Bridging gaps in oral health: The need for a national EMR-based oral health data repository

Oral health is an integral part of overall health, yet it often remains segregated from broader healthcare systems in Canada. Initiatives like the Canadian Dental Care Plan (CDCP), the Oral Health Access Fund, and the National Oral Health Research Strategy (NOHRS) have made significant strides in improving access to dental care and addressing oral health inequities. However, there remains an opportunity to enhance these efforts by integrating data systems to provide comprehensive insights.^1-3

Canada currently lacks a centralized system to track disease rates or evaluate funded plans effectively. Claims data, while useful, has limitations. It often lacks clinical context, is restricted to reimbursement requirements, and may be inaccurate due to improper coding. It also fails to capture uninsured populations and may not represent the general population. Additionally, claims data is limited by coverage caps, which can leave out important services or treatments that are not reimbursed. These gaps make it difficult to gain a comprehensive understanding of patient care and health outcomes. Leveraging electronic medical record (EMR) data can address this gap, offering real-time insights to better understand oral health trends, service utilization, and equity gaps. Unlike population-based surveys that provide snapshots, EMRs enable continuously updated data reflecting real-world clinical practices, advancing evidence-based decisions and improving oral health outcomes nationwide.⁴

In addition to creating this repository, developing a Pan-Canadian Oral Health data Standard is critical in ensuring data consistency, interoperability, and meaningful use across provinces and territories. Furthermore, leveraging advanced technologies such as artificial intelligence (AI) can enable cutting-edge data analysis, generating predictive models to better target resources and improve public health outcomes.

Exploring Canada’s oral health data framework

National Oral Health Research Strategy

The National Oral Health Research Strategy (NOHRS) is a forward-thinking initiative aimed at advancing oral health research across Canada. It brings together leading organizations, including the Canadian Institutes of Health Research’s Institute of Musculoskeletal Health and Arthritis, Canadian Association for Dental Research, and the Association of Canadian Faculties of Dentistry, to address critical challenges in oral health equity, research, and innovation.

Key priorities of NOHRS include:

Access to oral health care: Addressing barriers faced by marginalized groups such as Indigenous communities, rural populations, and low-income families through research and policy development.
Equity and inclusion: Focusing on person-centered approaches to reduce identity-related inequities in oral health.
Emerging technologies: Leveraging tools such as artificial intelligence and omics to enhance research capabilities and patient care.
Knowledge mobilization: Promoting the effective translation of research findings into actionable strategies for healthcare providers, policymakers, and communities.
Sustainability: Advancing environmentally sustainable practices and materials in oral health care.

NOHRS emphasizes collaboration, inclusivity, and the integration of innovative methodologies to create a dynamic research ecosystem. By combining its strategic priorities with real-time electronic medical record (EMR) data, NOHRS has the potential to provide actionable insights, enabling targeted interventions and fostering a more equitable and efficient oral healthcare system in Canada.¹

Canadian Dental Care Plan (CDCP)

Launched in December 2023, the Canadian Dental Care Plan addresses inequities in dental care by targeting underserved populations. Initially focused on families earning less than $90,000 annually, the plan has already benefited over 650,000 Canadians. In March 2025, the Government of Canada announced a significant expansion: beginning June 1, 2025, CDCP coverage will extend to all eligible uninsured Canadians aged 18 to 64, in addition to the seniors and children already covered. This expansion is expected to provide coverage to millions more Canadians, making it one of the largest public dental programs in the country’s history. Integrating data from the dental care plan into a centralized repository will ensure policymakers can track outcomes in near real-time, refining strategies to maximize impact and equity as the program’s reach grows.²

Oral Health Access Fund

The Oral Health Access Fund is a new initiative aimed at reducing oral health inequities across Canada. It provides financial support to communities and organizations working to improve access to dental care for underserved populations, including low-income families, Indigenous communities, and rural/remote residents. By prioritizing the reduction of systemic barriers, the fund enhances Canada’s capacity to address disparities and ensure equitable access to oral health services. Integrating data from this initiative into a centralized repository would enable near real-time tracking of its impact and guide policy decisions to maximize its reach and effectiveness.³

Global insights on oral health data

American Dental Association

The American Dental Association (ADA) achieved a milestone in dental data interoperability by adopting the Fast Healthcare Interoperability Resources (FHIR) standard. This initiative enables the seamless sharing of full dental records across various systems, showcasing the transformative potential of standardized data exchange in enhancing healthcare delivery. Additionally, the ADA has developed comprehensive Dental Quality Measures, as outlined in their 2025 Adult Measures User Guide. These measures provide a framework for evaluating the quality of care and outcomes in dental practices, emphasizing patient-centered approaches and data-driven decision-making.^{5, 6}

The ADA also plays a pivotal role in advancing oral health data integration through the Oral Data Interoperability Network (ODIN). ODIN is instrumental in standardizing data exchange protocols, ensuring consistency, and aligning with evidence-based standards. By improving the accessibility and usability of oral health data, ODIN supports benchmarking, quality improvement, and enhanced patient outcomes. Furthermore, the ADA’s focus on data standards, interoperability, and quality metrics serves as a model for Canada as it develops its centralized oral health data strategies.⁷

World Health Organization (WHO)

The World Health Organization (WHO) Global Strategy on Oral Health (2022–2030) emphasizes integrating oral health into primary care and leveraging data systems for decision-making. This strategy highlights the importance of creating inclusive and comprehensive oral health data frameworks to address disparities and improve outcomes globally. Canada can draw inspiration from WHO’s emphasis on data-driven strategies as it works toward developing its centralized repository for oral health data.⁸

Transforming Canada’s healthcare landscape

Pan-Canadian Health Data Content Framework

The Pan-Canadian Health Data Content Framework, developed by the Canadian Institute for Health Information (CIHI) and Canada Health Infoway, aims to standardize and unify health data across Canada. It emphasizes person-centric design, inclusivity, and strong data governance while aligning with international standards. By improving interoperability and ensuring consistent data across provinces, the framework enables seamless data exchange, fostering real-time insights to address public health challenges effectively.⁹

CIHI health indicators

The Canadian Institute for Health Information (CIHI) has also developed a comprehensive set of health indicators to assess healthcare system performance across Canada. These indicators measure key areas such as access, quality, outcomes, and equity, enabling provinces and territories to benchmark their healthcare services. Incorporating oral health metrics into this framework could further enhance Canada’s ability to evaluate and improve dental care delivery.¹⁰

Connected Care for Canadians Act (Bill C-72)

Introduced in June 2024, the Connected Care for Canadians Act establishes legal requirements to ensure interoperability in health information technology. The act mandates:

The secure and seamless exchange of data between healthcare systems.
The prohibition of data blocking by vendors to encourage open access.
The protection of patient privacy while facilitating greater data transparency.¹¹

Why a centralized repository is essential

A centralized dental health information repository built on data directly sourced from electronic medical records (EMRs) offers transformative opportunities for oral health research, policymaking, and equity-focused interventions:

1. Timelier monitoring of oral health trends: Data sourced from EMRs provides continuously updated insights into emerging oral health trends.^6,7,9

2. Comprehensive national data coverage: By aggregating EMR data from clinics across Canada, the repository would reflect the diversity of the population and capture regional variations, ensuring a holistic understanding of oral health.^9,10

3. Standardized data across provinces: A Pan-Canadian Oral Health Data Standard would ensure consistency enabling inter-provincial comparisons, improved benchmarking, and better integration with broader health systems.^7,9,12

4. Addressing oral health inequities: Data from the repository would support targeted interventions.¹³

5. Integration with Primary Healthcare: Linking oral health data with primary healthcare systems fosters a holistic approach to patient care emphasizing the connection between oral and systemic health.⁸

6. Driving research and innovation: Leveraging artificial intelligence and omics data enables predictive modeling and longitudinal studies.^1,14

7. Incorporating performance metrics: Developing oral health-specific indicators, similar to CIHI’s health indicators, would allow for better benchmarking and evaluation of care outcomes across provinces and territories.¹⁰

Charting the path forward for oral health data

1. Develop Pan-Canadian oral health data standards: Establishing consistent data collection and reporting frameworks ensures interoperability and facilitates better integration of oral health data into national healthcare systems.^7,9

2. Expand real-time EMR adoption and data integration: Encourage the widespread use of EMRs across dental clinics and integrate these into a centralized repository to provide timely, actionable insights.¹²

3. Focus on marginalized communities: Prioritize addressing oral health disparities in underserved populations, including Indigenous groups, rural residents, and low-income families.¹³

4. Leverage artificial intelligence: Utilize AI tools to analyze large datasets for predictive modeling, trend identification, and resource allocation to improve public health outcomes.^14,15

5. Engage Multisectoral Stakeholders: Foster collaboration between policymakers, healthcare providers, researchers, and community organizations to drive holistic improvements in oral health systems.⁹

6. Incorporate CIHI Indicators for oral health: Leverage the Canadian Institute for Health Information’s (CIHI) framework of health indicators to create specific oral health metrics. These indicators would enable provinces and territories to benchmark performance, assess equity, and evaluate the impact of interventions effectively.¹⁰

7. Integrate oral health into primary healthcare systems: Align oral health services with broader healthcare systems to promote a patient-centered, cohesive approach to health care delivery.⁸

Conclusion: A new era in oral health with data-driven solutions

The creation of a Centralized National Dental Health Information Repository leveraging data from EMRs is not just a visionary initiative but a necessary step to close gaps in oral health equity, research, and policymaking. By integrating real-time data from dental clinics into a unified system, Canada can empower stakeholders to identify trends, allocate resources effectively, and implement targeted interventions.

In particular, the Canadian Dental Care Plan (CDCP) would greatly benefit from robust data analysis to evaluate its effectiveness. A centralized repository would enable the tracking of how CDCP-funded programs impact oral health outcomes, ensuring they meet equity and cost-effectiveness goals. Advanced data analytics could provide insights into resource allocation and improve the reach of such initiatives, ensuring that the program delivers measurable improvements in oral health equity and access.

This initiative offers a unique opportunity to seamlessly integrate oral health into the broader healthcare ecosystem. Organizations like the Canadian Institute for Health Information (CIHI), which has the expertise to analyze and derive actionable insights, the repository can provide evidence-based strategies for improving oral health outcomes. CIHI’s health indicators and robust analytics capabilities will ensure that interventions are measurable and impactful. As a prescribed entity under the Personal Health Information Protection Act (PHIPA), CIHI ensures that health data collected for this initiative is securely managed in compliance with privacy regulations. This framework reinforces the integrity and confidentiality of the centralized repository, fostering trust among stakeholders and ensuring the responsible use of health data.¹⁶

Additionally, the repository’s focus on advanced technologies like artificial intelligence and alignment with global strategies such as the WHO Global Strategy on Oral Health positions Canada as a leader in oral health innovation. However, its success depends on strong collaboration among policymakers, healthcare providers, researchers, and communities.

Ultimately, this transformative effort has the potential to enhance the quality of life for Canadians, reduce disparities, and establish a sustainable, equity-focused model for oral health that serves as a benchmark for global healthcare systems.

Oral Health welcomes this original article.

References

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Oral Health Access Fund [Internet]. Canada.ca; 2023 [cited 2025 Jan 7]. Available from: https://www.canada.ca/en/services/health/healthy-living/dental-oral/oral-health-access-fund.html
Nashville Biosciences. Claims data vs EHRs: Distinct but United in Real-World Research [Internet]. Nashville Biosciences; [cited 2025 Jan 7]. Available from: https://nashbio.com/blog/ehr/claims-data-vs-ehrs/
ADA News. Dental data exchange hits milestone with successful sharing of full records [Internet]. ADA News; [cited 2025 Jan 7]. Available from: https://adanews.ada.org/ada-news/
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American Dental Association. June 2023 AIP Review: Dental Standards and Updates [Internet]. American Dental Association; 2023 Jun [cited 2025 Jan 7]. Available from: https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/practice/dental-standards/aip-review/1111_odin_aip_june2023.pdf?rev=a7934ae810ae447a914ca647756ba93e&hash=6EF2465A3AAFFB2AE70907CD2E6914A6
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Canadian Institute for Health Information. Pan-Canadian Health Data Content Framework: Data Content Standard [Internet]. Available from: https://www.cihi.ca/sites/default/files/document/pan-canadian-health-data-content-framework-data-content-standard-en.pdf. Accessed January 7, 2025.
Canadian Institute for Health Information. Health Indicators 2013 [Internet]. Available from: https://www.cihi.ca/sites/default/files/document/health-indicators-2013-en.pdf. Accessed January 7, 2025.
Parliament of Canada. Connected Care for Canadians Act (Bill C-72) [Internet]. Parliament of Canada; 2024. Available from: https://www.parl.ca/documentviewer/en/44-1/bill/C-72/first-reading. Accessed January 7, 2025.
Walters A. Why electronic health records need to be integrated into dentistry. Dentistry IQ [Internet]. 2024 Mar 29. Available from: https://www.dentistryiq.com/practice-management/practice-management-software/article/55000854/why-electronic-health-records-need-to-be-integrated-into-dentistry . Accessed January 7, 2025
Levy BB, Goodman J, Eskander A. Oral healthcare disparities in Canada: Filling in the gaps. Can J Public Health. 2022;114(1):139–45. doi: 10.17269/s41997-022-00692-y
Panahi O. Empowering dental public health: Leveraging artificial intelligence for improved oral healthcare access and outcomes. Juniper Online J Public Health. 2024;9(1):Article 555754. doi: 10.19080/JOJPH.2024.09.555754
McKinsey & Company. The potential benefits of AI for healthcare in Canada [Internet]. Available from: https://www.mckinsey.com/industries/healthcare/our-insights/the-potential-benefits-of-ai-for-healthcare-in-canada. Accessed January 7, 2025.
Canadian Institute for Health Information. CIHI’s PHIPA Report [Internet]. October 2020. Available from: https://www.cihi.ca/sites/default/files/document/cihi-phipa-report-final-october-2020-en.pdf.

About the author

Georgy Jacob is a certified health information professional with extensive experience in both clinical dentistry and health information management. With a deep understanding of health information systems, Dr. Jacob has worked in several capacities across hospitals in Canada, playing a pivotal role in implementing major electronic health record (EHR) systems. Currently serving as a Program Specialist at the Canadian Institute for Health Information (CIHI), Dr. Jacob contributes to advancing national healthcare data standards and enhancing the integration of health information systems to improve care delivery and public health outcomes in Canada.