title: Dental treatment and employment outcomes among social assistance recipients in Ontario, Canada.
abstract: BACKGROUND
  Policy advocates continue to argue for the expansion of dental care services for people on social assistance in order to meet their health needs and to promote the move from welfare-to-work. However, there is little to no evidence to support the idea that receiving dental care ultimately improves employment outcomes.
  
  
  METHODS
  A retrospective cohort study was designed using administrative data from five Ontario regions and from the province's social assistance ministry. Employment outcomes among treatment and no-treatment cohorts were assessed at three, six and 12 months from baseline. Multivariable regression modeling was performed.
  
  
  RESULTS
  We received data for 8742 people (2742 treatment, 6000 no-treatment). At one year, employment outcomes were not significantly different between the two groups (adjusted odds ratio=0.93; 95% CI: 0.83-1.03). Post-hoc analysis show that the change in proportion of individuals leaving social assistance for employment over time was significantly higher (p=0.0014) among those receiving treatment (13-29%; 124% increase) than those not receiving treatment (18-33%; 83% increase).
  
  
  CONCLUSIONS
  At one year, dental treatment alone does not appear to be significantly associated with leaving assistance for employment in this population. However, this study suggests that people who received dental treatment may have been particularly disadvantaged and dental treatment may help to level them up in terms of employment outcomes over time.
authors.affiliation: Discipline of Dental Public Health, Faculty of Dentistry, University of Toronto, Ontario, Canada. Electronic address: sonica.singhal@mail.utoronto.ca.
authors.forename: Sonica
authors.initials: S
authors.lastname: Singhal
authors.affiliation: Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Ontario, Canada. Electronic address: MamdaniM@smh.ca.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Mamdani
authors.affiliation: Factor-Iwentash Faculty of Social Work, University of Toronto, Ontario, Canada. Electronic address: andrew.mitchell4@sympatico.ca.
authors.forename: Andrew
authors.initials: A
authors.lastname: Mitchell
authors.affiliation: Hospital for Sick Children, Department of Pediatrics, Faculty of Medicine, University of Toronto, Ontario, Canada. Electronic address: Howard.Tenenbaum@dentistry.utoronto.ca.
authors.forename: Howard
authors.initials: H
authors.lastname: Tenenbaum
authors.affiliation: Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Ontario, Canada. Electronic address: LebovicG@smh.ca.
authors.forename: Gerald
authors.initials: G
authors.lastname: Lebovic
authors.affiliation: Discipline of Dental Public Health, Faculty of Dentistry, University of Toronto, Ontario, Canada. Electronic address: carlos.quinonez@utoronto.ca.
authors.forename: Carlos
authors.initials: C
authors.lastname: Quiñonez
mesh_terms: D000328:Adult; D003729:Dental Care; D004651:Employment / Q000191:economics* / Q000523:psychology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D009864:Ontario; D012189:Retrospective Studies; D012946:Social Welfare / Q000191:economics
keywords: Dental services research; Dental treatment; Employment; Health policy; Oral health inequalities; Social assistance; Welfare recipients