As the Cree Health Board strives to secure sufficient dental services throughout the region, new facilities are expanding the quality and availability of care within communities. In January, Waskaganish became the latest Cree community to open a state-of-the-art Community Miyupimaatisiiun Centre (CMC).
Waskaganish’s new health clinic is about four times the size of the former one with a much wider range of services and equipment. It features two treatment rooms for dentists, one for a dental hygienist and one for specialists. As the community is positioned as a third regional hub, along with Chisasibi and Mistissini, patients from Wemindji and Eastmain will have greater access to its specialized services.
New CMC clinics have also opened in Mistissini, Waswanipi, Eastmain and Nemaska, but the CHB faces difficulties in meeting the growing demand for dental professionals. In Waskaganish, there’s currently one full-time dentist and a part-time dental hygienist with hopes to add another permanent dentist and specialized services. Root canals (endodontics) should come later this year.
“Unfortunately, a reality we’re facing right now is that because of a lack of access people use services only when an emergency occurs,” said Lucie Papineau, head of dentistry. “No one likes this. We’re looking at education solutions, bringing in extra resources, improving working conditions.”
As department head since 2008, Papineau explained that coordinated efforts with Quebec’s Health Ministry largely succeeded in keeping regional clinics fully staffed until the pandemic. After services finally resumed, a backlog of dental emergencies created a “shock wave” for clinics.
The Canadian Dental Care Plan began offering dental benefits to millions of low- and middle-income people in May 2024, closely modelled on the federal Non-Insured Health Benefits (NIHB) program for Indigenous people. However, dental clinics in the south became so busy as a result that professionals who formerly came to Eeyou Istchee were no longer availabile.
“We’re working with different partners to make sure services come back to the territory,” said Papineau. “To alleviate that crisis, the CHB started an autonomous program that allows patients to seek dental care by themselves while they are travelling for business, visiting family or even going to a hockey tournament.”
The temporary measure launched last June encourages eligible clients to book appointments at their preferred clinic outside the territory and receive reimbursement according to Cree NIHB rates for travel, lodging and service fees. Cree beneficiaries can consult a list of clinics in Quebec and Ontario whose service fees go straight to the CHB.
“On the website, we have 25 or 30 clinics that are well informed about how the health board works and are willing to see our patients,” Papineau said. “There were about 2,000 [appointments] last year, so people do use it. It’s a small way for us to make sure people have access.”
While specialists may visit Waswanipi and Whapmagoostui, Cree patients must travel to Chisasibi or Mistissini for specialized services, such as prosthetic crowns, orthodontics and complex surgeries like biopsies to test for cancer. Often leaving behind their private practice for these brief visits, specialists have appointments tightly planned so they’re booked solid for up to 12-hour days.
Cree clinics are now impressively equipped, becoming fully digital in recent years. Instead of the x-rays and gooey molds of patient mouths that were once the norm, there are faster, easier and transferrable digital imaging machines and 3D scanners. There’s also a clinical microscope for performing root canals.
“Instead of sending people out for services, they can receive excellent care in their own community,” asserted Papineau. “In the new hospital, hopefully we’ll have a general anaesthesia space to treat children who need to be put to sleep to have their teeth fixed.”
The regional hospital planned to open in Chisasibi in 2029 will feature a comprehensive dental department – just as more Cree students are looking at careers in dentistry. While some are currently enrolled in dentist or hygienist programs down south, many dental assistants have graduated from the CHB’s 10-week training program over the years.
In September, Charlene Weapenicappo became the first to graduate as a dental hygienist. Returning to practice in her home community of Eastmain, she envisions expanding her knowledge to eventually lead more Cree dental professionals or perhaps even studying further to become a dentist.
“What I enjoy most about being a dental hygienist is seeing all the kids I work with,” said Tina Cheechoo, who has returned to practice in her hometown Waskaganish after many years working in Ontario. “Their excitement to be here always makes my day.”
Dental hygienist Faith Gilpin recently transferred to the public health department after seven years at Mistissini’s clinic. She organizes activities and promotions to support oral health at school, daycare, maternal programs and in the community. Following post-pandemic setbacks, the region’s dental prevention program is ramping up.
CHB management is working with partners to expand services and personnel, aiming for 12 full-time dentists and 6 full-time dental hygienists. In partnership with McGill University, a mentorship program could soon bring more dentist graduates into the territory for an extra year of supervised clinical work to further their learning.
“There’s a lot to look forward to despite the difficulties we’re facing,” Papineau said. “We’re fortunate the administration recognizes the importance of dental care for the population’s overall health. Yes, a dentist can fix a problem, but you have the power to prevent it.”