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Jon Perlus, a periodontist and dental implant surgeon. (JENNIFER ROBERTS FOR THE GLOBE AND MAIL)
Jon Perlus, a periodontist and dental implant surgeon. (JENNIFER ROBERTS FOR THE GLOBE AND MAIL)

Health

Smile, and don’t give up dental coverage in retirement Add to ...

It was about 15 years ago when Jon Perlus, a Toronto dentist who specializes in gum disease and dental implants, told a patient he needed major dental work. The patient decided to forgo the procedure.

Dr. Perlus saw the same patient recently – on the verge of retirement, with his teeth in bad shape, and wondering how he is going to pay for the work he should have had done years ago.

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“It would have put him in a position to maintain a pretty good level of dental health for the rest of his life,” Dr. Perlus says. “Now he’s facing a situation where he’ll have to deal with fairly significant dental costs after he’s retired.”

A sad story, Dr. Perlus says, but what’s even sadder is that it’s not an uncommon tale. With more Canadians today keeping all or most of their natural teeth well into their senior years, dental care – and the costs that go along with it – can become a significant financial burden in retirement.

A Statistics Canada survey conducted between 2007 and 2009 found older Canadians had more problems with their teeth than their younger counterparts. For example, 43 per cent of those between 60 to 79 had cavities, compared with just 6 per cent among the 20- to 39-year-old group. When it came to gum disease, 24 per cent of seniors reported moderate gum disease, versus 16 per cent among all adult Canadians.

At the same time, more than half of seniors don’t have dental insurance – a major factor in Canadians’ decision to see a dentist. Tim Clarke, Canadian health benefits and innovation leader at human resources consulting firm Aon Hewitt, points to a downward trend in employer-paid dental insurance for retirees: In 2002, close to 40 per cent of employers in Canada provided dental coverage for their retired workers. A decade later, that number has dropped to 30 per cent.

Lack of dental insurance, combined with the switch to a fixed income and, in many cases, squeezed household budgets, means many retired Canadians find themselves having to choose between a healthy mouth or having enough to live on with dental problems. That’s why it is important to include dental care in a retirement plan, says Franco Caligiuri, a financial adviser and president of Capital Core Financial in Vancouver.

“[Dental care] is, without a doubt, an item that most people do not include in their planning,” he says. With the cost of dental care increasing by about 6 to 9 per cent each year, “extra savings can be wiped out in one major dental procedure.”

Wallace Thompson, vice-president of sales and client management at Manulife Financial, points out that most provinces provide dental benefits for retirees with low income, and will also cover the costs of dental procedures that are deemed to be medically necessary.

For those who don’t qualify for public benefits, private dental insurance is a must, Mr. Thompson says. Things to look at when choosing a plan include frequency of recall visits, maximum reimbursement amount, waiting period before benefits kick in, and whether it covers basic and major restorative dental services such as dentures, crowns and bridges.

“For retirees, it is important that they select the option that includes major restorative services,” Mr. Thompson says.

Some companies give their employees the option of continuing their work-sponsored extended health and dental plan after they retire, with the retiring employee paying all or part of the premiums. Unlike a brand-new policy, this won’t require a medical exam to qualify for coverage.

“Depending on the level of contribution, it probably makes sense to continue the coverage,” Mr. Clarke at Aon Hewitt says. “Most plans don’t allow retirees to opt out of coverage and get back later, so don’t just think about short-term cash flow; think about what your long-term dental care needs might be.”

To get a sense of what those long-term needs might be, it’s a good idea to get a thorough dental exam before retiring, Dr. Perlus says.

“If you get a comprehensive dental exam when you’re close to retirement, say at age 60, you’ll get a good picture of where you stand in terms of oral health and what you’re likely facing in the future.”

Having this preretirement exam often nudges those with employer-sponsored coverage to get the work they need done while their insurance is still in place, Dr. Perlus says. This may sound like a no-brainer, but many people put off going to the dentist, perhaps because they’re too busy or are simply scared, he says.

To manage the costs of dental care, some retirees are opting to travel to countries where dental services are significantly cheaper than in Canada, says Paul McTaggart, chief executive officer of Dental Departures, a Seattle company that arranges dental appointments overseas – in countries such as Mexico and Costa Rica – for its U.S. and Canadian clients.

Of Dental Departures’ Canadian customers, 60 per cent are retirees. Depending on where the dental procedure is done, they pay as much as 70 per cent less than they would in Canada, says Mr. McTaggart, whose company does background checks on all the dentists it works with.

However they choose to pay for their dental care in retirement, Canadians need to make sure they have a plan that will allow them to look after teeth as they age, Dr. Perlus says.

“Your quality of life is significantly reduced when your teeth aren’t healthy,” he says. “So plan for your dental health just as you would plan for other aspects of retirement.”

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