The aides in Health Minister George Smitherman's office who keep deflecting Irwin Lightman's calls probably figure he's a pleasant old fellow whom their boss can safely ignore.

They're right on two counts out of three.

The retired Toronto dentist is elderly. He just celebrated his 86th birthday. And he's thoroughly charming. But ignoring him - or disregarding his message - would not be a good idea.

Lightman thinks Smitherman should visit a few of Ontario's nursing homes and look inside the residents' mouths. What he'll find are teeth rotted to the gum, advanced periodontal disease, painful mouth sores and ill-fitting dentures that make it difficult to eat.

"When a person checks into an extended-care facility, their dental hygiene plummets," he said. "It's the last thing that's taken care of.

"Your outlook on life can be pretty miserable when you lose all your teeth."

Lightman knows what he's talking about. For 26 years, he volunteered his services as a dentist at the Baycrest Centre for Geriatric Care. In his younger days, he and a colleague, Hugh MacKay, travelled the province on behalf of the Royal College of Dental Surgeons of Ontario, running dental clinics for seniors. For two years, he served as president of the American Society for Geriatric Dentistry in Chicago.

Lightman didn't have any special training in geriatric dentistry. There were no such courses when he studied at the University of Toronto in the '40s. (There still aren't many.) 

But he learned, through experience, how to treat patients with hearing difficulties, cognitive problems, mobility restrictions and the many diseases associated with aging. 

What worries him is that dentists don't do that now. "It's nobody's fault. It's just that in a youth-oriented society, the elderly aren't considered important."

Nor do faculties of dentistry prepare students for the effects of aging. "All it would take is one course in gerontology," Lightman says.

The health ministry seems oblivious to the problem. For years, the Ontario Dental Association, social service agencies, seniors' organizations, local public health officials and concerned dentists have urged Queen's Park to develop an oral health plan for the elderly. The response, no matter which party is in power, has been a polite nod, followed by silence.

Lightman started calling Smitherman last spring. He had no intention of berating or badgering the minister. He just wanted to ask for help for the thousands of seniors in urgent need of dental attention in long-term-care facilities.

"A wall went up," he recounted. One of the minister's advisers listened to him patiently and agreed with the points he made. But when Lightman asked to speak to the minister - or have his message passed on - the aide equivocated, saying it wasn't his job to determine Smitherman's priorities.

The same thing happened a second time.

Lightman doesn't expect the government to come up with a large amount of money or a lifelong oral health strategy right away. He'd just like to know that the minister is aware of the gap in seniors' care and is committed to addressing it.

At minimum, he says, the staff in nursing homes could be taught the basics of dental hygiene. If they even brushed residents' teeth once a day, it would make a huge difference. 

He also thinks his own profession could be more public-spirited. In his day, young dentists routinely visited homes for the aged (as they were then known) treating residents free of charge. He'd like to see a revival of that volunteer spirit.

Lightman, a grandfather of six, admits he doesn't know much about political advocacy. 

Until arthritis forced him to retire at 81, he was busy treating patients. He thought the dental program he had helped pioneer at Baycrest - still regarded as one of the bright spots in seniors' care - would spread to other seniors' institutions. He assumed cabinet ministers listened to citizens who sought to raise valid public policy concerns.

Lightman is frustrated, but he doesn't intend to give up.

He'll keep writing letters to dental journals, talking to younger colleagues, telling his story to anyone who will listen and looking for a way to get through to Smitherman.

In a world of high-tech, high-pressure lobbying, a well-intentioned octogenarian shouldn't have a chance. 

In a government where wisdom is respected, Lightman just might.