An N.W.T. dentist who served small communities in the territory for over a decade is calling on the territorial and federal governments to bring back regular dentist visits to small communities after years of declining access.
Dentist Pirjo Friedman worked for Yellowknife-based Adam Dental Clinic since 2011, spending most of her time visiting small communities as the primary visiting dentist for the Sahtu region, Dehcho region, and the communities of Łutsel K’e and Fort Resolution.
She recently retired at the age of 74, making her last visit to small communities in May.
She said that broken dental equipment and run-down dental rooms in small communities have made it much harder for dentists to visit — and the issue is getting worse.
In the last couple years alone, Friedman said dental rooms or equipment in Fort Liard, Délı̨nę, Tulı́t’a and Fort Good Hope have all become damaged enough that she has had to stop visiting.
“There’s one health centre where the pipes underneath the dental room freeze and the sewage smacks up into the dental room, so there’s sewage in the dental room,” she said, as one example.
Now that she has retired, she said she worries about what will happen in the communities she was still visiting as well.
‘A little bit upsetting’
Louis Balsillie is the Chief of Deninu Kųę́ First Nation in Fort Resolution. Friedman served his community for a decade. He said the community has had no dentist visits since Friedman retired, so community members now need to drive two hours to Hay River if they need a dentist.
Balsillie said it’s one of many cutbacks in health and social services hurting small communities like his.
“It gets a little bit upsetting because it’s quite a way to travel,” he said. “Nobody has the dollars nowadays.”
Fort Providence resident Jolene Lacorne said her community is in the same position.
She worked as an assistant for Friedman when the dentist visited Fort Providence and Fort Simpson, booking and scheduling appointments and doing work like sterilizing equipment. She said during Friedman’s visits to Fort Providence, her team served about 20 patients a day over 12 hours. She estimates about 60 per cent of those patients had serious dental issues.
“I think it was important to have the one dentist, especially Dr. Friedman, who knew the majority of the people from our community,” she said.
Lacorne added that since Friedman retired she has continued to get texts and calls from stressed residents asking when the dentist will be back.
She is now directing all of those calls to the local health centre. But she said getting a referral to a dentist this way can be challenging — especially for kids who often need to go to Edmonton, where more dentists offer sedation or anesthesia.
“Before you even get treatment, you need to get a checkup first. And then you get referred. And then you got to go through medical travel and all that to get approved before you get out to Edmonton or anything,” she said.
She also fears that dental care for some kids and elders will slip through the cracks now that Friedman isn’t checking in regularly.
Many communities have already gone longer without dental visits. In Gamètı̀, health centre worker Terry Gon said records showed no dentist has visited since 2021.
No dentists contracted to provide visits
Prior to the COVID-19 pandemic, most small communities in N.W.T. got visits from a dentist a few times a year. Those visits were administered by the territorial government and funded by Indigenous Services Canada, which is responsible for funding dental care for First Nations and Inuit in Canada.
But there have been no contracts for dentists to make regular visits to small communities since the COVID-19 pandemic ended.
Some dentists, like Friedman, visited communities under the terms of previous contracts, but N.W.T. Health Minister Lesa Semmler told CBC those visits have been “very minimal.”
She said staff at the Department of Health and Social Services found that in one year, the N.W.T. government billed Indigenous Services Canada $12 million for N.W.T. residents’ travel dentists.
In a statement, Indigenous Services Canada said in-community dental services are managed through territorial government contracts “which depend on the state of readiness of territorial-owned facilities in communities.”
“Where in-community dental services are not available, NIHB provides coverage to support clients to travel to the nearest appropriate location to receive services.”
Semmler said she didn’t have details on what work is being done to book new short-term contracts, but said the territory isn’t ready to start offering dentists new long-term contracts to visit small communities yet.
She said the territory has applied for funding from Health Canada’s fund to fix dental rooms in small communities, and they are expecting to hear whether they were approved for that funding this week.
Semmler said the territorial government plans to wait until there is a new contribution agreement with Indigenous Services Canada before negotiating with N.W.T. dentists for new contracts to visit small communities. The last contribution agreement between the parties ended in March 31, 2025.
“At this point I can’t give you a best timeline,” Semmler said, adding she is hopeful she will be able to offer more details on when dental visits will resume “within a couple months”.
Friedman criticized both the federal and territorial governments for delaying people’s access to dental care because of disagreements over funding.
“It’s their responsibility to provide the dental visits,” she said. “The people who live in the communities are suffering.”
link