PREPARED BY: Windsor Essex County Health Unit

DATE: 2026-06-25

Oral health is an essential component of overall health, well-being, and quality of life. Oral diseases can affect eating, speaking, sleeping, learning, social interactions, and overall physical and mental health (CDC, 2024). Despite being largely preventable, oral diseases remain among the most common chronic conditions worldwide (WHO, 2024). Dental caries (i.e., tooth decay or cavities) continue to be a significant public health concern because of their high prevalence, cumulative nature, and unequal distribution across populations (Bernabe et al., 2025).

The burden of oral disease is influenced by a range of social, economic, environmental, and structural factors, including income, education, housing, access to dental care, dental insurance coverage, oral health literacy, and other social determinants of health. As a result, poorer oral health outcomes are disproportionately experienced by individuals facing social and economic disadvantage. This underscores the importance of examining oral health across diverse contexts to guide targeted interventions, inform public policy, and allocate resources effectively (Amaral Junior et al., 2025).

The importance of children’s oral health is well established. Untreated dental caries during childhood can contribute to pain, infection, difficulty eating and sleeping, missed school days, diminished academic performance, and poorer health-related quality of life. Given the progressive and cumulative nature of dental caries, early prevention, identification, diagnosis, and access to treatment are critical to reducing long-term health impacts. The 2022 World Health Organization Global Oral Health Status Report identified oral diseases as a major global public health challenge and highlighted persistent inequities in access to preventive and treatment services. The report also emphasized the need for stronger surveillance systems, population-based prevention strategies, and coordinated action to improve oral health for all (WHO, 2024).

Population-level interventions help promote positive oral health outcomes regardless of differences in income or access to private insurance. These interventions include enhanced public education, publicly funded dental care, and Community Water Fluoridation (CWF), all of which help prevent oral disease and support more equitable oral health outcomes across the community.

Against this broader context, local monitoring of oral health indicators is essential for identifying population needs, evaluating public health interventions, and supporting evidence-informed decision-making. In Windsor-Essex County, the Windsor-Essex County Health Unit (WECHU) monitors trends in oral health indicators, advocates for healthy public policy, and stays abreast of the latest research to ensure a comprehensive and current understanding of effective and safe oral health interventions. In doing so, the WECHU provides up-to-date information on community oral health through the Oral Health Data Dashboard. This report draws on dashboard findings and related local reporting, with particular attention to oral health indicators, screening and preventive services, children’s oral health, and oral health-related hospital utilization. Together, these data provide an overview of oral health status and oral health-related needs across Windsor-Essex County to support ongoing surveillance, program planning, and decision-making.

DISCUSSION

Available local data indicate that oral health remains an important public health priority in Windsor and Essex County. The WECHU Oral Health Data Dashboard provides an overview of oral health in the region, supports monitoring of outcomes relevant to the Ontario Public Health Standards, and offers insights to inform planning and evaluation.

Children’s Oral Health and Preventive Services

Children continue to be a priority population for surveillance, oral health promotion, and early intervention. Through school-based oral health screening programs, WECHU identifies children with urgent dental treatment needs and facilitates referrals to appropriate dental care providers. These screening programs also support surveillance of oral health trends and help identify priority populations to guide prevention and outreach initiatives.

Preventive services provided to eligible children through publicly funded programs such as Healthy Smiles Ontario (HSO), a program led locally by the WECHU, include oral examinations, scaling, fluoride varnish applications, pit and fissure sealants, and oral health education. WECHU’s dental clinics therefore play an important role in improving access to preventive and treatment services for eligible children who may otherwise face barriers to dental care (WECHU, n.d.).

Although programs such as HSO improve access to care, availability alone does not guarantee equitable access, and many families may still face barriers to routine dental services. As a result, early identification and timely intervention remain essential for addressing oral disease before it progresses to more severe and avoidable treatment needs.

It is important to note that disruption to screening and routine oral health services during COVID-19 reduced opportunities for early identification and preventive care during the 2020–21 period. Screening efforts that resumed during the pandemic focused primarily on medium- and high-risk schools, resulting in a higher proportion of children with unmet oral health needs being captured in 2021–22 surveillance data. Following the resumption of regular screening, the percentage of caries-free children improved steadily (WECHU, n.d.).

Oral Health Care for Older Adults

Seniors are also an important population for oral health surveillance, preventive services, and access to care. Oral health needs often become more complex with age, as older adults may experience a greater burden of oral disease because of chronic conditions, medication use, hyposalivation (dry mouth), functional limitations, and difficulties accessing routine dental care (Murali et al., 2025).

Through publicly funded programs such as the Ontario Seniors Dental Care Program (OSDCP), eligible older adults can access preventive and treatment services. Although these programs improve access, barriers related to cost, transportation, mobility, awareness, and service navigation persist. Ongoing monitoring of seniors’ oral health needs is therefore important for supporting service planning and ensuring the sustainability of programs for an aging population.

The WECHU oral health clinic also provides a range of preventive and treatment services for OSDCP-eligible seniors, and many older adults receive care in-house. Services include dentures, restorations, root canal treatment, and extractions, with referrals arranged for more complex procedures when needed. This supports access to care for seniors who may otherwise face barriers to obtaining routine dental services.

Equity Considerations in Oral Health Care

Windsor-Essex County has experienced population growth and increased diversity in recent years, driven by immigration and newcomer settlement. From 2011 to 2021, Windsor experienced a 32% population increase, compared with an 11% increase in Ontario (IRCC, 2025). These demographic changes can increase demand for oral health services and public health programming. Newcomers also face barriers such as communication challenges, limited insurance coverage, and financial constraints, which can further restrict access to oral health services. Ongoing monitoring of oral health indicators is therefore important to ensure that services remain responsive to the needs of a growing and diverse population.

Access to dental care for prevention and treatment is essential to maintaining oral health. Although Windsor-Essex residents have access to publicly funded programs such as HSO and the Ontario Seniors Dental Care Program (OSDCP), barriers to care persist for some populations. More broadly, oral health outcomes are shaped by access to care, income, dental insurance coverage, oral health literacy, and other social determinants of health. Local reporting suggests that oral health concerns are not evenly distributed across the community, highlighting the importance of considering inequities and barriers to care when interpreting oral health trends.

KEY INSIGHTS FROM THE WECHU ORAL HEALTH DASHBOARD

Prevalence and severity of dental caries (WECHU, n.d.)

• Dental caries remains a significant oral health concern among children in Windsor-Essex County. School screening data show that Grade 2 students consistently have the lowest proportion of caries-free children, suggesting a higher caries burden in this age group.
• Screening data also show that Grade 2 students tend to have the highest decayed, missing/extracted, and filled teeth (deft/DMFT) scores, indicating the greatest cumulative burden of dental disease.
• Between 2021 and 2025, the mean Grade 2 deft/DMFT score decreased from 3.3 to 2.2, suggesting improvement; however, Grade 2 students continue to experience more decay than younger children.

Urgent dental needs (WECHU, n.d.)

• The percentage of children with urgent dental needs increased from 11.0% in 2015–16 to a peak of 17.7% in 2021–22. By 2024–25, the percentage had declined to 11.8%, approaching pre-pandemic levels.

Impact of Community Water Flouridation on Oral Health (WECHU, n.d.)

• Following the reintroduction of CWF in January 2022, oral health indicators improved across several measures. CWF is an evidence-based population-level intervention for preventing dental caries and a safe and effective means of improving population-level oral health, particularly for those experiencing health inequities. 
• CWF is associated with an approximate 25% reduction in tooth decay among children and adults (Public Health Agency of Canada, 2022). Continued monitoring will be important in assessing its longer-term impact in the region.
• CWF at optimal levels does present a small risk for mild dental fluorosis (a cosmetic occurrence of small white spots on teeth). This occurrence is affected by the presence of naturally occurring fluoride, such as in well water and the use of fluoridated toothpaste and other oral health products in both fluoridated and non-flouridated communities.  
• Dental fluorosis rates are published on the WECHU Oral Health Dashboard and the WECHU remains committed to monitoring rates of fluorosis with the reintroduction of CWF in some local communities since January 2022.

These local indicators suggest a continued need to prioritize oral health as a population health issue in Windsor-Essex County. The findings support continued surveillance and reporting, prevention and early identification initiatives, population-based interventions, referral pathways for urgent care, and ongoing efforts to reduce barriers to dental care access while addressing inequities that place some groups at greater risk of poor oral health outcomes.

PUBLIC HEALTH IMPLICATIONS

Overall, these findings reinforce the importance of oral health as a public health issue in Windsor and Essex County. In response, WECHU continues to emphasize surveillance, prevention, early identification of need, access to care for eligible residents, and broader population-level strategies such as CWF that support equitable oral health outcomes.

Ongoing use of the WECHU Oral Health Data Dashboard and related local reporting can help monitor trends over time, identify priority populations, and inform program planning, service delivery, and communication with decision-makers about the oral health status of Windsor-Essex County residents.

REFERENCES

• Amaral Junior, O. L. do, Braccini Fagundes, M. L., Hugo, F. N., Kassebaum, N. J., & do Amaral Giordani, J. M. (2025). Structural determinants of inequalities in untreated dental caries in the Global Burden of Disease Study. PLOS One, 20(6), e0325138. https://doi.org/10.1371/journal.pone.0325138
• Bernabe, E., Wagner Marcenes, Rizwan Suliankatchi Abdulkader, Abreu, L. G., Afzal, S., Fadwa Naji Alhalaiqa, Sadeq Al-Maweri, Alsharif, U., Anayochukwu Edward Anyasodor, Arora, A., Saeed Asgary, Ashraf, T., Balasubramanian, M., Morteza Banakar, Barrow, A., Azadeh Bashiri, Belay, S. A., Uzma Iqbal Belgaumi, Alemshet Yirga Berhie, & Bhardwaj, P. (2025). Trends in the global, regional, and National Burden of Oral Conditions from 1990 to 2021: a Systematic Analysis for the Global Burden of Disease Study 2021. The Lancet, 405(10482). https://doi.org/10.1016/s0140-6736(24)02811-3
• CDC. (2024, May 23). Oral Health Facts. Oral Health. https://www.cdc.gov/oral-health/data-research/facts-stats/index.html
• Immigration, Refugees and Citizenship Canada. (2025, December 23). Immigration and our local economies. Government of Canada. https://www.canada.ca/en/immigration-refugees-citizenship/campaigns/immigartion-matters/local-economies/windsor.html
• Murali, A., Muddappa, S. C., Rajan, R. R., Joseph, A., Ravi, A. B., Murali, A., Dr Sapna C. Muddappa, Rajan, R., Joseph, A., & Arjun, D. (2025). Barriers to Geriatric Oral Health: A Multifaceted Public Health Issue. Cureus, 17(8). https://doi.org/10.7759/cureus.89604
• Public Health Agency of Canada. (2022, December 20). The State of Community Water Fluoridation across Canada. Www.canada.ca. https://www.canada.ca/en/public-health/services/publications/healthy-living/community-water-fluoridation-across-canada.html
• Windsor-Essex County Health Unit. (n.d.). Oral health data dashboard. https://www.wechu.org/reports/oral-health-0
• World Health Organization. (2024). Global strategy and action plan on oral health 2023–2030. https://www.who.int/publications/i/item/9789240090538