................................................................................................... 9

4.2 Summary of Oral Health Services and Providers ............................................................................. 10

4.3 Oral Health Services and Providers On-reserve, by Health Authority ............................................. 14

5.0 Discussion and Recommendations........................................................................................................ 17

Appendix A: Health Canada‟s First Nations and Inuit Health Branch Early Childhood Development

Programs ..................................................................................................................................................... 24

Appendix A2: Public Health Agency of Canada (PHAC) .......................................................................... 26

Appendix B: Non Insured Health Benefits ................................................................................................. 27

Appendix C: 2011 Early Childhood Oral Health Services, Population Estimates*, and Child Development

Programs for On-Reserve Communities ..................................................................................................... 30

Appendix D: Oral Health Care Providers for On-Reserve Communities – Detailed Survey Results ......... 40

Appendix E: Off-Reserve Community Services ......................................................................................... 68

Appendix F: Public Health Agency of Canada, Off-Reserve Early Childhood Development Programs ... 72


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1.0 Introduction

In July 2011, BC Ministry of Health (MOH), the five Regional Health Authorities, and

Health Canada‟s First Nations and Inuit Health Branch (FNIHB) conducted an environmental

scan of oral health services available both on- and off-reserve for First Nations and Aboriginal

children in BC from birth to seven years of age. This work was undertaken at the request of the

Tripartite Planning Committee for First Nations and Aboriginal Maternal and Child Health.

Information was obtained about what kind of oral health services are available, where they are

available, who provides each service (e.g. Health Authority public health, Health Canada, Band,

or other), frequency of services, and locations of on-reserve dental operatories/clinics.

The purpose of this report is to provide a picture of oral health prevention and treatment

services offered on- and off-reserve to First Nations and Aboriginal children across BC. The

environmental scan findings will be used to support the development of a First Nations and

Aboriginal child oral health strategy.

Services available may change from year to year. Information included in this Report

provides a profile of those services available at the time of the scan. Efforts have been made to

capture and verify all services within the scope of the scan, however there may be additional

services provided at a local level that are not reflected in this report.

2.0 Background

Dental health has been shown to have a significant impact on general health and well-

being. Research has found associations between dental disease and a variety of other diseases,

including diabetes, heart disease, and respiratory disease.1 The two primary dental diseases are

caries and periodontal disease. Early Childhood Caries (ECC) is defined as the presence of tooth

decay involving any primary tooth in a child younger than six years of age; this complex disease

process involves transmission of infectious bacteria, dietary habits, and oral hygiene.2 Young

children often acquire this transmissible disease through a primary caregiver before age three.3

Children with ECC are known to be at increased risk of decay in both primary and permanent

dentition, and may also experience misalignment and crowding of permanent teeth, resulting in

poor bite.4

The 2009-2010 BC Dental Survey of Aboriginal Kindergarten-Aged Children identified

that the oral health of Aboriginal children is significantly poorer than the oral health of non-

1 Model Core Program paper for Dental Public Health, October, 2006.

2 Irvine, J. D., Holve, S., Krol, D., Schroth, R.; Canadian Paediatric Society, First Nations, Inuit and Métis Health

Committee and American Academy of Pediatrics, Committee on Native American Child Health. Early childhood

caries in Indigenous communities: a joint statement with the American Academy of Pediatrics. Pediatr Child Health

(2011) 16(6):351-357. 3 Model Core Program paper for Dental Public Health, October, 2006.

4 From Schroth, R. J., Harrison, R. L., Lawrence, H. P. and Peressini, S. 2008. Oral Health and the Aboriginal Child:

A forum for community members, researchers and policy-makers. Quoted in: Irvine, J. D., Holve, S., Krol, D.,

Schroth, R.; Canadian Paediatric Society, First Nations, Inuit and Métis Health Committee and American Academy

of Pediatrics, Committee on Native American Child Health. Early childhood caries in Indigenous communities: a

joint statement with the American Academy of Pediatrics. Pediatr Child Health (2011) 16(6):351-357.


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Aboriginal children, as illustrated in Figure 1 and Figure 2 below.5 The survey indicated that

28.5% of Aboriginal kindergarten-aged children had evidence of visible decay, compared to

16.2% of non-Aboriginal children. 8.8% of these Aboriginal children had evidence of decay in

three or four quadrants, compared to 3.7% of non-Aboriginal children.

Caries immune is defined as „no visible evidence of broken enamel or existing restorations‟

5 Dental Survey of Aboriginal Kindergarten-Aged Children 2009-2010 – A Provincial and First Nations School

Analysis - Ministry of Health Services - Healthy Women, Children and Youth Secretariat, January, 2011

0% 20% 40% 60% 80% 100%

Aboriginal

Non-Aboriginal

Aboriginal Non-Aboriginal

% Caries Immune 39.3% 65.1%

% Restorations Present 32.2% 18.8%

% Visible Decay 28.5% 16.2%

Figure 1: Percent caries immune, restorations present and visible decay for Kindergarten-aged Aboriginal and Non-Aboriginal Children, Provincial Dental Survey, 2009/10 (95% confidence intervals displayed)

0% 10% 20% 30% 40%

Aboriginal

Non-Aboriginal

Aboriginal Non-Aboriginal

% Urgent referrals 5.0% 1.8%

% Non-urgent referrals 24.4% 14.6%

Total Referrals 29.4% 16.4%

Figure 2: Percent of Kindergarten-aged Aboriginal and Non-Aboriginal Children Requiring Referral for Treatment, Provincial Dental Survey, 2009/10 (95% confidence intervals displayed)


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The 2009-2010 BC Dental Survey of Aboriginal Kindergarten-Aged Children identified

also that the dental health of kindergarten-aged First Nations children in First Nations schools is

poorer than the dental health of Aboriginal children in public or independent schools.6 41.5% of

Aboriginal children attending public or independent schools were caries immune (no evidence of

visible decay and no existing restorations), while only 18.1% of First Nations children attending

First Nations schools surveyed were caries immune. First Nations schools had a higher

percentage of children with evidence of visible decay. In First Nations schools, 9.3% of children

showed evidence of decay in three or four quadrants compared to 8.8% of Aboriginal children in

public or independent schools.

As shown in Figure 2, 5.0% of Aboriginal children surveyed received referrals for dental

treatment due to the urgency of their condition, a rate almost three times higher than the rate of

1.8% for non-Aboriginal children. In addition, 24.4% of Aboriginal children in BC who were

surveyed received non-urgent referrals for dental treatment, a rate almost one and a half times

higher than the rate of 14.6% for non-Aboriginal children. In 2009, the Provincial Health Officer

reported that from 1996/1997 to 2006/2007, the rate of dental surgeries for Status Indian children

under five years of age was 3 to 4 times higher than the rate for other resident children in BC;

and in 2006/2007, the rate of dental surgeries for Status Indian children under the age of five was

39.7 per 1,000, compared to 10.5 per 1,000 for other resident children in this age group.7

Oral health treatment services for Aboriginal people are funded through the Non Insured

Health Benefits (NIHB) (see Appendix B). Coverage for NIHB Dental services is determined on

an individual basis, taking into consideration current oral health status, recipient history,

accumulated scientific research, and availability of treatment alternatives. Dental services must

be provided by a licensed dental professional, such as a dentist, dental specialist, or denturist,

who has agreed to provide services to First Nations and Inuit clients through the NIHB Program.

Service providers are encouraged to bill the Program directly so that recipients do not face

charges at the point of service when receiving health care goods or services. When a recipient

does pay directly for goods or services, he or she may seek reimbursement from the NIHB

Program. Requests for reimbursement must be received on a NIHB Client Reimbursement

Request Form, within one year from the date of service or date of purchase. Dentists in BC have

a longstanding series of issues with serving First Nations clients who are funded through Non

Insured Health Benefits.

Restorative or surgical treatment of ECC is challenging and costly for all children,

especially for those from remote communities, and is unlikely to solve dental disease in

Indigenous communities.8 Preventive oral health care during childhood is imperative for

ensuring long-term reduction in dental caries. Primary prevention of dental disease not only

6 Dental Survey of Aboriginal Kindergarten-Aged Children 2009-2010 – A Provincial and First Nations School

Analysis - Ministry of Health Services - Healthy Women, Children and Youth Secretariat, January, 2011 7 Pathways to Health and Healing:- 2

nd Report on the Health and Well-being of Aboriginal People in British

Columbia , Office of the Provincial Health Officer, 2009. 8 Irvine, J. D., Holve, S., Krol, D., Schroth, R.; Canadian Paediatric Society, First Nations, Inuit and Métis Health

Committee and American Academy of Pediatrics, Committee on Native American Child Health. Early childhood

caries in Indigenous communities: a joint statement with the American Academy of Pediatrics. Pediatr Child Health

(2011) 16(6):351-357.


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preserves healthy teeth but decreases the current tremendous demand for restorative and surgical

care.8

Not all First Nations communities have access to oral health preventive programs or

services; or the preventive services may be episodic or more recently established. For

communities receiving on-reserve preventive oral health services, those services are provided by

Health Canada‟s First Nations and Inuit Health Branch (FNIHB) to pregnant women, and

children from birth to seven years of age, and/or by Health Authority public health to children

from birth to school entry. Off-reserve preventive oral health services are provided by Health

Authority public health.

Historically, Health Canada oral health services for First Nations children on-reserve

have focused on addressing the high demand for treatment and did not include a preventive

focus. In 2004, the Children‟s Oral Health Initiative (COHI) was introduced nationally as a pilot,

with three communities in BC. It has expanded ever since, in all regions of Canada, and has

achieved program status with Health Canada. This program was developed by Health Canada‟s

First Nations and Inuit Health Branch (FNIHB) as a policy response to the acute oral health

needs of Aboriginal children9. COHI is designed to prevent and control tooth decay in First

Nations children, with a goal of shifting the emphasis in oral health care in this population from a

primarily treatment based approach to a more balanced prevention and treatment focus.

Health Authorities have also provided oral health services to some First Nations

communities as part of their broader provincial mandate. Currently, Health Authorities use three

main strategies in delivering preventive oral health services for First Nations and Aboriginal and

non-Aboriginal children. The first strategy is the provision of public health preventive dental

services through registered dental hygienists and certified dental assistants. Goals are to increase

the prevention of early childhood caries, and to improve identification of higher risk, more

vulnerable segments of the population. First Nations children may access these services if

available in their community, or may present at a Health Authority public health office to access

public health dental staff. The second strategy is a combination of public awareness, education

and media campaigns. An example of a public awareness and education tool is the early

childhood oral health DVD – How to Take Care of Your Child’s Teeth (2009), developed by BC

Ministry of Health in collaboration with the BC Dental Association and BC Dental Public Health

Committee. The third strategy is the kindergarten dental survey, conducted provincially every

three years. This survey is used as a surveillance tool to determine provincial and regional trends

in oral health. The 2009-2010 BC Dental Survey of Aboriginal Kindergarten-Aged Children was

referred to earlier in this section. The next provincial Kindergarten survey is scheduled for the

2012-2013 school year; the survey will be offered to First Nations schools on reserve.

Oral health messaging is provided to First Nations and Aboriginal families through

routine contact with Health Authority public health programs, and through Health Canada‟s

Early Childhood Development programs. These Health Canada programs are delivered through

FNIHB on-reserve and described in Appendix A. The Public Health Agency of Canada provides

off-reserve Early Childhood Development programs that encourage oral health promotion

9 Lawrence, H. P., Oral health interventions among Indigenous populations in Canada, International Dental Journal

(2010) 60: 1-6.


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activities, as described in Appendix A2 & F. Oral health education is also available to pregnant

women and families through some Health Authority public health offices.

A Maternal Child Dental Health DVD was distributed to all First Nations communities in

January 2012. The DVD sponsored by the Tripartite Planning Committee for First Nations and

Aboriginal Maternal and Child Health, provides information for Aboriginal families and

caregivers on the importance of oral health care and the prevention of early childhood caries.

3.0 Definitions

On-Reserve Health Authority Public Health Services: refers to First Nations communities

with oral health prevention services on-reserve, provided by Health Authority public health.

On-Reserve Children’s Oral Health Initiative (COHI) Services: refers to First Nations

communities with early childhood caries prevention services on-reserve, provided by COHI.

Services are delivered by Health Canada dental therapists, or band-employed dental hygienists.

On-Reserve Health Authority Public Health – COHI Services: refers to First Nations

communities with early childhood caries prevention services on-reserve, through funding

partnerships between Health Canada (COHI) and health authorities. Services are delivered by

health authority public health.

On-Reserve Band -Administered Dental Services: refers to Bands that contract out services to

independent dental hygienists or health authority dental staff.

On-Reserve Dental Clinics: refers to First Nations communities with a dental operatory or

clinic on-reserve. Facilities can range from a temporary chair to one or more permanent chairs.

The clinic may or may not be in use. If the facility is in use, services are provided by a dental

therapist, dental hygienist, or dentist.

No On-Reserve Oral Health Services: refers to First Nations communities without oral health

prevention or treatment services on-reserve.

Off-Reserve Aboriginal Oral Health Services: refers to oral health prevention and treatment

services located off-reserve for Aboriginal and First Nations people.

4.0 Results

The environmental scan identified:

the current distribution of First Nations children on-reserve who are zero to four years

of age and five to seven years of age;

locations and nature of oral health services on- and off-reserve for First Nations and

Aboriginal pregnant women, and children zero to seven years of age; and

the locations of Health Canada child development programs that provide health

information to First Nations and Aboriginal parents and children.


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This section presents the findings from the Scan. (Please see Appendix C for an overview of the

services provided in each community, and Appendix D for more detailed information.)

4.1 Population Distribution

Of the 203 on-reserve First Nations communities across BC, information was obtained

for 201 (Figure 3). As of November 2011, there were an estimated 61,999 individuals living on-

reserve in BC, including 4,166 children from zero to four years of age, and 3,125 children from

five to seven years of age. 10,

11

Analysis of the population distribution indicates there are 18 on-

reserve communities with more than 50 children zero to four years of age, as shown in Table 1

below. Six of these communities are located within the service area of Vancouver Island Health

Authority (VIHA); five within the service area of Vancouver Coastal Health Authority (VCHA);

four within the service area of Northern Health Authority (NHA), two within the service area of

Interior Health Authority (IHA), and one within the service area of Fraser Health Authority

(FHA). These 18 communities also have larger populations of children five to seven years of

age. (See Appendix C for population distribution by community).

Table 1: BC First Nations On-Reserve Communities with >50 children 0-4 years of age

and/or 5-7 years of age, using Nov. 2011 Aboriginal Affairs Northern Development Canada

(AANDC) population estimates6

HA ID Community Population

All 0-4yrs 5-7yrs

FHA 581 Seabird Island 572 54 35

IHA 705 Lytton 938 57 44

IHA 688 Tk‟emlups Indian Band (Kamloops) 642 53 27

NHA 532 Kispiox 698 59 39

NHA 607 Lake Babine Nation 1456 90 76

NHA 674 Lax-kw‟alaams (Port Simpson) 732 61 32

NHA 617 Tl‟azt‟en Nation 661 69 37

VCHA 538 Heiltsuk (Bella Bella) 1171 68 62

VCHA 557 Lil‟Wat Nation (Mount Currie) 1479 106 78

VCHA 550 Musqueam 754 61 51

VCHA 539 Nuxalk Nation (Bella Coola) 894 77 68

VCHA 555 Squamish 2393 129 114

VIHA 659 Ahousat 739 90 51

VIHA 642 Cowichan 2643 268 186

VIHA 724 Gwa‟Sala-Nakwaxda‟xw 527 75 50

VIHA 648 Snuneymuxw First Nation (Nanaimo) 689 51 35

VIHA 641 Stz‟uminus First Nation (Chemainus) 768 61 53

VIHA 653 Tsartlip 619 59 45

10

Population figures for children 0-4 and 5-7 years of age are not available for three communities, all in the service

area of Northern Health Authority: Taku River Tlingit First Nation, Liard First Nation (also known as Lower Post or

Daylu Dene), and Dease River. These communities are listed in the AANDC database as Yukon Territory Bands 11

Population figures given are estimates only, and refer to Status First Nations Band members living on-reserve.

They do not include non-Status First Nations people or non-Band members living in communities.


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4.2 Summary of Oral Health Services and Providers

The following section is a summary of the information provided by regional Health

Authorities and Health Canada. Information about on-reserve oral health services is provided in

more detail for each Health Authority in section 4.3.

On-Reserve Health Authority Public Health

Health Authority public health provides oral health services, screening, or prevention in a

total of 104 of 203 First Nations communities (see Figure 6). This total includes 62 communities

where Health Authority public health is the sole provider; 22 communities with Health Canada –

Health Authority partnerships for delivery of the COHI program; 14 additional communities

served by both Health Authority and Health Canada; and six communities served by mix of

service providers including Health Authority, Health Canada, and/or Band. Two of these six

communities receive services provided by UBC Dentistry staff.

The type of oral health prevention programs and services provided by Health Authority

public health varies significantly. For example, services could include fluoride varnish programs,

caries risk assessments, kindergarten screening, preventive education for prenatal women,

parents, and children, and full dental clinics. Public health services are provided by registered

dental hygienists (RDH), certified dental assistants (CDA), and Public Health Nurses (PHNs) or

other staff.

In some areas, Health Authority staff provide fluoride varnish training to local

community members on-reserve, federal health nurses, community health representatives, home

support workers and maternal child health program staff. These partnerships can be initiated in a

variety of ways; wherever the community shows interest and public health dental hygienists are

available to work with the community. This can occur through either the communities

approaching the Health Authority or through discussion with other service partners.

On-Reserve Health Canada’s First Nations and Inuit Health Branch (FNIHB) - Children’s

Oral Health Initiative (COHI)

COHI services are provided exclusively on-reserve, and delivered within all Regional

Health Authorities except Vancouver Coastal Health Authority. Of the 203 First Nations

communities in BC, 62 have COHI programs (Figure 5). Health Canada provides all funding for

COHI. Services are currently delivered in three different models: by Health Canada-employed

dental therapists, by Health Authority-employed dental hygienists, and by band-employed dental

hygienists. COHI services include oral health education and information kits for parents with

infants and children, with messaging about proper oral hygiene and low sugar diet, screening and

risk assessment starting in infancy, fluoride varnish, Alternative Restorative Treatment (ART)12

for baby teeth, and sealants. Bands are funded by Health Canada to hire community members as

COHI Aides, who provide an ongoing oral health "presence" in the community as well as

12

ART is a type of temporary filling used in the COHI program to fill cavities in very young children, in order to

relieve pain, and delay the need for invasive dental treatment. It is performed by first using hand instruments to

remove decay, then placing a fluoride-releasing glass ionomer restorative material in the cavity. ART can be

provided by dental therapists and dentists.


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program support. The COHI Aide plays a vital role in the success of COHI and help to ensure

that cultural and local factors are considered in the provision of COHI education, prevention and

treatment services. Of the 62 COHI programs, approximately one third (22) are delivered

through funding partnerships with Health Authorities (public health). Frequency of COHI

services varies from a weekly basis to several times per year, depending on population numbers.

On-Reserve Dental Clinics

Of the 203 First Nations communities in BC, 50 have on-reserve dental clinics, with two

additional clinics to be built by 2012. As noted earlier, these clinics may or may not be currently

in use, and may range from a temporary chair to one or more permanent chairs. The most

common reason a clinic is not being fully utilized is due to a lack of dental professionals to

provide service in communities. This includes un-staffed Health Canada dental therapy positions.

Also, populations are very small in many communities, and so it is not financially feasible for a

dental professional to establish a practice there.

Dental prevention and treatment services in these clinics are delivered by a dental

hygienist, dental therapist, or dentist, depending on the clinic. These clinics are all located in

Health Canada funded health centres, with all equipment and instruments having been provided

by Health Canada. Operational expenses for these clinics are paid for by the bands, and

consumable supplies are provided by the dental professional using the facility, i.e. a Health

Canada dental therapist or a dentist. Clinics in Mt. Currie, Sto:lo Nation, Seabird Island and

Namgis now provide dental treatment on a fee-for-service basis, and are operated by the band(s).

Services offered at on-reserve dental clinics vary depending on the oral health care provider

working at the clinic.

Communities with No Oral Health Services Located On-Reserve

56 communities have no oral health services located on-reserve, as shown in Table 2

below. Of these, 7 communities are within the service area of Fraser Health Authority (FHA), 13

are within the service area of Interior Health Authority (IHA), 20 are within the service area of

Northern Health Authority (NHA), one is within the service area of Vancouver Coastal Health

Authority (VCHA), and 15 are within the service area of Vancouver Island Health Authority

(VIHA).

This scan identified several factors influencing whether oral health services are provided

in specific on-reserve communities. One of these factors is the number of young children living

on-reserve. Population figures for children zero to four and five to seven years of age were

available for 53 of the 56 communities that have no oral health services on-reserve.13

. At the time

of this report, 41 of the 53 communities (77%) had fewer than 10 children zero to four years of

age; nine communities had between 10 and 20 children zero to four years of age; two

communities had between 21 and 30 children zero to four years of age; and one community had

90 children zero to four years of age.

13

Population figures for children 0-4 and 5-7 years of age are not available for three communities: Taku River

Tlingit First Nation, Liard First Nation (also known as Lower Post or Daylu Dene), and Dease River. These

communities are listed in the INAC database as Yukon Territory Bands


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Table 2: BC First Nations On-Reserve Communities with No Oral Health Services Located

On-Reserve, with Nov. 2011 INAC population estimates14

HA ID Community Population (*Masked<10)

All 0-4yrs 5-7yrs

FHA 580 Kwaw-kwaw-Apilt 32 * *

FHA 560 Kwikwetlem First Nation 38 * *

FHA 586 Peters 45 * *

FHA 585 Popkum 1 * *

FHA 566 Qaygayt (New Westminster) 0 0 0

FHA 588 Union Bar 10 * *

FHA 589 Yale First Nation 67 * *

IHA 685 Ashcroft 79 * *

IHA 686 Bonaparte (St‟uxutews or Stuctwesemc) 236 18 10

IHA 590 Bridge River 219 16 10

IHA 591 Cayoose Creek 86 * *

IHA 693 Coldwater 404 22 14

IHA 703 High Bar 2 * *

IHA 699 Nooaitch 118 10 *

IHA 692 Oregon Jack Creek 20 * *

IHA 595 Seton Lake 349 17 16

IHA 698 Shackan 83 * *

IHA 605 Shuswap 114 * *

IHA 707 Skuppah 67 * *

IHA 594 Ts‟kw‟aylaxw First Nation (Pavilion) 274 12 11

NHA 709 ?esdilagh (Alexandria) 54 * *

NHA 619 Burns Lake 46 * *

NHA 620 Cheslatta Carrier Nation (Grassy Plains) 167 10 *

NHA 504 Dease River 66 not avail. not avail.

NHA 672 Gitxaala Nation (Kitkatla) 453 30 23

NHA 675 Hartley Bay 146 11 11

NHA 721 Kluskus 51 * *

NHA 607 Lake Babine Nation 1456 90 76

NHA 611 Lheidli T‟enneh (Shelly) 101 * *

NHA 715 Lhtako Dene Nation 74 * *

NHA 502 Liard First Nation (Lower Post or Daylu Dene) 507 not avail. not avail.

NHA 673 Metlakatla 94 * *

NHA 612 Nadleh Whuten (Nautley) 229 18 *

NHA 726 Nee-Tahi-Buhn 57 * *

NHA 729 Skin Tyee 59 * *

NHA 613 Stellat‟en First Nation (Stellaquo) 217 * 10

NHA 608 Takla Lake First Nation 402 15 14

NHA 501 Taku River Tlingit First Nation 95 not avail. not avail.

NHA 725 Wet‟suwet‟en First Nation 121 * 12

14


They do not include non-Status First Nations people or non-Band members living in communities


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HA ID Community Population (*Masked<10)

All 0-4yrs 5-7yrs

NHA 728 Yekooche 96 * *

VCHA 541 Oweekeno/Wuikinuxv Nation (Rivers Inlet) 91 * *

VIHA 635 Da‟naxda‟xw First Nation (Tanakteuk) 57 * *

VIHA 627 Gwawaenuk Tribe 17 * *

VIHA 661 Hesquiaht 163 * *

VIHA 624 K‟omoks First Nation 117 * *

VIHA 553 Klahoose First Nation (Quadra) 77 * *

VIHA 628 Kwiakah 6 * *

VIHA 625 Kwicksutaineuk-ah-kwaw-ah-mish (Gifford Is.) 78 * *

VIHA 643 Lake Cowichan First Nation 12 * *

VIHA 629 Mamalilikulla-Qwe‟Qwa‟Sot‟Em 60 * *

VIHA 639 Nuchatlaht 51 * *

VIHA 651 Qualicum First Nation 58 * *

VIHA 632 Tlatlasikwala 44 * *

VIHA 637 Tlowitsis Tribe 79 * *

VIHA 666 Toquaht 18 * *

VIHA 667 Uchucklesaht 28 * *

Other factors identified as influencing the provision of oral health services on-reserve

include: proximity of the on-reserve community to other locations providing oral health services;

degree of geographical isolation of the community; travel time and travel costs to provide service

to the community; human and financial resources available; as well as community readiness, and

whether the community has identified oral health as a priority.

Off- Reserve Health Authority Public Health

Regional Health Authority staff provide off-reserve oral health services to First Nations

and Aboriginal families (see Appendix E). Service locations tend to be Aboriginal Friendship

Centres, health centres, and Head Start programs located in urban areas. The nature and

frequency of services and sources of funding vary significantly, similar to the variance in on-

reserve public health services. Oral health information is incorporated into routine public health

services such as during immunization/well child clinics offered through public health offices.

Health Canada’s First Nations and Inuit Health Branch and Public Health Agency of

Canada’s Early Childhood Development Programs

Oral health messaging from the Children‟s Oral Health Initiative (COHI), is being

incorporated into Early Childhood Development programs for First Nations and Aboriginal

families (on reserve), through programs provided by First Nations and Inuit Health Branch

(FNIHB). These programs include the Maternal Child Health (MCH) Program, British Columbia

First Nations Head Start On-Reserve (BCFNHSOR) Program, FASD Home Visiting Program,

and the Canadian Prenatal Nutrition Program (CPNP).

Public Health Agency of Canada (PHAC) administers early childhood programs (off

reserve) such as the Aboriginal Head Start in Urban and Northern Communities (AHSUNC)

program and Community Action Program for Children (CAPC), and the Canada Prenatal


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Nutrition Program (CPNP). Opportunities exist to support oral health promotion activities and

messaging to families through these programs and services. Table 3 below shows the number

and distribution of these programs by Health Authority. (Information about these programs is

included in Appendix A. Current program locations for MCH, BCFNHSOR and FASD are

included in Appendix C. Current program locations for AHSUNC, CPNP and CAPC are

included in Appendix F.)

Table 3: Early Childhood Development programs for First Nations and Aboriginal

Families provided through Health Canada’s First Nations and Inuit Health Branch

(FNIHB) and Public Health Agency of Canada

Health

Authority

FNIHB Early Childhood Development

Programs

PHAC

MCH BCFNHSOR FASD CPNP AHSUNC CAPC CPNP

FHA 7 24 9 6 2 4 7

IHA 6 35 7 9 1 5 11

NHA 18 35 11 11 5 2 11

VCHA 2 7 0 4 2 7 5

VIHA 10 20 12 10 2 3 10

TOTAL 43 121 39 40 12 21 44

4.3 Oral Health Services and Providers On-reserve, by Health Authority

This section presents information about programs and services currently delivered on-

reserve, grouped geographically according to regional Health Authority service area. This

information was provided by regional Health Authorities and Health Canada. (See Appendix C

for an overview of services provided in each community, and Appendix D for additional details

by community, including frequency of services.)

Fraser Health Authority

Information was provided for 32 on-reserve communities located within the service area

of Fraser Health Authority (FHA). FHA has an estimated on-reserve population of 4,656

individuals identified as Status Indian 15

, including 343 children zero to four years of age and 264

children five to seven years of age.

25 of the 32 communities receive oral health services. COHI is provided in a total of 15

communities. In 11 of these 15 communities, a Health Canada dental therapist delivers COHI

services; a Fraser Health dental hygienist delivers COHI services to the remaining four other on-

reserve communities. Health Authority public health delivers preventive oral health services to

10 additional communities, with services including fluoride varnish, and dental health education

sessions.

15




15 | P a g e

Seven communities have no oral health services on-reserve. Each of these communities

currently has fewer than 10 children zero to four years of age.

There are four on-reserve dental clinics/operatories within the service area of FHA. These

include Tzeachten - Sto‟lo Nation Dental Clinic, Boston Bar/Anderson Creek, Seabird, and

Sumas.

Interior Health Authority


of Interior Health Authority (IHA). IHA has an estimated on-reserve population of 14,709

individuals identified as Status Indian13

, including 869 children zero to four years of age and 668

children five to seven years of age.


communities. Two Health Canada dental therapists provide COHI services to six on-reserve

communities. Health Authority staff deliver COHI services to two on-reserve communities, and

band-employed dental hygienists deliver COHI services to eight additional on-reserve

communities. Health Authority Public Health delivers oral health services, including preventive

education, caries risk assessments, fluoride varnish, and kindergarten survey/screening to 25

communities. Of the communities included in the counts above, three (Esketemc, Lower Nicola

Band, and Upper Nicola Band) receive both Health Authority services and COHI delivered by

Health Canada.

Although there are 13 communities with no dental services on-reserve, seven of the 13

communities (53%) currently have fewer than 10 children zero to four years of age. Five of the

six remaining communities are located within 10 to 40 kilometres of a larger community.

five communities have between 10 and 20 children zero to four years of age -

o Bonaparte, which is within 10 km of Cache Creek

o Bridge River, which is within 10 km of Lillooet

o Nooaitch, which is within 20 km of Merritt

o Seton Lake, which is 70 km from Lillooet

o Ts‟kw‟aylaxw, which is approximately 40 km northwest of Lillooet; and

one community, Coldwater, which has 22 children zero to four years of age, and

is within 20 km of Merritt.

There are nine on-reserve dental clinics/operatories within the service area of IHA.

Northern Health Authority

The service area of Northern Health Authority (NHA) includes almost two-thirds of

British Columbia‟s geographical area. Information was provided for 54 on-reserve communities.


16 | P a g e

NHA has an estimated on-reserve population of 18,247 individuals identified as Status Indian16,

17, including 1,182 children zero to four years of age and 862 children five to seven years of age.


communities. In 10 of 17 communities, a Health Canada dental therapist delivers COHI services,

and Northern Health dental hygienists provide COHI services to 7 on-reserve communities. In

addition to its COHI partnerships, NHA delivers oral health services which include a fluoride

varnish program. In some communities, training is provided to interested health care workers. In

13 communities, the fluoride varnish program is provided on-reserve by Health Authority staff;

in two of these communities on Haida Gwaii, UBC Dental Residents provide treatment service

on a regular basis. Three of the communities receiving Health Authority services also receive

treatment services by Health Canada dental therapists. One community receives dental therapist

treatment only, through Health Canada.

20 communities have no oral health services on-reserve. Population figures for children

zero to four years of age were not available for three of those communities (Taku River Tlingit

First Nation, Liard First Nation (also known as Lower Post or Daylu Dene), and Dease River). These

communities are listed in the INAC database as Yukon Territory Bands, and are in remote

locations close to the BC-Yukon border. For the 17 communities for which figures are available,

11 communities (65%) currently have fewer than 10 children zero to four years of age:

four communities have between 10 and 20 children zero to four years of age -

o Cheslatta, which is within 40 km, including ferry, of Burns Lake

o Hartley Bay, which is in a remote location on BC‟s west coast

o Nadleh Whuten, which is within 40 km of Vanderhoof and 90 km of Burns

Lake

o Takla Lake; which is in a remote location north of Fort. St. James with limited

road access;

one community, Gitxaala (Kitkatla), has 30 children zero to four years of age, is in a

remote location on a small coastal island across the strait from Haida Gwaii, and

currently has a vacant dental therapist position; and

one community grouping, Lake Babine Nation, has 90 children zero to four years of

age, and is located in and around Burns Lake, where there is an on-reserve

operatory/clinic but no dental therapist or dentist.

There are 20 on-reserve dental clinics/operatories within NHA, with an additional two to

be completed in 2012.

Vancouver Coastal Health Authority


of Vancouver Coastal Health Authority (VCHA). VCHA has an estimated on-reserve population

16

Population figures do not include the communities of Taku River Tlingit First Nation, Liard First Nation (also

known as Lower Post or Daylu Dene), or Dease River, which are listed in the INAC database as Yukon Territory

Bands. 17




17 | P a g e

of 9,177 individuals identified as Status Indian3, including 580 children 0-4 years and 483

children 5-7 years.

13 of the 14 communities have oral health services on-reserve. No COHI services are

provided within VCHA. Health Canada provides services to three on-reserve communities,

including two for which Health Canada provides funding for dentist services, and one for which

both Health Canada and Health Authority public health provide service. Health Authority public

health provides services to an additional 7 communities, and funds one on-reserve Dental Clinic.

One on-reserve community, not served by Health Canada or VCHA public health, funds its own

Fluoride varnish program.

One community has no dental services on-reserve. This community currently has fewer

than 10 children zero to four years of age.

There are five on-reserve dental clinic/operatories within VCHA.

Vancouver Island Health Authority


of Vancouver Island Health Authority (VIHA). VIHA has an estimated on-reserve population of

14,542 individuals identified as Status Indian18

, including 1,192 children 0-4 years and 848

children 5-7 years.


communities. In five of these 14 communities, three Health Canada dental therapists provide

COHI services, and VIHA dental hygienists provide COHI services for an additional nine

communities. Services are provided by Health Authority Public Health for 21 communities,

including 16 served by Health Authority alone, three served by both Health Canada and Health

Authority public health, one served by Health Authority and Band, and one served by Health

Canada, Health Authority, and Band.

15 communities have no dental services on-reserve. Each of these communities currently

has fewer than 10 children zero to four years of age.

There are 11 on-reserve dental clinics/operatories within VIHA.

5.0 Discussion and Recommendations

As mentioned earlier in this report, the 2009-2010 Kindergarten dental survey19

showed

that there are significant disparities in oral health between Aboriginal children and non-

Aboriginal children in BC, and that the dental health of First Nations children in First Nations

schools is poorer than the dental health of Aboriginal children in public or independent schools.

When considering the findings of the survey in relation to the findings of this environmental

scan, it is important to note that the shift in emphasis within publicly-delivered oral health

services for First Nations and Aboriginal children from a treatment-based focus to a preventive

18


They do not include non-Status First Nations people or non-Band members living in communities. 19

Dental Survey of Aboriginal Kindergarten-Aged Children 2009-2010 – A Provincial and First Nations School

Analysis - Ministry of Health Services - Healthy Women, Children and Youth Secretariat, January, 2011


18 | P a g e

focus is a fairly recent development. Given that changes in oral health take time, and that the

benefits of preventive services are incremental, benefits of recently-initiated preventive services

may not be reflected in the 2009-2010 Kindergarten Survey.

The environmental scan confirms that oral health preventive services for First Nations

and Aboriginal children vary considerably by type and frequency, and vary in terms of who

provides the services. It confirms also that there are a number of First Nations communities

where oral health preventive services are not offered, and that there are dental operatories/clinics

in several communities that are not currently being used. While there are a few common reasons

for the presence or absence of preventive oral health services in communities, there are different

reasons and combinations of reasons within a particular community; community-specific

information may be required in order to explain the findings for that community.

The lack of access to oral health prevention services presents issues of poor oral health and

escalating preventable treatment costs that have a negative impact on each and all of the

Tripartite partners. Working together to invest in areas of oral prevention would unify the

relationships and strengthen Tripartite partnerships.

In order to accomplish the overarching goal of improving oral health for First Nations

and Aboriginal children on and off-reserve, it is recommended that a clear, coordinated, and

comprehensive provincial preventive oral health strategy be developed. This strategy should

include guidelines for types and frequencies of preventive oral health services for First Nations

and Aboriginal children across BC. Creating an effective, efficient strategy that is supported by

families and communities will require all stakeholders to work together in a coordinated manner,

with strong communication, and joint planning. Establishment of an Early Childhood Oral

Health Steering Committee is recommended. It is suggested that the strategy be guided by the

Tripartite partners and be developed in consultation with the British Columbia Dental

Association, British Columbia Dental Hygiene Association, Health Officers Council, Federal

partners, Health Authorities, First Nations Health Council, First Nations communities, and the

First Nations and Aboriginal Maternal Child Health Strategic Planning Committee.

Suggested steps in creating this strategy include:

developing a more detailed understanding of barriers to service delivery using a First

Nations and Aboriginal lens, and identifying and analyzing any identified patterns;

reviewing best practices in other jurisdictions for preventing early childhood caries in

First Nations and Aboriginal communities;

reviewing existing resources available to support delivery of the oral health services; and

considering recommendations from other relevant reports20,21,22

on early childhood oral

health in the creation of feasible approaches to address gaps identified in the

environmental scan.

20

Dental Survey of Aboriginal Kindergarten-Aged Children 2009-2010 – A Provincial and First Nations School

Analysis - Ministry of Health Services - Healthy Women, Children and Youth Secretariat, January, 2011 21

Evaluation of BC Early Childhood Dental Programs. Human Early Learning Partnership, 2011. 22

A Canadian Oral Health Strategy Federal, Provincial, and Territorial Director‟s working group meeting –

Montreal August 2005.


19 | P a g e

An early childhood oral health strategy should include:

ensuring incorporation of key oral health messages for First Nations and Aboriginal

children and families into existing Health Authority public health prevention

programming and federal maternal and child health programs and services;

ensuring culturally appropriate educational resources are available for Aboriginal

families and care providers about prevention of early childhood caries;

offering cultural competency training for staff delivering oral health services;

encouraging public policy and healthy environments within First Nations communities

that promote oral health; and

ensuring that oral health prevention strategies, while focusing on children, promote the

importance of oral health, and also focus on encouraging lifestyle choices within families

and communities that support good oral health.

Maximizing the impact of preventive services developed within the early childhood oral

health strategy will require collaboration between all service providers and a focus on program

monitoring, and a robust evaluation. In addition, it is recommended that the early childhood oral

health strategy be an integrated component of the continuum of care of maternal-child health

services, aligning with existing prenatal, maternal, and early childhood health, programs and

services. It should also be integrated with primary care services, community social service

agencies and other key partners.


20 | P a g e

Figure 3. First Nations Communities in British Columbia. Source: First Nations and Inuit Health Canada, May 2007.

First Nations Communities in British Columbia.


21 | P a g e

Trail

Osoyoos

Atlin

Dease Lake

Fort St. John

Dawson Creek

SmithersTerrace

Prince RupertMasset

Prince George

Quesnel

Williams Lake

Golden

Revelstoke

Kamloops

Merritt

Vernon

Kelowna

Penticton

Whistler

Hope

Chilliwack

Courtenay

Nanaimo

Duncan

Victoria

Castlegar

Nelson

Kimberley

Cranbrook

Fernie

Stuart

Victoria

Hope.

Duncan

Vancouver

2011 Oral Health service data provided by Children’s Oral Health Initiative (COHI) and Regional Health Authorities

Population of Children 0-4 Years Old by First Nations Communities

Population = 0

Population = 1-9

Population = 10-50

Population = > 50

Figure 4. Population of Children 0-4 Years Old by First Nations Communities.


22 | P a g e

Trail

Osoyoos

Atlin

Dease Lake

Fort St. John

Dawson Creek

SmithersTerrace

Prince RupertMasset

Prince George

Quesnel

Williams Lake

Golden

Revelstoke

Kamloops

Merritt

Vernon

Kelowna

Penticton

Whistler

Hope

Chilliwack

Courtenay

Nanaimo

Duncan

Victoria

Castlegar

Nelson

Kimberley

Cranbrook

Fernie

Stuart

Victoria

Hope.

Duncan

Vancouver


Population of Children 5-7 Years Old by First Nations Communities

Population = 0

Population = 1-9

Population = 10-50

Population = > 50

Figure 5. Population of Children 5-7 Years Old by First Nations Communities


23 | P a g e

Trail

Osoyoos

Atlin

Dease Lake

Fort St. John

Dawson Creek

SmithersTerrace

Prince RupertMasset

Prince George

Quesnel

Williams Lake

Golden

Revelstoke

KamloopsVernon

Merritt

Kelowna

Penticton

Whistler

Hope

Chilliwack

Courtenay

Nanaimo

Duncan

Victoria

Castlegar

Nelson

Kimberley

Cranbrook

Fernie

Stuart

Victoria

Hope.

Duncan

Vancouver


Children’s Preventive Oral Health Service Providers in First Nations Communities

On-Reserve Health Authority PublicHealth Services

On-Reserve Children’s Oral HealthInitiative (COHI) Services

On-Reserve Health Authority PublicHealth – COHI Services

On-Reserve Dental Clinics

No On-Reserve Oral Health Services

Figure 6. Children’s Preventive Oral Health Service Providers in First Nations Communities.


24 | P a g e

Appendix A: Health Canada’s First Nations and Inuit Health Branch Early

Childhood Development Programs

Following are descriptions of Early Childhood Development Programs, which are delivered

through Health Canada‟s First Nations and Inuit Health Branch (FNIHB) and the Public Health

Agency of Canada (PHAC). Details about locations within each Health Authority where these

provided are located in Appendix C (FNIHB) and Appendix F (PHAC).

Health Canada’s First Nations and Inuit Health Branch (FNIHB) Programs

Recently, First Nations & Inuit Health Branch (FNIHB) has been undergoing some

restructuring in preparation for the transfer of FNIHB Health Services to First Nations

governance through the Interim First Nations Health Authority. Previously, the Early Childhood

Development Unit within FNIHB consisted of three programs: Maternal Child Health (MCH),

BC First Nations Head Start on Reserve (BCFNHSOR), and Fetal Alcohol Spectrum Disorder

(FASD) Program. With the restructuring, the unit has now absorbed the management of two pre-

existing programs: Canada Prenatal Nutrition Program (CPNP) and Children‟s Oral Health

Initiative (COHI). This restructuring does not include any increased funding; it is purely an

administrative and management change.

There are FNIHB programs currently being delivered in up to 203 First Nations

communities across BC. Services are delivered in many ways, ranging from centre based

programming, home visiting and outreach, or a combination. Oral health messaging (from the

COHI program) and services are currently being incorporated into all these programs with front

line staff receiving direct training, support and resources pertaining to oral health promotion.

Oral health promotion activities currently being implemented through the FNIHB programs

range from community to community and program to program. As the five programs integrate,

oral health promotion activities will slowly be integrated into all programs with front line staff

implementing a range of services. Acting as an integrated unit, cross training of front line staff

from all programs is utilized as much as possible with COHI staff providing the oral health

training and information.

Maternal Child Health Program (MCH)

The MCH program is designed to support pregnant First Nations women and families

with infants and young children, who live on-reserve, to reach their fullest developmental and

lifetime potential. Program clients include all First Nations pregnant women and new parents,

living on reserve with long term support for those families who require additional supports. The

MCH program is made up of four main components: 1) screening and assessment of pregnant

women, new parents, and children to assess family needs, 2) Goal oriented home visiting by

trained lay professional and/or a community health nurse/MCH nurse, 3) case management for

families with complex care needs requiring extra support, and 4) preconception/reproductive

health activities. Culture is also an aspect of the MCH program, integrated throughout the

program as the lens through which activities are implemented. Family care plans are developed,

in collaboration, with the MCH care teams (can also include external partners/service providers)

and the families taking a strength-based approach to address the needs of the families.


25 | P a g e

Historically, the program did not include any messaging or materials on maternal and child oral

health, however this is starting to be incorporated into MCH activities. The MCH program is

currently being delivered to 43 First Nations within BC.

Canada Prenatal Nutrition Program (CPNP)

The CPNP - First Nations and Inuit Health Branch program provides funding to BC First

Nations to develop or enhance services to improve maternal and infant nutritional health, to

promote healthy pregnancies and improve infant outcomes. The CPNP has provided funding

since 1996. Today, all First Nations in BC receive CPNP funding based on a formula that

considers total population and number of women within child bearing age. Appreciably,

community size and fluctuations in annual birth rates contribute some variability to the level of

service that is provided through this program to women who are planning pregnancy, pregnant

women, mothers of infants and infants up to one year of age. Program frameworks developed by

Health Canada identify high risk women as the key target population for this program and in

community it is generally understood that all women of child bearing age are the target

population. Oral health prevention activities include education and awareness with respect to

maternal oral health practices as well as infant feeding and family oral health practices that

promote the prevention of caries in infants.

BC First Nations Head Start On-Reserve Program (BCFNHSOR)

The BCFNHSOR Program funds activities that support social development, self esteem

and school readiness. Early intervention strategies are also available to address the learning and

developmental needs of young children living in First Nations communities. The goal is to

support early child development strategies that are designed by communities. BCFNHSOR

programming is centered around six components: education; health promotion; culture and

language; nutrition; social support; and parental/family involvement. Program clients include

children from birth to 6 years of age, and their families living on-reserve. The BCFNHSOR

program is delivered in 121 on-reserve communities within BC. The BCFNHSOR oral health

services are delivered in partnership with the COHI Program and other health services available

in the communities.

Fetal Alcohol Spectrum Disorder (FASD)

The Fetal Alcohol Spectrum Disorder (FASD) program provides funding to 38 BC First

Nations to develop or enhance services to addresses the number of health problems that are

associated with alcohol use by mothers during pregnancy. FASD was first introduced in 2005.

Health Canada's First Nations and Inuit Health Branch has worked with First Nations

communities over the past several years on “asset mapping”. Asset Mapping is a tool that helps

communities identify their strengths and to develop a plan of action to build on those strengths to

prevent FASD births and to support individuals and families affected by FASD births.

The FASD program is delivered in 38 First Nations, with a presence in each of the five

Regional Health Authorities with the exception of Vancouver Coastal. FASD is also located in

28 of the BCFNHSOR communities, 10 of the MCH communities and 17 of the COHI

communities.


26 | P a g e

Appendix A2: Public Health Agency of Canada (PHAC)

The Public Health Agency of Canada (PHAC) is working to build an effective public

health system that enables Canadians to achieve better health and well-being in their daily lives

by promoting good health, helping prevent and control chronic diseases and injury, and

protecting Canadians from infectious diseases and other threats to their health. PHAC is

committed to reducing health disparities between the most advantaged and disadvantaged

Canadians. Because public health is a shared responsibility, PHAC works in collaboration with

all levels of government (provincial, territorial and municipal) to build on each others‟ skills and

strengths23

.

The following programs are examples of Early Childhood programs supported by the Public

Health Agency of Canada.

Aboriginal Head Start in Urban and Northern Communities (AHSUNC)

The AHSUNC Program is an Early Childhood Development program for Aboriginal

(First Nations, Inuit, and Métis) children and their families living in urban and northern

communities. Projects are intended for children ages 0 – 6, with a primary emphasis on children

3 – 5 years of age. Typical projects offer half-day structured preschool experiences for 35 to 40

children. The program focuses on Aboriginal culture and language, education and school

readiness, health promotion, nutrition, social support, and parental involvement. The AHSUNC

program is delivered at 12 sites around BC.

Community Action Program for Children (CAPC)

The PHAC CAPC program provides funding to communities to develop comprehensive,

culturally appropriate prevention and early intervention programs to promote the health and

development of children 0 – 6 years and their families living in conditions of risk. Oral health

prevention activities may be delivered through health authority public health nursing

presentations, and education sessions. CAPC programming is delivered through 22 coalitions, at

104 project sites around BC.

Canadian Prenatal Nutrition Program (CPNP)

The CPNP provides funding to community groups to develop or enhance services that

improve maternal and infant nutritional health, promote healthy pregnancies and improve infant

outcomes. Oral health prevention activities may include Public Health Nursing visits, and

education. Program participants include pre- and post-natal Aboriginal and non-Aboriginal

women, and infants up to twelve months of age who live off-reserve, particularly those identified

as high risk. The CPNP is delivered at 44 sites around BC.

23

http://www.phac-aspc.gc.ca/about_apropos/back-cont-eng.php- Website accessed February 27 2012.

http://www.phac-aspc.gc.ca/about_apropos/back-cont-eng.php-


27 | P a g e

Appendix B: Non Insured Health Benefits

NIHB Dental Expenditure and Utilization Data (2010)

The Non-Insured Health Benefits program, (NIHB), is based on the 1979 Indian Health Policy

which describes the responsibility for the health of First Nations as shared amongst various

levels of government, the private sector and First Nations communities. Health Canada's First

Nations and Inuit Health Branch (FNIHB) is responsible for the policy and management of the

NIHB Program.

The NIHB Program of Health Canada provides approximately 900,000 registered First Nations

people and Inuit with a limited range of medically necessary, health-related, goods and services

when they are not otherwise insured by provincial, territorial or other third party health plans.

There are approximately 130,000 First Nations people in BC. Third party health plans are those

usually provided by insurance companies.

Objectives: The objectives of the program are to provide benefits to eligible First Nations in a

manner that:

Is suitable to their unique health needs.

Helps eligible First Nations to reach an overall health status on par with other Canadians.

Is cost effective.

Will maintain health, prevent disease and assist in detecting and managing illnesses, injuries

or disabilities.

In 2009/10, the national NIHB dental expenditures amounted to $194.9 million, accounting for

19.7% of the total NIHB expenditures. The British Columbia portion of dental expense was

$28.04 million or about 14.4% of the total dental expenditure.

Figure 1: Chart detailing the costs associated with the Non-Insured Health Benefits Program (2009 – 2010)

24.

24

Source: Non-Insured Health Benefits Program – Annual Report (2009-2010). Available online at: http://www.hc-

sc.gc.ca/fniah-spnia/pubs/nihb-ssna/2010_rpt/index-eng.php


28 | P a g e

“Promoting children’s oral health is a good policy: oral health is integral to children’s well-being and

investing in it makes solid financial sense..... For every dollar spent on preventive oral health care, as

much as $50 is saved on restorative and emergency oral health procedures”25

NIHB Fee-for-Service Dental Expenditures by Sub-Benefit

Nationally, expenditures for Restorative Services (crowns, fillings, etc.) were the highest of all

dental sub-benefit categories at $77.2 million in 2009/10. This is a 12.6% increase over the

previous fiscal year. Diagnostic Services (examinations, x-rays, etc.) at $20.1 million and

Preventive Services (scaling, sealants, etc.) at $19.1 million were the next highest sub-benefit

categories, followed by Oral Surgery (extractions, etc.) at $15.9 million and Removable

Prosthodontics (dentures, etc.) at $9.7 million. In 2009/10, the three largest dental procedures by

expenditure were Composite Restorations ($57.1 million), Scaling ($13.1 million) and

Extractions ($11.1 million).

Coverage for NIHB Dental services is determined on an individual basis, taking into

consideration current oral health status, recipient history, accumulated scientific research, and

availability of treatment alternatives. Dental services must be provided by a licensed dental

professional, such as a dentist, dental specialist, or denturist, who has agreed to provide services

to First Nations and Inuit clients through the NIHB Program.

An eligible recipient must be identified as a resident of Canada and one of the following:

A registered Indian according to the Indian Act;

An Inuk recognized by one of the Inuit Land Claim organizations; or

An infant less than one year of age, whose parent is an eligible recipient.

When recipients are eligible for benefits under a private health care plan, or public health or

social program, claims must be submitted to these plans and programs first before submitting

them to the Non Insured Health Benefits Program.

NIHB Dental Claimants and Non-Claimants by Age Group and Gender 2009/10

Nationally, claimants under the age of 20 accounted for 42% of all NIHB eligible clients who

received dental benefits through the Health Information and Claims Processing Services system,

while claimants 65 years and older accounted for approximately 3%. Of the claimants under 20

years of age, forty-five percent were males and 39% were females.

Nationally, of the 831,090 clients eligible to receive dental benefits through the NIHB Program,

301,851 (36%) claimants received at least one dental procedure paid through the Health

Information and Claims Processing Services (HICPS) system in 2009/10.

A higher proportion of female clients (56%) accessed dental services compared to male clients

(44%). This compares to the total eligible population where 51% are female and 49% are male.

The average age of dental claimants was 28 years, and the highest average age of dental

claimants was found in the Yukon (34 years of age) while the lowest was in Nunavut at 24 years

of age.

25

© 2011 Children Now. All Rights Reserved.


29 | P a g e

In the last five years, annual growth rates for NIHB Dental expenditures have ranged from a high

of 10.5% in 2009/10 to a low of 3.0% in 2006/07, with the average annualized growth rate being

6.4%.

Recipient Reimbursement

Service providers are encouraged to bill the Program directly so that recipients do not face

charges at the point of service when receiving health care goods or services.

When a recipient does pay directly for goods or services, he or she may seek reimbursement

from the NIHB Program. Requests for reimbursement must be received on a NIHB Client

Reimbursement Request Form, within one year from the date of service or date of purchase.

The range of dental services covered by the NIHB Program includes:

Diagnostic services such as examinations and radiographs;

Preventive services such as scaling, polishing, fluorides and sealants;

Restorative services such as fillings;

Endodontic services such as root canal treatments;

Periodontal services such as deep scaling;

Prosthodontic services such as removable dentures;

Oral surgery services such as simple extractions;

Orthodontic services to correct significant irregularities in teeth and jaws; and

Adjunctive services such as general anaesthesia and sedation

The largest net increase in 2009/10 expenditures took place in the British Columbia Region

where total dental costs grew by $3.3 million.26

26

Provincial dental fee comparisons should be read with some caution as each province negotiates fee schedules,

timing, and length of contracts independently.


30 | P a g e

Appendix C: 2011 Early Childhood Oral Health Services, Population Estimates*, and Child Development Programs for

On-Reserve Communities (*Source: Indian and Northern Affairs Canada, November, 2011. Population figures given are estimates only, and refer to Status First Nations Band members

living on-reserve. They do not include non-Status First Nations people or non-Band members living in communities.)

Legend: COHI=Children’s Oral Health Initiative; HC=Health Canada, FNIHB; COHI HC(B) = COHI service funded by Health Canada and delivered by Band;

HA=Health Authority; Op/Clinic=Operatory/Clinic whether in use or not in use; BCFNHSOR=Aboriginal Head Start On-reserve Program; FASD=Fetal Alcohol

Spectrum Disorder Home Visiting Program; MCH=Maternal Child Health Program)

HSDA COMMUNITY ID #

ORAL HEALTH SERVICES POPULATION(*Mask

ed <10) FNIHB DEVEL. PROGRAMS

COHI

HA Op/ Clinic

Therapist

Non-COHI- Prevention (P) or Restorative Treatment (T))

None All Ages

0-4 Yrs

5-7 Yrs

BCFNHSOR FASD MCH HC HC-

HA

Fraser Health Authority

East Aitchelitz 558 ●

32 * * ● ●

East Boothroyd 700 ●

93 * * ●

East Boston Bar First Nation 701

●

●

98 * * ●

East Chawathil (Seabird Island) 583 ●

379 31 32 ●

East Cheam 584 ●

260 23 19 ● ●

North Katzie (Pitt Meadows) 563 ●

307 21 16 ●

South Kwantlen First Nation 564 ●

92 * * ●

East Kwaw-kwaw-Apilt 580

● 32 * * ● ●

East Kwikwetlem First Nation 560

● 38 * *

East Leq' a: mel First Nation 579 ●

134 * 12 ● ●

East Matsqui 565 ●

107 11 10 ●

East Peters 586

● 45 * *

East Popkum 585

● 1 * * ● ●

North Qaygayt (New Westminster) 566

● 0 0 0

East Scowlitz 568 104 * * ● ●

http://pse5-esd5.ainc-inac.gc.ca/fnp/Main/Search/FNMain.aspx?BAND_NUMBER=558&lang=eng















31 | P a g e

HSDA COMMUNITY ID #



COHI

HA Op/ Clinic

Therapist


None All Ages

0-4 Yrs

5-7 Yrs


HA

●

East Seabird Island 581 ●

● 572 54 35 ● ●

South Semiahmoo 569 ●

56 * *

East Shxwhá:y Village (Skway) 570 ●

98 * *

East Shxw'ow'hamel First Nation 587

●

98 10 * ● ● ●

East Skawahlook First Nation 582 ●

12 * * ● ●

East Skowkale 571 ●

170 * * ● ●

East Skwah 573 ●

286 23 * ● ● ●

East Soowahlie (Cultus Lake) 572 ●

184 * * ●

East Spuzzum 708

●

47 * * ●

East Squiala First Nation 574 ●

129 25 * ●

East Sts'ailes (Chehalis Indian Band) 559 ●

561 36 28 ●

East Sumas First Nation 578 ●

●

174 * 12 ● ●

South Tsawwassen First Nation 577 ●

174 * * ●

East Tzeachten 575 ●

●

263 22 12 ●

East Union Bar 588

● 10 * *

East Yakweakwioose 576 ●

33 * * ● ●

East Yale First Nation 589

● 67 * *

FHA Subtotals: 32 communities

11 4 10 4

7 4656 343 264 24 9 7

Interior Health Authority

East ?Akisq'nuk First Nation (Columbia Lake)

604 ●

155 10 * ●

West Adams Lake 684 ●(B)

422 16 21 ● ●

West Alexis Creek (Redstone) 710 ●

● 347 12 13 ●























32 | P a g e

HSDA COMMUNITY ID #



COHI

HA Op/ Clinic

Therapist


None All Ages

0-4 Yrs

5-7 Yrs


HA

West Ashcroft 685

● 79 * *

West Bonaparte (St'uxutews or Stuctwesemc)

686

● 236 18 10 ●

West Bridge River 590

● 219 16 10 ●

West Canim Lake 713 ● ●(P) 441 18 10 ●

West Cayoose Creek 591

● 86 * *

West Coldwater 693

● 404 22 14 ●

West Cook's Ferry (Fraser Canyon Indian Band)

694 ●

79 * *

West Esketemc (Alkali Lake) 711 ● ●

● ● (T) 466 29 15 ● ●

West High Bar 703

● 2 * *

West Kanaka Bar 704 ●

78 * * ●

East Ktunaxa First Nations (Tobacco Plains)

603 ●

95 * * ●

West Little Shuswap Lake (Skwlax) 689 ●(B)

●

235 11 * ●

West Lower Nicola 695

●

549 42 29 ●

Central Lower Similkameen 598 ●

286 18 14 ●

West Lytton 705 ●

938 57 44 ●

West Neskonlith 690 ●(B)

327 20 14

West Nicomen (Fraser Canyon Indian Band)

696 ●

70 * * ●

Central Nk'mip (Osoyoos or Inkameep) 596 ●

371 29 29 ●

West Nooaitch 699

● 118 10 *

Central Okanagan 616 ●

908 46 45 ●

West Oregon Jack Creek 692

● 20 * * ●

Central Penticton 597 ●

608 47 35 ●

West Seton Lake 595

● 349 17 16 ●





























33 | P a g e

HSDA COMMUNITY ID #



COHI

HA Op/ Clinic

Therapist


None All Ages

0-4 Yrs

5-7 Yrs


HA

West Shackan 698

● 83 * *

East Shuswap 605

● 114 * *

West Simpcw First Nation 691 ●(B)

248 * 10 ●

West Siska 706 ●

104 * *

West Skeetchestn 687 ●(B)

245 12 13 ● ●

West Skuppah 707

● 67 * * ●

West Soda Creek (Xatsull First Nation) 716 ● ● (T) 183 11 * ● ●

Central Splatsin First Nation (Spallumcheen or Enderby)

600 ●(B)

●

394 23 23 ●

East St. Mary's 602 ●

212 13 12 ●

West Stswecem'c Xgat'tem First Nation (Canoe Creek or Dog Creek)

723

● ●(T) 317 12 21 ● ●

West T'it'q'et (Lillooet or T'it'kit) 593 ●

198 13 * ●

West Tk'emlups Indian Band (Kamloops)

688 ●(B)

●

642 53 27 ● ●

West Tl'etinqox-t'in Government Office (Anaham)

712 ●

● Vacant 603 31 21 ●

West Toosey 718 ●

166 12 * ●

West Ts'kw'aylaxw First Nation (Pavilion)

594

● 274 12 11 ●

West Ulkatcho (Anahim Lake) 722 ● ● ●(T) 701 38 35 ●

West Upper Nicola 697

●

426 13 22 ●

Central Upper Similkameen 599 ●

62 * *

Central Westbank First Nation 601 ●

● 423 33 19 ● ●

West Whispering Pines/Clinton 702 ●(B)

61 * * ● ●

West Williams Lake / Sugar Cane Band

719 ● ●(T) 263 19 22 ● ●

West Xaxli'p (Fountain Indian Band, Cacl'ep)

592 ●

392 21 15 ●











http://pse5-esd5.ainc-inac.gc.ca/FNP/Main/Search/FNMain.aspx?BAND_NUMBER=723&lang=eng





















34 | P a g e

HSDA COMMUNITY ID #



COHI

HA Op/ Clinic

Therapist


None All Ages

0-4 Yrs

5-7 Yrs


HA

West Xeni Gwet'in First Nations Government (Nemaiah Valley)

714 ●

● Vacant 258 13 *

East Yakunyk (Lower Kootenay) 606 ●

108 * * ●

West Yunesit'in (Stone) 717 ●

277 25 12

IHA Subtotals: 51 communities 14 2 23 9

13 14709 869 668 35 7 6

Northern Health Authority

NI ?Esdilagh (Alexandria) 709

● 54 * *

NE Blueberry River First Nations 547 ●

● 236 21 18 ●

NI Burns Lake 619

● 46 * * ●

NI Cheslatta Carrier Nation (Grassy Plains)

620

● 167 10 * ●

NW Dease River** 504

● 66 not avail.

not avail.

NE Dene Tsaa Tse K'Nai First Nation (Prophet River)

544 ●

114 11 * ●

NE Doig River 548 ●

143 * 15 ●

NE Fort Nelson First Nation 543 ●

434 31 18 ●

NW Gitanmaax (Old Hazelton) 531 ●

808 41 32 ● ● ●

NW Gitanyow 537 ●

● ● (T) 422 38 23

NW Gitsegukla 535 ●

● ● (T) 468 38 26 ●

NW Gitwangak (Kitwanga) 536 ● (T) 438 39 20 ●

NW Gitxaala Nation (Kitkatla) 672 ● Vacant ● 453 30 23 ●

NW Glen Vowell 533 ●

187 12 * ● ●

NW Hagwilget Village (New Hazelton)

534 ●

● (T) 233 23 10 ●

NW Haisla Nation (Kitamaat) 676 ●

668 20 18 ●

NE Halfway River First Nation 546 ●

159 13 * ●

NW Hartley Bay 675 ● Vacant ● 146 11 11 ●


























35 | P a g e

HSDA COMMUNITY ID #



COHI

HA Op/ Clinic

Therapist


None All Ages

0-4 Yrs

5-7 Yrs


HA

NW Iskut 683 ●

● ● (T) 352 35 23 ● ●

NW Kispiox 532 ●

● ● (T) 698 59 39 ● ● ●

NW Kitselas 680 ● ● ●(T) 266 22 14 ● ●

NW Kitsumkalum 681 ● ●(T) 220 17 * ● ●

NI Kluskus 721

● 51 * *

NI Kwadacha (Fort Ware) 610 ●

● ● (T) 290 21 22 ●

NW Kyah Wiget (Moricetown) 530 ●

● ● (T) 697 39 28 ●

NI Lake Babine Nation*** 607

● ● 1456 90 76 ●

NW Lax-kw'alaams (Port Simpson) 674 ● ● ●(T) 732 61 32

NI Lheidli T'enneh (Shelly) 611

● 101 * *

NI Lhtako Dene Nation 715

● 74 * *

NE Liard First Nation** (Lower Post or Daylu Dene)

502

● 507 not avail.

not avail.

●

NW Metlakatla 673

● 94 * * ●

NI Nadleh Whuten (Nautley) 612

● 229 18 * ● ●

NI Nak'azdli (Necosli) 614 ●

750 45 33 ●

NI Nazko 720 ●

168 14 15 ●

NI Nee-Tahi-Buhn 726

● 57 * * ●

NW Nisga'a Village of Gingolx 671 ●

461 13 19 ● ●

NW Nisga'a Village of Gitwinksihlkw 679 ●

212 10 * ● ●

NW Nisga'a Village of Laxgalt'sap 678 ●

614 43 39 ● ●

NW Nisga'a Village of New Aiyansh 677 ●

●

903 34 26 ● ●

NW Old Massett Village Council 669 ●

● 756 33 18

























36 | P a g e

HSDA COMMUNITY ID #



COHI

HA Op/ Clinic

Therapist


None All Ages

0-4 Yrs

5-7 Yrs


HA

NI Saik'uz First Nation (Stony Creek)

615 ●

● 430 19 14 ● ●

NE Saulteau First Nations 542 ●

372 24 13 ●

NW Skidegate 670

●

731 39 36 ● ●

NI Skin Tyee 729

● 59 * * ●

NI Stellat'en First Nation (Stellaquo) 613

● 217 * 10 ● ●

NW Tahltan (Telegraph Creek) 682 ●

● ●(T) 336 22 11 ● ●

NI Takla Lake First Nation 608

● ● 402 15 14 ●

NW Taku River Tlingit First Nation** 501

● 95 not avail.

not avail.

●

NI Tl'azt'en Nation**** 617 ●

661 69 37 ●

NI Tsay Keh Dene 609

● ●(T) 247 19 24 ●

NI Tsekani First Nation (McLeod Lake)

618 ●

●(T) 132 14 * ●

NE West Moberly First Nations 545 ●

86 12 *

NI Wet'suwet'en First Nation 725

● 121 * 12 ● ●

NI Yekooche 728

● ● 96 * * ● ●

NHA Subtotals: 54 communities

10 7 14 20

20 18915 1182 862 35 11 18

Vancouver Coastal Health Authority

NS-CG Heiltsuk (Bella Bella) 538 ● ● (T) 1171 68 62 ● ●

NS-CG Kitasoo (Klemtu) 540 ● 320 19 18 ●

NS-CG Lil'Wat Nation (Mount Currie) 557 ●

● 1479 106 78 ●

Van. Musqueam 550 ●

754 61 51

NS-CG N'Quatqua (Anderson Lake or D'Arcy)

556 ●

207 * * ●

NS-CG Nuxalk Nation (Bella Coola) 539 ● ● ● (T) 894 77 68

NS-CG Oweekeno/Wuikinuxv Nation (Rivers Inlet)

541

● 91 * *


























37 | P a g e

HSDA COMMUNITY ID #



COHI

HA Op/ Clinic

Therapist


None All Ages

0-4 Yrs

5-7 Yrs


HA

NS-CG Samahquam (Southern Stl'atl'imx Nation)

567 ●

113 12 *

NS-CG Sechelt 551 ●

660 34 27 ●

NS-CG Skatin Nations 562 ●

133 * *

NS-CG Sliammon 554 ●

● 587 26 26 ●

NS-CG Squamish 555 ●

2393 129 114 ●

NS-CG Tipella (Douglas) 561 ●

88 * *

NS-CG Tsleil-Waututh Nation (Burrard First Nation)

549 ●

287 29 17 ●

VCHA Subtotals: 14 communities

0 0 11 5 2 1 9177 580 483 7 0 2

Vancouver Island Health Authority

Central Ahousaht 659 ●

● (T) 739 90 51 ● ●

South Beecher Bay 640 ●

112 * * ●

Central Cowichan 642 ●

● ●(T) 2643 268 186 ● ●

North Da'naxda'xw First Nation (Tanakteuk)

635

● 57 * *

Central Ditidaht 662 ●

241 16 14 ● ●

North Ehattesaht 634 ●

140 13 10

Central Esquimalt 644 ●

183 26 14 ● ●

North Gwa'Sala-Nakwaxda'xw 724 ●

● ●(T) 527 75 50 ●

North Gwawaenuk Tribe 627

● 17 * *

Central Halalt (H'ulh-etun) 645 ● ● ● (T) 110 10 *

Central Hesquiaht 661

● 163 * * ●

North Homalco (Campbell River) 552 ●

●

248 * * ●

Central Hupacasath First Nation 664 ●

141 * * ●

Central Huu-ay-aht First Nations 663 ● ● ●(T) 133 10 11

North Ka:'yu:'k't'h'/Che:k:tles7et'h' First Nations (Kyuquot)

638 ●

● ●(T) 171 10 * ●




























38 | P a g e

HSDA COMMUNITY ID #



COHI

HA Op/ Clinic

Therapist


None All Ages

0-4 Yrs

5-7 Yrs


HA

North Klahoose First Nation (Quadra) 553

● 77 * *

North K'ómoks First Nation 624

● 117 * * ●

North Kwakiutl (Fort Rupert) 626 ●

● 328 17 12 ● ●

North Kwiakah 628

● 6 * * ●

North Kwicksutaineuk-ah-kwaw-ah-mish (Gifford Is.)

625

● 78 * *

Central Lake Cowichan First Nation 643

● 12 * *

Central Lyackson 646 ●

● ●(T) 41 * *

Central Malahat First Nation 647 ●

163 17 *

North Mamalilikulla-Qwe'Qwa'Sot'Em 629

● 60 * * ●

North Mowachaht/Muchalaht 630 ●

253 25 10

North Namgis First Nation (Alert Bay) 631 ●

● 977 36 40 ●

North Nuchatlaht 639

● 51 * *

South Pacheedaht First Nation 658 ●

121 * *

South Pauquachin 652 ●

276 26 20 ●

Central Penelakut 650 ●

565 43 32 ● ●

Central Qualicum First Nation 651

● 58 * *

North Quatsino 633 ●

● 225 16 16

Central Snaw-Naw-As First Nation (Nanoose First Nation)

649 ●

170 15 14 ● ● ●

Central Snuneymuxw First Nation (Nanaimo First Nation)

648 ●

689 51 35 ● ●

South Songhees First Nation 656 ●

363 36 32 ●

Central Stz'uminus First Nation (Chemainus First Nation*)

641 ● ● ●(T) 768 61 53 ● ●

Central Tla-o-qui-aht First Nations***** 660 ●

372 42 21 ● ●

North Tlatlasikwala 632 ● 44 * *





























39 | P a g e

HSDA COMMUNITY ID #



COHI

HA Op/ Clinic

Therapist


None All Ages

0-4 Yrs

5-7 Yrs


HA

North Tlowitsis Tribe 637

● 79 * *

Central Toquaht 666

● 18 * *

South Tsartlip 653 ●

619 59 45 ●

North Tsawataineuk (Kingcome) 636 ●

154 * * ●

South Tsawout First Nation 654 ●

557 46 34 ●

Central Tseshaht 665 ●

429 30 19 ● ●

South Tseycum 655 ●

113 * * ● ●

South T'Sou-ke First Nation (Sooke) 657 ●

134 * *

Central Uchucklesaht 667

● 28 * *

Central Ucluelet First Nation 668 ●

221 20 *

North Wei Wai Kai (Cape Mudge or Quinsam)

623 ●

380 20 10 ●

North Wei Wai Kum (Campbell River) 622 ●

371 35 17 ●

VIHA Subtotals: 50 communities

5 9 21 11

15 14542 1192 848 20 12 10

Provincial Total Communities Served

40 22 79 49

56 61999 4166 3125 121 39 43

*Chemainus Includes the communities of: Kulleet Bay, Shell Beach, and I.R. #11

**Dease River, Liard and Taku River are located in B.C. but they are listed in the INAC database as Yukon territory Bands

***Lake Babine includes the communities of: Fort Babine, Tachet and Woyenne.

****Tl'azt'en Nation includes the communities of: Binchi, Tache and Middle River (Dzit'ainli)

*****Tla-o-qui-aht includes the communities of: Esowista and Opitsaht















40 | P a g e

Appendix D: Oral Health Care Providers for On-Reserve Communities – Detailed Survey Results

Health Authority

Community Name/Alias

ID HSDA Dental Services Frequency

Dental Therapist serving

community

On-Reserve Dental

Operatory/ Clinic (Y/N)

Service Provider/ Mapping

Fraser Aitchelitz 558 East COHI Several times per year Yes, COHI No Health Canada

Fraser Boothroyd Indian Band 700 East COHI- FV and info sessions on-reserve

monthly Yes, COHI sealants and ART

No Health Canada-Health Authority

Fraser Boston Bar First Nation 701 East COHI- FV and info sessions on-reserve NEW ABC Dental,1 op/chair - dentist screened 40 children at Anderson Creek Health Clinic in Sept 2011, currently treating ~1/mo.

monthly 1 day/month

Yes, COHI sealants and ART

Yes Health Canada-Health Authority

Fraser Chawathil 583 East Fluoride Varnish and dental health education sessions on-reserve On-reserve – Head Start

3 x / year No No Health Authority

Fraser Cheam 584 East Fluoride Varnish and dental health education sessions on-reserve On-reserve – Head Start

3 x/ year No No Health Authority

Fraser Katzie Band – Pitt Meadows

563 North Fluoride Varnish and dental education sessions on-reserve On-reserve – Head Start

FV and dental education 4x/year

No No Health Authority

Fraser Kwantlen 564 South Fluoride Varnish and dental education sessions on-reserve On-reserve – Head start

FV and dental education 2-3x/ year


Fraser Kwaw-kwaw-Apilt 580 East No No none

Fraser Kwikwetlem 560 East no N/A no No None


41 | P a g e

Health Authority




community

On-Reserve Dental



Fraser Leq’a:mel 579 East COHI Several times per year Yes, COHI No Health Canada

Fraser Matsqui 565 East COHI Several times per year Yes, COHI No Health Canada

Fraser Peters 586 East None No No None

Fraser Popkum First Nation 585 East (part of Sto'lo First Nations) No No None

Fraser Qaygayt (New Westminster)

566 North no N/A no No None

Fraser Scowlitz 568 East on-reserve 3 – 4 x/year No No Health Authority

Fraser Seabird Island 581 East Fee for Service Dental Clinic Prevention education provided by health authority

Limited Prevention education provided by Health Authority 1x/year

? Yes Health Authority / Band

Fraser Semiahmoo 569 South on-reserve 2x/year No No Health Authority

Fraser Shxw’ow’hamel First Nation

587 East COHI- FV and dental health education sessions on-reserve



Fraser Shxwha:y 570 East COHI Several times per year Yes, COHI No Health Canada

Fraser Skawahlook First Nation

582 East (part of Sto'lo First Nations) Dental education and promotion and Fluoride varnish

ongoing No No Health Authority

Fraser Skowkale 571 East COHI Several times per year Yes, COHI No Health Canada

Fraser Skwah 573 East COHI Several times per year Yes, COHI No Health Canada

Fraser Soowahlie 572 East Fluoride Varnish and dental education sessions on-reserve On-reserve – Head start

3 x / year No No Health Authority


42 | P a g e

Health Authority




community

On-Reserve Dental



Fraser Spuzzum First Nation 708 East COHI- FV and info sessions on-reserve



Fraser Squiala 574 East COHI Several times per year Yes, COHI No Health Canada

Fraser Sts'ailes (Chehalis) 559 East COHI Several times per year Yes, COHI No Health Canada

Fraser Sumas 578 East COHI Several times per year Yes, COHI Yes Health Canada

Fraser Tsawwassen First Nation

577 South on-reserve 2x/year No No Health Authority

Fraser Tzeachten 575 East COHI Sto'lo Nation Dental Clinic. Fee for service

COHI weekly Clinic managed and staffed by the Band

Yes, COHI Yes Health Canada, Band

Fraser Union Bar 588 East no N/A No No None

Fraser Yakweakwioose 576 East COHI Several times per year Yes, COHI No Health Canada

Fraser Yale 589 East no N/A No No None

Interior ?Akisq'nuk First Nation/Columbia Lake Band

604 East Ktunaxa Nation Head Start Program Off-reserve Better Babies POP- @ Windermere Health Centre- targets vulnerable groups but not specifically Aboriginal; Aboriginal families attend

Head start 1x/yr POP 1x/yr


Interior Adams Lake 684 West COHI – DH is employed by band Weekly No No Health Canada-Band

Interior Alexis Creek Indian Band (Redstone)

710 West ?Esqui Ch’I Bid Ts’egwenelyax (Red Stone) Head Start- Health Fair-screenings done

HA 1x/yr upon invitation No Yes Health Authority

Interior Ashcroft Indian Band 685 West No services on-reserve No No None


43 | P a g e

Health Authority




community

On-Reserve Dental



Interior Bonaparte Indian Band/St’uxutews

686 West No services on-reserve No services No No None

Interior Bridge River Indian Band

590 West Bridge River Head Start Services offered-declined No No None

Interior Canim Lake Indian Band

713 West - DT prevention services - HA - Eliza Archie Daycare Head Start

DT 2x/year Yes, prevention only

No Health Canada, Health Authority

Interior Canoe Creek Indian Band/Dog Creek/Stswecem’c Xgat’tem

723 West Head Start-Preschool Fair (fill in when therapist cannot) DT restorative services with portable equipment

HA upon invitation DT 3-4x/year

Yes, treatment No Health Authority

Interior Cayoose Creek Band 591 West No services on-reserve - offered and declined Note: Working to do training with COHI and HUB development

No services No No None

Interior Coldwater Indian Band 693 West No services on-reserve No services No No None

Interior Cook’s Ferry 694 West COHI Several times per year Yes, COHI sealants and ART

No Health Canada

Interior Esketemc (Alkali Lake) 711 West -COHI and DT Treatment Clinic -Head Start-Preschool fair -HA Presentations -HA School survey

COHI/DT - Weekly HA upon invitation

Yes, treatment and COHI

Yes Health Canada, Health Authority

Interior High Bar 703 West No services HA -no services No No None


44 | P a g e

Health Authority




community

On-Reserve Dental



Interior Kamloops Indian Band/Tk'umlups

688 West COHI – DH is employed by band. Band is setting up fee for service dental clinic.

Weekly No Yes Health Canada-Band

Interior Kanaka Bar 704 West COHI Several times per year Yes, COHI sealants and ART

No Health Canada

Interior Little Shuswap/Skwlax 689 West COHI – DH is employed by band. Band is setting up fee for service dental clinic.

Weekly No Yes Health Canada-Band

Interior Lower Similkameen/LSIB

598 Central -LSIB Early Childhood Dev-FV -Parenting Group

HA - FV Every 4 mos HA - Parenting Group 1x/yr


Interior Lower Kootenay/Yakunyk

606 East on-reserve LTL/FV Program Preschool/School Health Fairs

HA - LTL/FV every 4 months HA - Health Fairs upon invitation 1x/yr


Interior Lower Nicola Band 695 West - COHI - Little Stars Head Start

COHI - weekly Head Start 4 days/month



Interior Lytton 705 West COHI Several times per year Yes, COHI sealants and ART

No Health Canada

Interior Neskonlith 690 West COHI – DH is employed by band Several times per year Yes, COHI sealants and ART

No Health Canada-Band

Interior Nicomen 696 West COHI Several times per year Yes, COHI sealants and ART

No Health Canada

Interior Nooaitch Indian Band 699 West No services on-reserve No services No No None


45 | P a g e

Health Authority




community

On-Reserve Dental



Interior Okanagan Indian Band 616 Central -on-reserve-Snc’c’amala?tn Head Start Program-Precious Smiles @ preschool with Band Nurse - Health Fairs when invited - Preschool Kits upon request Off-reserve: - Friendship Centre-Early Childhood Development-LTL/FV - Vernon Family Resource Centre - Moms and Tots Program FV

HA - FV Every 3 mos HA - Health Fairs 1x/yr upon invitation HA - Preschool Kits upon request HA - Friendship Centre - FV every 3 mos HA - Moms/Tots - FV every 4 mos


Interior Oregon Jack Creek Indian Band

692 West No services on-reserve No services No No None

Interior Osoyoos Indian Band 596 Central -Head Start Program @ Daycare-FV -Daycare School uses preschool kit-DRKYC -Pregnancy Group

HA - FV Every 4 mos HA - Preschool Kit 1x/yr HA - Pregnancy Group 1x/yr


Interior Penticton Indian Band 597 Central -Little Paws Family Centre-Head Start-FV - Parenting Group -Preschool uses preschool kit - DRKYC on-reserve/Preschool uses preschool kit-DRKYC

HA - FV every 4 mos HA - Parenting Group 1x/yr HA - Preschool kit 1x/yr


Interior Seton Lake Indian Band 595 West No services on-reserve No services No No None

Interior Shackan Indian Band 698 West No services on-reserve No services No No None

Interior Shuswap Indian Band 605 East No services - offer declined No No None


46 | P a g e

Health Authority




community

On-Reserve Dental



Interior Simpcw (Barriere) 691 West COHI – DH is employed by band Weekly No No Health Canada-Band

Interior Siska 706 West COHI Several times per year Yes, COHI sealants and ART

No Health Canada

Interior Skeetchestn 687 West COHI – DH is employed by band Weekly No No Health Canada-Band

Interior Skuppah Band 707 West No services on-reserve No services No No None

Interior Soda Creek Band/Xatsull FN

716 West -on-reserve-Health Fair/screening -DT restorative services with portable equipment 2 times per year

HA upon invitation DT 2x/year

Yes, treatment No Health Canada, Health Authority

Interior Spallumcheen/Splatsin 600 Central COHI – DH is employed by band. Band is setting up fee for service dental clinic

Weekly Yes, COHI sealants and ART

Yes Health Canada- Band

Interior St. Mary’s Indian Band 602 East LTL/FV program @ reserve daycare

HA - Every 4 mos No No Health Authority

Interior Stone Band/Yunesitin FN

717 West on-reserve -Health Fairs new mom groups

HA upon invitation for Health Fairs HA Every 4 mos for new mom groups


Interior T’it’q’et/Lillooet Band 593 West Head Start-Ts’kw’aylaxw Preschool/Daycare-Preschool fairs

HA upon invitation No No Health Authority

Interior Tl’etinqox-t’in Government Office (Anaham - not same as Anahim Lake, which is Ulkatcho #722)

712 West Health Authority (Health Fairs, Kindergarten and Preschool Round-up)

HA - upon request Position Vacant*

Yes Health Authority


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Interior Tobacco Plains Indian Band/Ktunaxa First Nations

603 East Ktunaxa Head Start HA - 1x/yr No No Health Authority

Interior Toosey 718 West

Health Authority (Health Fairs, Kindergarten and Preschool Round-up)

HA - upon request No No Health Authority

Interior Ts’kw’aylaxw First Nation/Pavilion Indian Band

594 West Ts’kw’aylaxw Preschool Head Start /Brushing program

HA - Upon request No No None

Interior Ulkatacho/Anahim Lake (not same as Anaham, #712)

722 West

DT treatment services Ulkatcho First Nation Head Start-Presentation Brushing Program at Head Start and School

DT Several times per year HA upon invitation

Yes Yes Health Canada/Health Authority

Interior Upper Nicola Indian Band

697 West - COHI - Upper Nicola Head Start

COHI - weekly Head Start 2 days/month



Interior Upper Similkameen 599 Central (South Okanagan-Keremeos)

Hedley Band office-FV referrals HA - Every 4 mos No No Health Authority

Interior Westbank First Nations Band

601 Central (Central Okanagan-West Kelowna)

-on-reserve - Sensyustin Elementary School - on-reserve daycare-LTL/FV - on-reserve Health and Wellness Centre - health fairs Note: off-reserve Skemxist Preschool, Rutland

HA - presentation, staff inservices upon request HA - on-reserve daycare - FV every 4 months HA - Health and Wellness Centre - upon request Skemxist Preschool every 4 months

No Yes/no dentist

Health Authority


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On-Reserve Dental



Interior Whispering Pines 702 West (Cariboo-Clinton)

COHI – DH is employed by band Several times per year No No Health Canada-Band

Interior Williams Lake Band/Sugar Cane

719 West (Cariboo-Williams Lake)

-Health Fairs/screenings -DT restorative services with portable equipment

HA upon invitation DT 3-4x/year

Yes, treatment No Health Canada, Health Authority

Interior Xaxli’p First Nation/Xaxli’p Band, Fountain Indian Band, Cacl’ep

592 West (Cariboo-Lillooet)

Xaxli’p Head Start-preschool fair & kindergarten fair

HA - Upon invitation No No Health Authority

Interior Xeni Gwet’in (Nemiah Valley)

714 West (Cariboo-Nemiah Valley)

Health Authority (Health Fairs, Kindergarten and Preschool Round-up)

HA - upon request Position Vacant*

Yes Health Authority

Northern Laxgalts’ap Village Council/ Greenville /Nass/ Nisga’a

678 NW No NH FV Training Note: Independent- has non Federal Health Coverage with CDA hired by Dentist to do direct prevention work- Dentist just retired - looking for options to keep prevention piece. FV training Oct 11/11 by PH staff

4x/year No No Health Authority

Northern Alexandria/ Esdilagh Indian Band

709 NI FV training 2006;2004 0 No No None

Northern Blueberry River First Nation

547 NE FV by PH 2x/year. Trying to partner with CHR or FSJ Natsadle Head Start individual to train to do FV.

2X/year No No Health Authority

Northern Burns Lake Band 619 NI FV training 2010;2006;2004;2003 (FHN, in 2003 also HS)

No No None

Northern Cheslatta Carrier Nation

620 NI FV training 2003 but FV not being done

0 No No None

Northern Dease River Band Council / Good Hope

504 NW No NH FV training 0 No No None


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Northern Doig River First Nation 548 NE FV by PH 2x/year. Trying to partner with CHR or FSJ Natsadle Head Start individual to train to do FV.


Northern Fort Nelson First Nation

543 NE COHI 6 times/yr as of Jan 2010 4 FV/year total w 6 visits/yr

Yes, COHI ART & sealants


Northern Gitanmaax 531 NW COHI Weekly Yes, COHI Health Canada

Northern Gitanyow 537 NW COHI and DT Treatment Clinic Several times per year Yes, treatment and COHI

Yes Health Canada

Northern Gitsegukla 535 NW COHI and DT Treatment Clinic Weekly Yes, treatment and COHI

Yes Health Canada

Northern Gitwangak Band Council / Kitwanga

536 NW DT Treatment Clinic Monthly Yes, treatment Yes, by Spring 2012

Health Canada

Northern Gitwinksihlkw village Governement/ Canyon City / Nass/ Nisga’a



Northern Glen Vowell 533 NW COHI Weekly Yes, COHI No Health Canada

Northern Hagwilget/New Hazelton

534 NW COHI and DT Treatment Clinic Biweekly Yes, treatment and COHI

Yes Health Canada

Northern Halfway River First Nation

546 NE FV by HA 2x/year. Trying to partner with CHR or FSJ Natsadle Head Start individual to train to do FV.


Northern Hartley Bay Village Council/ Gitga’at/Kulkayu

675 NW No NH FV training Vacant position

Yes None

Northern Iskut 683 NW COHI and DT Treatment Clinic Several times per year Yes, treatment and COHI

Yes Health Canada


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Northern Kincolith/ Gingolox Village Government / Nass/Nisga'a



Northern Kispiox 532 NW COHI and DT Treatment Clinic Weekly Yes, treatment and COHI

Yes Health Canada

Northern Kitamaat Village Council

676 NW FV training but nurse left - PH does FV at Headstarts 3x/year


Northern Kitkatla/ Gitreatmentaala Nation /Dolphin Island

672 NW FV training 2010 - but no FV being done

0 Vacant position

Yes None

Northern Kitselas Band Council/ Kulspal/Kshish

680 NW Dental Therapist FV training 2011;2005(FHN). FV by PH staff at Headstarts.

Dental Therapist 6x/year 3x/year

Yes, treatment Yes Health Canada, Health Authority

Northern Kitsumkalum Band Council

681 NW Dental Therapist FV training 2011;2010 & 2005 ((CN & Health Director), LPN, ECE Headstart.(FHN). FV by PH staff at Headstarts.

Dental Therapist occasionally. 3x/year

Yes, treatment Will be built in 2012

Health Canada, Health Authority

Northern Kwadacha (Fort Ware) 610 NE (covered by NW due to easier access)

COHI and DT Treatment Clinic Several times per year Yes, treatment and COHI

Yes Health Canada


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Northern Lake Babine Nation - Fort Babine/ Wit’at - Old Fort / Nedoats - Tachet Landing - Donald’s Landing/ Pinkut Lake - Woyeene

607 NI FV training 2010;2008;2003 (FHN, in 2003 also 3 CHRs)-

0 No Yes, in Fort Babine only, no DT or dentist

None

Northern Lax-kw'alaams Band/Port Simpson

674 NW Dental Therapist does treatment on iterant basis. No dedicated DT at this time. Note: Aug 2011 CHR trained and doing FV. Previously Health Authority PH travelled to do FV.

DT 4x/year 4x/year


Northern Lheidli T’enneh Band /Shelly

611 NI NO NH FV training 0 No No None

Northern Lhoosk’uz Dene Gov. Admin/ Kluskuz

721 NI FV training 2007 - but no FV being done

0 No No None

Northern Lhtako Dene/ Red Bluff Band

715 NI FV training 2009 - but no FV being done

0 No No None

Northern Liard FN/Lower Post/Datky Dena Council/ Daylu Dena

502 NE (NW sees due to location)

No NH FV Training Brushing Supplies sent 2008

0 No No None

Northern McLeod Lake Indian Band/ Tsekani First Nation

618 NI PHN Trained and covers community services and does FV when she can reach the children.

FV 4x/year Yes. Limited services

No Health Authority

Northern Metlakatla Band Council / Maxtaxaata

673 NW FV training 2010 - but no FV being done

0 No No None

Northern Moricetown 530 NW COHI and DT Treatment Clinic Weekly Yes, treatment and COHI

Yes Health Canada

Northern Nadleh Whut’en Indian Band/ Nautley

612 NI 2010 last FV training - yes FV program in place

4x FV/year No No None


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On-Reserve Dental



Northern Nak’azdli Band Council/ Necoslie

614 NI COHI FV training 2008;2004;2002 (FHNs & in 2008 also 4 Maternal Child Health Reps)

4 FV/year total w 6 visits/yr



Northern Nazko First Nation 720 NI FV training 2010; 2007 (maternal health rep). FV program was present in Community COHI starting Fall 2011




Northern Nee-Tahi-Buhn Band/ Francoise Lake

726 NI FV training 2004;2003 (FHN) - no FV being done

0 No No None

Northern New Aiyansh Village Government/ Gitlakdamix / Nass/Nisga’a

677 NW No NH FV Training Note: Independent- has no Federal Health Coverage with CDA hired by Dentist to do direct prevention work- Dentist just retired - looking for options to keep prevention piece. FV training Oct 11/11 by PH staff. Dr Baird (dentist) rotated between 2 sites/clinics in Nass. He recently retired (Summer 2011?). Clinic now closed. FV prevention was being done. Communities don't want to lose prevention (FV) piece and have discussed training options with NW PH Dental Lead.

4x/year No Yes Health Authority

Northern Old Masset Village Council

669 NW UBC Dental Residents provide services. Treatment. Does not appear that prevention services are in place. This clinic is funded by Health Canada on contract with UBC.

0 No Yes (6 months/year UBC Dental Resident)

UBC, Health Authority


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On-Reserve Dental



Northern Prophet River First Nation/ Dene Tsaa Tse K’Nai First Nation

544 NE COHI 4-6x/yr as of Jan 2010 4 FV/year total w 6 visits/yr



Northern Saik’uz Nation/ Stony Creek

615 NI Used to have COHI but it has been discontinued.FV training 2006;2004 (HSW, FHN & CHR)

No Yes, no services

Health Authority

Northern Saulteau First Nation 542 NE COHI 6 times/yr as of Jan 2010 4 FV/year total w 6 visits/yr


No Heath Canada-Health Authority

Northern Skidegate Band Council 670 NW UBC Dental Residents provide services. Treatment. Does not appear that prevention services are in place. This clinic is funded by Health Canada on contract with UBC.

0 No Yes (6 months/year UBC Dental Resident)

UBC, Health Canada

Northern Skin Tyee Band 729 NI FV training 2006;2004 (FHN) - 0 No No None

Northern Stellat’en First Nation/ Stellaquo

613 NI FV training 2006;2004;2003 but FV not being done

0 No No None

Northern Takla Lake First Nation 608 NI FV training 2004;2003 (HCS,FHN,CHR)- was COHI but not now. No FV being done

0 No Yes, no services

None

Northern Taku River Tlingit First Nation

501 NW No NH FV Training 0 No No None

Northern Telegraph Creek (Tahltan)

682 NW COHI and DT Treatment Clinic Several times per year Yes, treatment and COHI

Yes Health Canada

Northern Tl’azt’en Nation includes: - Tachie - Binche - Middle River

617 NI COHI partnership with NH starting Fall 2011




Northern Tsay Keh Dene Band 609 NI No NH FV Training 0 Yes Yes Health Authority

Northern West Moberly Lake First Nations

545 NE COHI 6x/yr as of Jan 2010 4 FV/year total w 6 visits/yr




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Northern Wet’suwet’en First Nation/ Broman Lake

725 NI FV training 2006;2004;2003 (HCS,FHN)

0 No No None

Northern Yekooche First Nation/ Portage/ Nancut

728 NI FV training 2006;2004;2003 (CHN & FHN) - no FV being done

0 No Yes None

Vancouver Coastal

Oweekeno (Rivers Inlet)

541 North Shore-Coast Garibaldi

No No None

Vancouver Coastal

Bella Bella 538 North Shore-Coast Garibaldi

Dental therapist occasionally. 4 dentists also provide services (2 work per diem with the band, and 2 are on contract with Health Canada).

Regular service. Dentists do not all work at the same time.

Yes, occasionally. Treatment only.

Yes Health Canada, Band

Vancouver Coastal

Bella Coola 539 North Shore-Coast Garibaldi

DT Treatment Clinic Dental Screening in schools and preschools Preventative Education Fluoride Varnish

Dental therapy 4 times/year 2 times/year, Dental Hygienist comes to the community for 1 week

Yes, treatment Yes Health Authority, Health Canada

Vancouver Coastal

Tsleil-Waututh Nation (Burrard)


fluoride varnish, preventive education, caries risk assessment on-reserve

3 times per year No No Health Authority

Vancouver Coastal

Kitasoo/Klemtu 540 North Shore-Coast Garibaldi

Dentist, on contract with Health Canada

Several times/yr No Yes Health Canada

Vancouver Coastal

Lil’Wat Nation – Mt. Currie


Parent/Child Group – dental education to parents of young children. On-reserve. Fee for service dentist. Dental clinic run by the Band.

on request, at least once yearly. Ongoing service by fee-for-service dentist.

No Yes Health Authority Dental Clinic funded by Band. Dentist and dental hygienist bill NIHB fee-for-service.


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Vancouver Coastal

Musqueam 550 Vancouver Fluoride Varnish, Preventive education and Caries Risk Assessments for 4 programs on-reserve - 1. Knee to Knee, 2. Children's House Preschool & Daycare, 3. Mom and Tots, and 4. Mom's Cafe

1. 3 x/year 2. 1/yr 3. 1x/month 4. 4x/year


Vancouver Coastal

N’Quatqua 556 North Shore-Coast Garibaldi

Health Centre – Fl varnish for children, education and facilitation of access to dental care for parents and adults. Day Care Centre – Fl varnish for children, education and facilitation of access to dental care for parents. On-reserve. Community Centre Health Fair – preventative education provided to families. On-reserve.

Twice yearly. Twice yearly. once yearly


Vancouver Coastal

Sechelt Band 551 North Shore-Coast Garibaldi

Fluoride varnish, education 3-4 times per year No No Health Authority

Vancouver Coastal

Skatin 562 North Shore-Coast Garibaldi

Skatin Health Unit – preventative education and facilitate access to dental treatment for adults in attendance. On-reserve. Head of the Lake School, Skatin – Fl varnish and preventative education for all children in the school.

once or twice yearly once or twice yearly



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On-Reserve Dental



Vancouver Coastal

Sliammon 554 North Shore-Coast Garibaldi

1. Preventive Education (on) 2. Preventive Education (on) 3. Preventive Education (on) 4. Fluoride Varnish (on) 5. CRA (on) 6. K Screening (on) 7. Dental Clinic (unique program run by Sliammon Health Board)—on-reserve

1. 3-4 times per year 2. 1-2 times per year 3. 2 times per year 4. ongoing (Band Employee trained by VCH DH) (most receiving 2-3 treatments). 5. ongoing (Band Nurse collects questionnaire from all 12 month immunizations and forwards to Community DH for CRA and follow-up) 6. 1 time per year 7. 2 days per month This is a brand new initiative (November 2010) which is neither a VCH nor COHI program. Dental treatment is provided at an on-reserve clinic. The DDS is paid (by Sliammon Band) a set amount per day and NIHB is billed by Sliammon.

No Yes Health Authority does oral health education Fluoride Varnish program funded by band.

Vancouver Coastal

Southern Stl’atl’imx Nation Samahquam


Samahquam Health Unit – Fl varnish for children, education and facilitation of access to dental care for parents. Only a few school aged children in the community when I attend as school is in Skatin.

once or twice yearly No No Health Authority


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Vancouver Coastal

Squamish Nation - Squamish


2 locations: 1) Squamish Sea to Sky: a)Ay’asLam Family Program - Fl varnish for children, education and facilitation of access to dental care for parents. On-reserve. b) Tin Mun Mun Day Care – Fl varnish for children, education for staff. Brushing program in place. On-reserve. 2) Squamish North Shore: fluoride varnish, preventive education, caries risk assessment

1a) Six to twelve times yearly . 1b) Two to four times yearly 2) three times per year


Vancouver Coastal

Tipella (Douglas) 561 North Shore-Coast Garibaldi

Band office/health centre – discussed access to dental care issues for families in community. On-reserve.

once yearly No No Health Authority

Vancouver Island

Da’naxda’xw FN (near Alert Bay)

635 North none No No None

Vancouver Island

Islan PtHardy Tlatlasikwala


Vancouver Island

Kingcome/ Tsawataineuk

636 North COHI services with VIHA DH 3 x/year Yes, COHI sealants and ART. May be some treatment starting 2012


Vancouver Island

Lake Cowichan FN 643 Central none No No None


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Vancouver Island

Stz’uminus FN (Chemainus)

641 Central Health Canada Dental Therapist On-reserve Health Authority services: • Prenatal/postnatal support • Preschool with FV • Infant & Toddler Day Care with FV

Dental therapist, 2 days/week Support As needed Preschool FV 3x/year Infant/Toddler FV 3x/year


Vancouver Island

T’sou-ke FN 657 South On-reserve at health centre: Fluoride varnish (children under 6) Caries risk assessment Prevention education – parenting group and one-on-one sessions Organized dental goody bags distributed to all newborn-preschool aged children in community

By invitation only (1-2x/year) - is this for all services offered?


Vancouver Island

Ahousaht 659 Central Whole Island is FN Dental Therapist visits VIHA dental hygienist attends 4X per year • Prenatal/post natal support • Infant day care with FV • Toddler daycare with FV • Ready Set Learn Health Fair • School- K screening • Lunch with Elders – promotion re oral health

2-4X/month Prenatal/post natal support 4x/yr Screening 1x/yr Promotion 1x/yr

Yes, infrequently for treatment



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On-Reserve Dental



Vancouver Island

Cowichan 642 Central Urban centre, with FN Health Centre. COHI and DT Treatment Clinic, also band employed DH Note: Off-reserve attend Friendship Centre POPs program

Full time Clinic Off-reserve 4x/year

Yes, treatment and COHI

Yes Health Canada Off-reserve HA

Vancouver Island

Ditidaht 662 Central COHI Several times per year Yes, COHI sealants and ART

No Health Canada

Vancouver Island

Ehatteshaht (Zeballos)

634 North Off-reserve: • FV • Strong Start

Strong Start 2x/year


Vancouver Island

Esquimalt 644 Central On-reserve: Best Babies Newsletter articles

Monthly


Vancouver Island

Gwa’sala’- Nakwaxda’xw FN (Pt Hardy)

724 North COHI services with VIHA DH Dental clinic in Health Centre On-reserve: • School education and screening Gr K-7 • Age 3-5 multidisciplinary parent consult/screening (Healthy Kids Clinics) Prenatal/Postnatal groups Note: Off-reserve: • Promising Babies • Strong Start

On-reserve School educ/screening Yearly Consult/screening Yearly Off-reserve: 2x/year 2x/year

Yes, COHI sealants and ART. May do some treatment.

Yes Health Canada-Health Authority Off-reserve HA

Vancouver Island

Gwawaenuk Tribe (Pt Hardy)



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Vancouver Island

Halalt (H'ulh-etun) 645 Central Dental therapist provides tx as of late 2011. Private DH provides DH therapy, Changing role for VIHA

Dental therapist 1 day/week

Yes, treatment Yes Health Canada-Health Authority-Band

Vancouver Island

Hesquiaht (Hot Springs Cove)

661 Central This community attends dental activities in Ahousaht at least twice a year

No No None

Vancouver Island

Homalco (Campbell River)

552 North On-reserve: COHI services with VIHA DH • Screening (done in conjunction with Fluoride varnish treatments) • Fluoride varnish treatments, • Sealants and ART provided by Dental Therapist for children <8yrs of age • Parent/tot group support Note: Off-reserve (Laichwiltach Family Centre): • Screening, fluoride varnish treatments for preschool children • Parent /tot group support

On-reserve: Fluoride varnish 5x/year Sealants and ART 1-2 x/year Parent-tot group 5x/year Off-reserve Screening/Fluoride Varnish 5 x/year Parent/tot group 4 x/year


Yes On-reserve: Health Canada-Health Authority Off-reserve HA

Vancouver Island

Hupacasath 664 Central Urban centre (Port Alberni), COHI community with Dental Therapist Note: Off-reserve Friendship Centre: • Prenatal/post natal groups • Health Fairs - both On & Off

Several times per year Off-reserve: Groups 6x/year Health Fairs 1x/year


No Health Canada Off-reserve HA

Vancouver Island

Huu-ay-aht FN (Pacheena Bay)

663 Central On-reserve: Dental Therapist visits regularly. Fully equipped dental operatory. This community is very pro-active, both VIHA DH and DT support. • Day care Head Start • FN health clinic with Dental

DT: 2-3 x/month Day Care Head Start 2x/year Clinic 2x/year



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Clinic

Vancouver Island

Klahoose FN (Quadra)

553 North none N/A No No None

Vancouver Island

Komox 624 North In urban community. Note: Off-reserve Friendship Centre: • Head Start, • Aboriginal Early Head Start

4x/year

No No On-reserve: None Off-reserve HA

Vancouver Island

Kwakiutl (Ft Rupert/Pt Hardy)

626 North On-reserve: COHI services with VIHA DH. Dental clinic in Health Centre on-reserve: • Head Start • Healthy Babies Note: Off-reserve: Friendship Centre

Several times per year Yes, COHI sealants and ART

Yes Health Canada-Health Authority Off-reserve HA

Vancouver Island

Kwiakah (east of Sayward)


Vancouver Island

Kwicksutaimneukah-kwah-ah-mish (Gifford Is)


Vancouver Island

Kyuquot 638 North COHI and DT Treatment Clinic Several times per year Yes, treatment and COHI

Yes Health Canada


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Vancouver Island

Lyackson 646 Central Private DH provides DH therapy Changing role for VIHA

By invitation, VIHA exploring new relationship

Yes Yes Health Authority

Vancouver Island

Malahat FN 647 Central Access DT via 645 Lyackson Private DH provides DH therapy Changing role for VIHA

By invitation, VIHA exploring new relationship


Vancouver Island

MamalilikullaQweQwaSotEm (by Alert bay)


Vancouver Island

Mowachaht (Gold River)

630 North COHI services with VIHA DH Several times per year Yes, COHI sealants and ART


Vancouver Island

Namgis FN 631 North Health Centre and Fee for service Dental Clinic with DDS/DH On-reserve: • School screening and education for K • Head Start • 3-5 year old health clinic/screening • FV Program

School screening 1/year Head Start 2/year Screening 1/year

No Yes Health Authority, Band

Vancouver Island

NuChatlaht (Zeballos)

639 North Some children participate in Fluoride varnish program at Ehattesaht # 634

No No None


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Vancouver Island

Pacheedaht N 658 South On-reserve: Dental Goody bags used by PHN with immunizations Special request dental screenings Note: Off-reserve: (offered to general community but majority First Nations clients) Port Renfrew Preschool: - Dental screening for prenatal moms and oral hygiene instruction/referral if necessary - Caries risk assessment - Fluoride varnish children 0-7 - Follow-up with parents by PHN or RDH or CHR - Brushing program Port Renfrew School: - Brushing program

No No Health Authority Off-reserve HA

Vancouver Island

Pauquachin 652 South On-reserve: Caries risk assessment Fluoride varnish children 0-7 Preventive education – one-on-one Follow-up by PHN or RDH Dental Goody Bags handed out by PHN at immunizations Health fairs and special events

Every 3 to 4 months Health Fairs/events As requested


Vancouver Island

Penelakut 650 Central Whole island is Reserve – as invited, varies each year. VIHA exploring new relationship

By invitation No No Health Authority

Vancouver Island

Qualicum FN 651 Central VIHA – developing relation – education 2x/year

No No None


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Vancouver Island

Quatsino 633 North Dental clinic in Health Centre, DDS & DH from Namgis provide service, COHI with VIHA DH Off reserve Well Baby Groups Prenatal Groups

COHI several times per year 2x/year 2x/year


Yes Health Canada-Health Authority

Vancouver Island

Scia’new FN Beecher Bay

640 South On-reserve at daycare: Fluoride varnish (children under 6) Caries risk assessment Follow-up with parents (letters home/phone contact) Health Fair

Fluoride varnish Monthly Caries risk Assessment Monthly Follow-up As needed Health Fair Special events – as needed


Vancouver Island

Snaw-Naw-As FN (Nanoose)

649 Central On-reserve attend: (New Health Centre being built for 2012) • Parent/tot group • Head Start Preschool with FV • Infant/Toddler Daycare with FV

As requested 3x/year 3x/year


Vancouver Island

Snuneymuwx FN (Nanaimo)

648 Central In urban centre. On-reserve: • Prenatal/postnatal support • Infant day care with FV • Toddler daycare with FV • Health Fairs • School Note: Off-reserve: Friendship Centre • Prenatal/post natal groups (POPs) • Parent/tot groups • Creating Healthy Families Group

On-reserve: Pre/postnatal -As needed Infant 4x/year Toddler 4x/year Health Fairs 2x/year School 1x/year Off-reserve: POPs 3x/year Parent/tot 3x/year Creating Healthy Families As invited


Vancouver Island

Songhees FN 656 South On-reserve: Healthy Babies group

Monthly



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Vancouver Island

Tla-o-qui-aht FN (Tofino) Two communities: Opitsaht on Meares Isl and Long Beach (Esowista)

660 Central COHI community with VIHA DH • Prenatal/post natal groups • Infant/Toddler day care • Head Start (2) • Health Fairs • Parent/tot groups

Groups As needed Day Care 4x/year Head Start 4x/year (each) Health Fairs 2x/year Parent/tot groups 4x/year



Vancouver Island

Tlowitsis Tri (islands N of Sayward)


Vancouver Island

Toquaht (Near Ucluelet)

666 Central None See clients at Tofino,# 660 Tla-o-qui-aht Moms usually do attend groups in Ucluelet.

No No None

Vancouver Island

Tsartlip 653 South On-reserve: Prenatal dental screenings/ oral hygiene instruction Caries risk assessment Fluoride varnish children 0-7 Preventive education – one-on-one Follow-up with RDH and band member Scheduling done by band member Health fairs and special events Band contracts for extra service per Month

Risk assessment Monthly Fluoride varnish Monthly Preventive ed. Monthly Follow-up As requested Band contracts As requested


Vancouver Island

Tsawout FN 654 South On-reserve: Caries risk assessment Fluoride varnish children 0-7 Preventive education – one-on-one Follow-up by RDH Health fairs and special events

2 times a year Health fairs/events As requested



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Vancouver Island

Tseshaht (Pt Alberni)

665 Central Near urban centre (Port Alberni). No COHI. Have First Nations Health Centre. on-reserve: • Moms group with FV for children • Infant/Toddler Daycare • School • Health Fair by invitation Note; Off-reserve Friendship Centre: See off-reserve with # 664

By invite Daycare 6x/year By invitation 6x/year


Vancouver Island

Tseycum 655 South On-reserve: Caries risk assessment by RDH Band member trained to do fluoride varnish children 0-7 Preventive education – one-on-one by band member Follow-up by band member

3 to 4 months/year by community health dental hygienist


Vancouver Island

Uchucklesaht Near Bamfield

667 Central none No No None

Vancouver Island

Ucluelet 668 Central COHI Note: Off-reserve: • Parent/tot groups

Several times per year Off-reserve: Parent/tot 4x/year


No Health Canada Off-reserve HA


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Vancouver Island

WeiWaiKum (Campbell River)

622 North On-reserve: COHI services with VIHA DH • Screening (done in conjunction with Fluoride varnish treatments) • Fluoride varnish treatments, • Sealants and ART provided by Dental Therapist for children <8yrs of age • Parent/tot group support Note: Off-reserve (Laichwiltach Family Centre): • Screening, fluoride varnish treatments for preschool children • Parent/tot group support

On-reserve: Fluoride varnish 5 x/year Sealants and ART 1-2 x/year Parent-tot group 4 x/year Off-reserve Screening/Fluoride varnish 5 x/year Parent-tot group 4 x/year


No Health Canada-Health Authority Off-reserve HA

Vancouver Island

WeiWeiKai (Cape Mudge)

623 North On-reserve: COHI services with VIHA DH • Screening (done in conjunction with Fluoride varnish treatments) • Fluoride varnish treatments, • Sealants and ART provided by Dental Therapist for children <8yrs of age • Parent/tot group support Note: Off-reserve (Laichwiltach Family Centre) see #622

On-reserve: Fluoride varnish 8 x/year Sealants and ART 1-2 x/year Parent-tot group 4 x/year Off-reserve: see #622


No Health Canada-Health Authority Off-reserve HA


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Appendix E: Off-Reserve Community Services

Health Authority

HSDA Location Community Agency Dental Services Frequency

FHA Abbotsford Abbotsford Aboriginal Center – Abbotsford Off Reserve Centre Several times yr.

FHA Burnaby Burnaby Métis Society – Burnaby Off Reserve 1x/year

FHA Chilliwack Chilliwack Aboriginal Strong Starts Fluoride Varnish and dental education sessions on reserve

Several times year

FHA Maple Ridge Maple Ridge Anishnaabe Groups Off Reserve Monthly

FHA Mission Mission Parent Education Group- Mission Off Reserve Strong Start centers 3 x / year

FHA New Westminster

New Westminster

Spirit of the Children Society – New Westminster

FHA North Surrey North Surrey Maxxine Wright Off Reserve Community Health Monthly

FHA North Surrey North Surrey Kla How eya – Urban Urban Aboriginal Friendship Centre 3x/year

IHA OK Vernon First Nations Friendship Centre POP Pres. consult/Screenings/ECD-LTL-FV every 3-4 mos

IHA OK Vernon Vernon Family Resource Centre Moms and tots Program FV every 4 mo.

IHA OK Kelowna Ki-Low-Na Friendship Society Presentations/Screenings 1-2x/yr

IHA OK Westbank health centre off reserve-children attend FV at health centre

IHA OK Enderby health centre LTL/FV Clinics every 4 months

IHA TCS Lillooet Lillooet Friendship Centre ECC Presentation/Screenings 1x/yr

IHA TCS Williams Lake Cariboo Friendship Society ECC Presentation 1x/yr

IHA TCS Merritt Conayt Friendship Society Proposal in progress n/a

IHA TCS Kamloops Interior New Friendship Centre Clients attend ICS FV-PH clinics Every 4 mos

NHA NE Aboriginal Preschools off-reserve including Natsdle, Dawson Creek Aboriginal Family Services, Chetwynd

FV 3x/year

NHA NE Halfway River First Nation

NH Dental offer screenings, first FV and counselling if Headstart/prenatal coordinator or parents/ community will continue FV with training.

1x/year by PH staff. (4x/yr FV if supported by FV trained partners.)

NHA NE Doig River First Nation

NH Dental offer screenings, first FV and counselling if Head Start/prenatal coordinator or parents/ community will continue FV with training.

1x/year by PH staff. (4x/yr FV if supported by FV trained partners.)

NHA NE Blueberry River First Nation

NH Dental offer screenings, first FV and counselling if Head Start/prenatal coordinator or parents/ community will continue FV with training.

1x/year (4x/yr FV if supported by FV trained partners.)


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Health Authority


NHA NE Fort St. John Natsadle/Aboriginal Head Start FV by PH & parent presentation 3-4x/yr FV

NHA NE Dawson Ck AB Family Health Services FV by PH & parent presentation 3-4x/yr FV

NHA NE Chetwynd Kici-awasimsak FV by PH & parent presentation 2x/yr FV

NHA NE Dawson Ck AB Babies Best Chance Parent presentation 2x/yr

NHA NE Fort Nelson Northern Rockies AB Women Parent presentation 1x/yr

NHA NI Grassy Plains Southside Health Centre (multiple partnership with FN & NH)

FV training 2010;2006;2004 1x/year training. 4x/yr FV by FV trained partners

NHA NI Prince George Head Start - 4 daycare sessions between 2 sites

FV applications & parent ed 4x/year FV Parent Ed 1x/yr

NHA NI Prince George AIFDP (Aboriginal Infant and Family Development Program)

FV applications & parent ed 4x/yr FV Parent Ed 1x/yr

NHA NI Prince George Emergency Dental Outreach Clinic-run by community dental professional volunteers and NH coordinator. Housed at Prince George Native Friendship Centre

emergency treatment 2x/month (evenings). Not limited to Aboriginal population

NHA NI Prince George UBC Dental Resident Housed at Prince George Native Friendship Centre.

basic treatment needs. Compliments services provided at the EDOC clinic (uses same clinic)

2x/year. Usually a 2 week session. Not limited to Aboriginal population.

NHA NW Kermode- Terrace

Kermode Friendship Center Head Start, POP, Child youth health, FADS

FV offered to registered Head Start children provided on site, screening, parent counselling. POPs -once a week drop in mothers group. Offer FV at POPs once a month, Child youth health- Once a year teaching to group, FADS event is planned throughout the year and occurs once a year on Sept 9th

FV 3x/yr. POPs 1x/mo. CY 1x/yr. FASD 1x/yr.

NHA NW Kermode- Prince Rupert

Child youth family mental health FASD FADS event- screening and counselling 1x/yr

NHA NW Smithers- office of Wets' uwetin

Drop-in family luncheon - once a month screening, and FV 1x/yr

NHA NW Friendship Center- Prince Rupert

Pregnancy Outreach group/ Preschool once a month FV at POPS/ Preschool- screening and FV

1x/mo. for pregnancy outreach. FV 3x/yr.

NHA NW Headstart: Prince Rupert

Head Start Screening, FV and counselling 3x/yr


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Health Authority


VCH Van Vancouver Collingwood Neighbourhood House-Amlatsi

VCH Van Vancouver Phil Bouvier Family Centre-Aboriginal Mother Goose

VCH Van Vancouver Phil Bouvier Building Blocks Drop-In

VCH Van Vancouver Singing Frog Aboriginal Head Start

VCH Van Vancouver Eagles Nest Aboriginal Head Start

VCH Van Vancouver Learning Lodge HBP

VCH Van Vancouver Sheway

VIHA South Victoria Hulitan Society (Urban) – Journeys of the Heart (Aboriginal pre-kindergarten program) - 2 locations

Off Reserve in school setting: Fluoride varnish Caries risk assessment Prevention education – to class (children and parents) and one-on-one counselling Implemented tooth brushing program July 2011 Nutrition Dental Workshop to 12 Hulitan staff

2 visits per class per school year

VIHA South Victoria Victoria Native Friendship Centre (VNFC) - urban

Off Reserve: Caries risk assessment Fluoride varnish children 0-5 Preventive education – one-on-one Follow-up by RDH or PHN Prenatal dental screenings/OHI/ referral Prenatal/post natal group Preschool dental screenings Nutrition Dental Workshop to staff

Monthly As requested Monthly Annually

VIHA South Victoria Slelenw Day Care Associated with Saanich Adult Education Centre

On Reserve land but open to all FN: Caries risk assessment Fluoride varnish children 0-7 Preventive education – one-on-one Follow-up by RDH

Every 3 to 4 months

VIHA South Victoria Lauwelnew Tribal School On Reserve land but open to all FN: Dental screening in Kindergarten Follow-up by RDH with letter or phone call

Annually


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Health Authority


VIHA South Victoria Trinity Time Off reserve: Caries risk assessment Fluoride varnish children 0-7 Preventive education – one-on-one Follow-up by RDH

Every 3-4 months


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Appendix F: Public Health Agency of Canada, Off-Reserve Early Childhood Development Programs Legend: CAPC=Community Action Program for Children; CPNP=Canadian Prenatal Nutrition Program;

AHSUNC=Aboriginal Head Start in Urban and Northern Communities

HEALTH AUTHORITY /

HSDA CITY TYPE PROJECT NAME ORAL HEALTH ACTIVITIES

FHA – South Aldergrove, Langley CAPC Langley Neighbourhood Coalition

FHA – North Burnaby, Maple Ridge,

New Westminster,

Mission, Port Coquitlam

CAPC FHA North CAPC Coalition

FHA - East Hope, Agassiz, Boston

Bar, Chilliwack

CAPC Communities for Children and

their Families

FHA - South Surrey CAPC Children Matter Coalition

FHA - East Hope CPNP Chilliwack/FHA Cascade CPNP

(Better Beginnings)

FHA – East Abbotsford CPNP Best for Babies, Abbotsford

Prenatal Nutrition Outreach

Program

FHA – East Mission AHSUNC Future 4 Nations Yes - Daily tooth brushing;

Partnership with Sto:lo Nation Dental

Services to provide fluoride treatment

and dental check-ups 2 times a year

FHA – East Mission CPNP Babies Best Chance

FHA – North Burnaby CPNP Burnaby/New Westminster POP

FHA – North Port Coquitlam CPNP Healthy Babies Program,

Tricities/Ridge Meadows


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HEALTH AUTHORITY /


FHA – South Surrey AHSUNC Awahsuk Yes - Tooth brushing

FHA – South Surrey CPNP Healthiest Babies Possible

FHA – South Aldergrove CPNP Best Babies of the Langleys

IHA Creston, Invermere,

Cranbrook, Elko, Golden

CAPC East Kootenay Community Action

Program for Children

IHA Kamloops CAPC CAPC BC South Central Coalition

IHA Kelowna, Penticton,

Keremeos, Oliver,

Princeton

CAPC Okanagan Similkameen CAPC

Coalition

IHA Lumby, Armstrong,

Salmon Arm, Sicamous,

Enderby, Vernon,

Revelstoke

CAPC North Okanagan CAPC Coalition

IHA Nelson, Nakusp, Grand

Forks, Castlegar, Kaslo,

Rock Creek, Salmo

CAPC West (Central) Kootenay

IHA – East Kootenay Cranbrook CPNP Better Babies

IHA – East Kootenay Fernie CPNP Better Babies

IHA – Kootenay

/ Boundary

Grand Forks CPNP Baby's Best Chance

IHA – Kootenay / Boundary Castlegar CPNP Beautiful Beginnings

IHA – Kootenay / Boundary Nelson CPNP Nelson & Kaslo Pregnancy

Outreach Program


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HEALTH AUTHORITY /


IHA - Okanagan Vernon CPNP Canada Prenatal Nutrition

Program (POWER)

IHA Kamloops CPNP Baby’s Head Start

IHA Trail CPNP Building Beautiful Babies

IHA - TCS Merritt CPNP ?eswakwm-Merritt Moms Building

Healthy Babies

IHA - TCS Salmon Arm CPNP Healthiest Babies Possible

IHA - TCS Williams Lake AHSUNC Little Moccasins Yes - Dental Screening for

preschoolers; staff are promoting

tooth brushing daily

IHA - TCS Williams Lake CPNP Williams Lake Pregnancy

Outreach Program

NHA - NI Prince George, Burns

Lake, Vanderhoof, FHA

Lake, Fort St James,

Quesnel

CAPC Fetal Alcohol Drug Effects

Coalition

NHA - NW Smithers, Terrace,

Kitimat, Prince Rupert

CAPC Northwest CAPC

NHA - NE Fort Nelson CPNP Healthy Moms, Happy Babies

NHA - NE Fort St John AHSUNC SAS Natsadle AHS Yes - Partnership with dental

hygienist, fluoride varnish 3 times per

year, talks with parents if issues

found with child's teeth

NHA - NE Fort St John CPNP Peace Liard Early Intervention

Project - Baby's Best Chance


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HEALTH AUTHORITY /


NHA - NI Burns Lake CPNP Healthy Start For Mommy and Me

NHA - NI Prince George AHSUNC Prince George AHS ‘1’ Yes - Dental professional visits

program several times per year to

screen and provide fluoride treatment.

NHA - NI Prince George AHSUNC Power of Friendship AHS Yes - Tooth brushing, Dental

hygienist visits twice a year to screen

and provide fluoride treatments

NHA - NI Prince George CPNP Healthiest Babies Possible

NHA - NI Quesnel CPNP Healthy Mothers, Healthy Babies

Quesnel Pregnancy Outreach

Program

NHA - NI Vanderhoof CPNP Canadian Prenatal Nutrition

Program (Vanderhoof, Carrier

Sekani Family Services)

NHA - NW Dease Lake CPNP Dease Lake Pregnancy Outreach

Program

NHA - NW Hazelton CPNP Canadian Prenatal Nutrition

Program - Starting Smart

NHA - NW Kitimat CPNP Kitimat Enhanced Healthy Babies

Program

NHA - NW Prince Rupert AHSUNC Prince Rupert AHS Yes - Tooth brushing, Partnership

with local dental hygienist from health

authority to screen 5-6 times per year,

however difficulty this year because

health unit did not have a hygienist on

staff for full year.


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HEALTH AUTHORITY /


NHA - NW Smithers CPNP Smithers Pregnancy Outreach

program

NHA - NW Terrace AHSUNC Kermode AHS Yes – Daily tooth brushing;

Partnership with Northern Health to

provide dental checks and varnishing.

Parents receive dental health

information packages and

toothbrushes.

NHA - NW Terrace CPNP Building Healthier Babies

VCHA North Vancouver CAPC First Years Count: Our Children,

Our Community, Our Commitment

VCHA Squamish, Sechelt,

Gibsons

CAPC Sea to Sky Sunshine Coast

Coalition

VCHA Sechelt, Gibsons CPNP Bellies & Babies

VCHA Vancouver CAPC Children's Coalition of the

Downtown Eastside: Children

Need Care Now

VCHA Vancouver CAPC Mount Pleasant Cedar Cottage

Coalition

VCHA Vancouver CAPC Family Initiatives

VCHA Vancouver CAPC Families Branching Out Coalition

VCHA Vancouver CAPC Children’s Coalition of the

Downtown Eastside - Children

Need Care Now


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HEALTH AUTHORITY /


VCHA– North Shore / Coast

Garibaldi

Powell River CPNP BOND (Babies Open New Doors)

VCHA– North Shore / Coast

Garibaldi

Squamish CPNP Healthy Pregnancy Outreach

Program

VCHA- Vancouver Vancouver AHSUNC Singing Frog Yes - Daily tooth brushing,

Partnership with dental hygienist for

screening 3 times per year

VCHA- Vancouver Vancouver AHSUNC Eagles Nest Yes - Daily tooth brushing,

Partnership with dental hygienist for

screening and classroom visits 3

times per year

VCHA- Vancouver Vancouver CPNP Healthiest Babies Possible

VCHA- Vancouver Vancouver CPNP Sheway

VCHA / FHA Richmond, Delta CAPC Richmond/Delta Family

Empowerment Program

VIHA Duncan, Port Alberni CAPC Healthy Children Healthy Futures

Coalition

VIHA Nanaimo, Campbell

River, Courtenay, Port

McNeill

CAPC Creating Healthy Families for

Healthy Children

Yes – DH visits 3-4x/year in Campbell

River, Courtenay, Pt McNeil

1x/year in Nanaimo

VIHA Victoria, Salt Spring,

Sooke

CAPC Capital Children Coalition


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HEALTH AUTHORITY /


VIHA - Central Courtenay AHSUNC Comox Valley AHS Yes - Dental hygienist visits four

times a year to do dental check-ups,

education, fluoride varnish

treatments, and referrals

VIHA - Central Courtenay CPNP Healthy Babies Prenatal Nutrition

Program

Yes – DH visits 4x/year

VIHA - Central Ladysmith CPNP Born Healthy

VIHA - Central Nanaimo CPNP Nanaimo Building Better Babies

VIHA - Central Port Alberni CPNP Knee~waas POP

VIHA - Central Tofino CPNP Family Ties Healthy Babies

Program

VIHA - North Campbell River AHSUNC Campbell River AHS Yes - Dental hygienist visits monthly.

Tooth brushing is promoted daily.

VIHA - North Campbell River CPNP Baby's Best Chance

VIHA - Northern Port McNeill CPNP Promising Babies

VIHA - South Duncan CPNP Healthiest Babies Possible,

Duncan

VIHA - South Victoria CPNP Victoria Best Babies (Pregnancy

Outreach Program)

VIHA - South Victoria CPNP Esquimalt Neighbourhood House-

Baby Groups (Birth - 12 months)

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