The Canadian Dental Care Plan starts next month - but many dentists are reluctant to participate

Marina von Stackelberg

The Canadian Dental Care Plan (CDCP) is set to start providing coverage next month - but it's not clear that enough dentists will enrol to provide care to the 1.6 million seniors that have signed up already.

Health Canada would not provide CBC News with a fig‐ ure for how many oral health care providers have regis‐ tered for the CDCP since ap‐ plications opened on March 11. The department will only say "thousands" have signed on.

According to their nation‐ al associations, there are ap‐ proximately 26,500 dentists, 1,700 independent hygienists and 2,400 denturists practis‐ ing in Canada - 30,500 in to‐ tal.

"I'm hearing that the signup is slow," said Dr. Heather Carr, president of the Canadi‐ an Dental Association. "I do not think it's as high as we would hope in order for this plan to be successful."

The $13 billion Canadian Dental Care Plan, announced in December, will provide low- and middle-income Canadian residents with den‐ tal insurance if they don't have private coverage. The national program will eventu‐ ally apply to one quarter of Canadians, but Ottawa is rolling out eligibility gradual‐ ly, starting with seniors first.

Seniors learning their dentists aren't taking part

Some seniors approved for coverage are finding out their dentists aren't participating.

"I was annoyed. I was real‐ ly cross," said Karen Triming‐ ham, 82, who lives in Yarmouth, N.S., where she's seen the same dentist for 16 years. "I didn't think they'd refuse me because I'm a reg‐ ular customer."

Trimingham said she doesn't want to drive hours from her rural community to find a dentist in another city who is signed up for the pro‐ gram.

"I've just got to continue paying. I'll just go and have the minimal amount done with the dentist I've got," she said. "Instead of having this tooth replaced that I lost a couple of months ago, I'll just go with the gap."

Victoria, B.C. senior Joanne Thibault, 68, said her dentist won't take part either.

"It really irks me that the federal government came out and announced a dental plan, but they didn't do their homework to get the thing in place so that my dentist could be part of it," she said.

"I'm not abandoning my dentist. I just want the feder‐ al government to do their job and to get this sorted out with them so that she can do her job."

Association presidents aren't signing up their own clinics

Canada's dentists, hygienists and denturists have broadly supported the idea of a na‐ tional public dental care plan, which they say will help pro‐ vide essential oral health care to people most in need who otherwise would have to pay out of pocket.

But the presidents of some provincial dentist asso‐ ciations - who are practising dentists themselves - have told CBC News they aren't planning to offer the pro‐ gram in their own dental of‐ fices.

They say Ottawa still has not provided enough details for a program due to launch in a matter of weeks.

They also say they're trou‐ bled by the fact that Ottawa is requiring them to sign con‐ tracts in order to join the pro‐ gram, something that no oth‐ er public or private plans re‐ quire.

"The patient should have the autonomy and the right to choose their own dentist," said Dr. Jenny Doerksen, president of the Alberta Den‐ tal Association.

"But unlike other dental plans, this federal program is asking the dentist to sign a contract that's seven pages long with a lot of unknown factors and unnecessary ter‐ ms and conditions."

Dental health care providers say they're also concerned about imposing a lot of new paperwork on al‐ ready overburdened admin‐ istrative staff.

"My staff have told me in no uncertain terms they don't want to do the program because they just cannot handle the extra burden that comes with it," said Dr. Rob Wolanksi, president of the B.C. Dental Association.

The CDCP is modelled on the Non-Insured Health Ben‐ efits, a federal program that provides dental care to First Nations and Inuit in Canada.

"It's a program that has faced criticism for years from both patients and patient communities, as well as providers," said Dr. Daron Baxter, president of the Man‐ itoba Dental Association.

"One of the main reasons is due to the intensive ad‐ ministrative burden that of‐ ten leads to delays in delivery of care."

Dentists also still don't know how the CDCP will co‐ ordinate with other plans of‐ fered by provinces and terri‐ tories.

Last-minute consulta‐ tion

Provincial dental associations say Ottawa only began con‐ sulting with them in Novem‐ ber, just a month before the program was announced.

"The dentists were brought in at the 11th hour," said Dr. Brock Nicolucci, pres‐ ident of the Ontario Dental Association.

"Why did we start so late and are we rushing in a pro‐ gram that maybe we should be putting the brakes on?"

WATCH | Dentists raise concerns about federal dental care rollout:

The federal government, they say, also initially pitched the plan as "free" dental care - and it isn't.

The program only covers some types of dental work and pays dental health care providers at a lower rate than the fees recommended by provincial and territorial guidelines issued by dental associations. Dentists say they still don't know exactly how much the federal gov‐ ernment will pay them for providing care. Those amounts change every year; the 2024 CDCP guide still hasn't been published.

There is also a significant co-pay for those with house‐ hold incomes between $70,000 and $90,000.

That means most patients should still expect a bill after visiting the dentist's chair.

Health Minister Mark Hol‐ land suggested Ottawa may sweeten the deal to entice more dental care providers to join.

"We're working actively on creating an alternative portal that will allow dentists to par‐ ticipate just directly. When a patient comes in front of them, to just put in the infor‐ mation, and be able to put in that claim," Holland told re‐ porters during a stop in Win‐ nipeg this week.

Holland compared the CDCP to the introduction of universal healthcare in Cana‐ da, which he says also came with challenges.

"There's a lot of fear, it's a new program, I get that," Hol‐ land said.

"But conversation by con‐ versation, it's been moving very positively, and I believe that we're going to have ex‐ ceptionally strong uptake."

Do you have questions about how Canada's new dental care plan may affect you? Send an email to ask@cbc.ca.