Canada's dental care plan begins today. Here's what you need to know

Marina von Stackelberg

The Canadian Dental Care Plan (CDCP) begins cover‐ ing 1.7 million seniors to‐ day - but many patients may have to wait a while to get their dental visits cov‐ ered.

The massive public oral health-care insurance pro‐ gram will eventually cover one quarter of Canadian resi‐ dents who don't have private dental plans, at a cost of $13 billion over the next five years. Ottawa is rolling out eligibility gradually, starting with seniors.

"They are very excited to have their teeth cleaned be‐ cause it has been many years," said Shannon Mait‐ land, an independent dental hygienist who runs a mobile clinic out of Carleton Place, just outside of Ottawa.

Maitland is one of 5,000 oral health-care providers who have signed up so far for the CDCP. But she won't start seeing patients under the program for several weeks because she's decided to wait and see how the initi‐ al rollout goes.

Dentists, denturists and hygienists have generally supported a national, publi‐ cly funded dental insurance program, arguing it will fill the gap of nine million lowand middle-income Canadi‐ ans who have to pay for oral health care out of pocket.

But while coverage for se‐ niors 70 years and older be‐ gins May 1, some patients are finding out their dentist isn't participating. Changes Ottawa made that will allow dentists to still process claims without registering don't come into effect until

July. On top of that, it will also be another six months until certain dental services that require pre-approval are cov‐ ered, like crowns and partial dentures.

Since the plan was an‐ nounced in December, there has also been confusion over who qualifies, how the plan affects other insurance pro‐ grams and whether enough dentists will sign up to meet demand.

Here are answers to some common questions about the plan.

How can I find a profes‐ sional offering the CD‐ CP?

The federal government con‐ tracted insurance provider Sun Life to administer the program. The company re‐ cently launched a searchable database of available CDCP providers.

According to their associa‐ tions, there are about 30,500 oral health-care profession‐ als who could sign up to offer the program, including roughly 26,500 dentists, 1,700 independent hygienists and 2,400 denturists.

That means only about 16 per cent of oral health-care providers have signed up so far.

Why won't my dentist sign up?

Some dentists have been re‐ luctant to register for the program because Ottawa wants them to sign contracts to provide care and they think the program will re‐ quire an unreasonable amount of paperwork.

"The vast majority of den‐ tists are still waiting for more information before they agree to participate," said Dr. Joel Antel, a Winnipeg dentist and the newly elected presi‐ dent of the Canadian Dental Association.

He said he hasn't signed up to provide the CDCP in his own clinic.

"I have to admit to a cer‐ tain amount of disappoint‐ ment, because I was involved in this process very early on and it looked really promis‐ ing," he said.

"Then at some point, it just took a turn and became complicated and onerous and unnecessarily so."

Will I have to switch dentists?

Dentists have the right to choose if they will accept pa‐ tients through the CDCP, as they can with existing public programs.

"If the dentist isn't partici‐ pating … they can't go to those dentists," Dr. Antel said. "So they may have to change dentists where they've had a long-term rela‐ tionship built up."

Can I access CDCP at a dentist that hasn't reg‐ istered?

Two weeks ago, Health Minis‐ ter Mark Holland attempted to address concerns when he announced that oral healthcare providers could bill the program directly without for‐ mally signing up.

That option won't be available until July. That means if your dentist isn't a registered provider, but will still accept you under the CD‐ CP, you won't be able to see them until the summer.

On Tuesday, Holland pushed back against the den‐ tal associations' continued criticism of the program, say‐ ing Ottawa listened to their concerns and simplified the CDCP.

"That's nuts. Just to be fair ... at some point let's call a spade a spade here. Are you crazy?" he said outside a cab‐ inet meeting in the House of Commons.

Holland said the federal government made the sys‐ tem easier to use while still keeping the necessary checks in place to guard against abuse, such as allowing Ot‐ tawa to audit claims.

"We created a normal … claim process that exists in every other insurance claim process everywhere, and they wanted us to simplify it. We did," Holland said.

"We've got it down now to a process that's as simple and as basic as anything else out there, if not simpler."

WATCH: Health minister pushes back against dental associations' claims:

How does the CDCP compare to other provincial plans?

If you have access to dental care through an existing pub‐ lic program, you can still qualify for the CDCP. That could be a provincial pro‐ gram offered through social assistance, disability, or na‐ tional programs like the NonInsured Health Benefits pro‐ gram for First Nations and Inuit.

Dr. Brandon Doucet, a No‐ va Scotia dentist who has ad‐ vocated for a national public dental insurance plan, said he understands many den‐ tists' reluctance - and a lot of it has to do with their experi‐ ences trying to provide the public programs in place right now.

"The existing public dental programs are very, very mea‐ gre and a lot of dentists are frustrated because the fees those programs pay out are often under half of what pri‐ vate plans pay," Doucet said.

By comparison, the CDCP covers more services and at a better rate than existing pub‐ lic plans, Doucet said. In No‐ va Scotia where he practices, Ottawa pays around 89 per cent of what the fee guide suggests. Those fee guides are put out by provincial den‐ tal association, which den‐ tists reference when they bill private insurance companies for their service.

Doucet says he thinks more dentists will sign up once the program gets un‐ derway when they realize they may lose money by not accepting CDCP patients.

"Many dentists just do not and have never wanted pub‐ lic dental care, similar to physicians' opposition to uni‐ versal health care in the 1960s," he said.

Doucet said Canada's public spending on dental care is about six per cent of the total spent on all oral care services - substantially less than the 10 per cent public share in the U.S., and the 57 per cent in Germany. The national program will bring that number closer to about 25 per cent.

Will I get free dental care?

As Doucet mentioned, the federal government has cre‐ ated its own fee grid of what it will pay oral health-care providers for each proce‐ dure, which is a slightly lower rate than the guides put out by provincial associations dentists.

But this is not "free" den‐ tal care.

Like private plans, the CD‐ CP only covers a certain amount of the cost of ser‐ vices, meaning a dental care provider can still charge their patient the difference. Pa‐ tients whose income (or com‐ bined family income) is un‐ der $90,000 should qualify but the coverage is only par‐ tial if you make between $70,000 and $90,000. More details can be found here.

What's covered?

Most routine dental care will be covered under the CDCP, including cleanings, X-rays, fillings, root canals and den‐ tures.

Some of the more com‐ plex dental services - such as partial dentures and crowns will require federal pre-au‐ thorization of payment. Preauthorized services won't be covered until November 2024.

"There are some things that certainly we were hoping to get all launched at the same time," said Jaro Wojcic‐ ki, a denturist in Penetan‐ guishene, Ont., and president of the Denturist Association of Canada.

"The government did say it's been difficult to manage having everything launch May 1. So they made some exceptions and some deci‐ sions ultimately on splitting up some of the procedures."

Oral health-care providers will need to educate their pa‐ tients to co-ordinate the treatment over this period, he said.

You can learn more about what's covered and when on the government's website here.

When will I be eligible?

The federal government is expanding eligibility for the CDCP gradually. As of May 1, Canadian residents 70 and older can get their oral health-care services covered by the program, and seniors aged 65 to 69 can sign up.

In June, people with dis‐ abilities and children under 18 will be included. (That's al‐ so when an interim dental benefit that has been cover‐ ing kids under the age of 12 since December 2022 will be replaced by the CDCP.)

The program will be avail‐ able to all eligible Canadian residents starting in 2025, ac‐ cording to the federal gov‐ ernment.

To qualify, a patient can't have access to any existing private dental insurance, re‐ gardless of how comprehen‐ sive your existing private cov‐ erage is. Ottawa has clarified that if you went out and pur‐ chased private insurance on your own, you will qualify for the CDCP once that plan is no longer in effect.

The government passed legislation last summer that requires employers to de‐ clare to the Canada Revenue Agency if they offer workers a private dental plan. This will enable Ottawa to audit claims through the CDCP.

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