Broken teeth and infected gums: 46K claims filed so far with Canadian Dental Care Plan

Marina von Stackelberg

Massive cavities, mouth‐ fuls of broken teeth, bleed‐ ing gums and abscesses they're just some of the se‐ rious dental issues Dr. Melvin Lee has treated in less than two weeks of pro‐ viding care under Canada's new public dental insur‐ ance plan.

"I've seen a lot of patients that have infections. Not just dental emergencies, but bor‐ derline medical emergen‐ cies," the Ottawa dentist said.

"I haven't seen patients in this condition since I did overseas mission dentistry work in Haiti and Peru."

Lee is one of nearly 9,000 oral health care providers who have signed up so far to provide care under the Cana‐ dian Dental Care Plan (CDCP).

That number has grown significantly since last month, when Ottawa said 5,000 had registered. There are approx‐ imately 30,500 oral health care providers across the country that could sign up.

The public plan eventually will provide dental coverage for one in four low- and mid‐ dle-income Canadian resi‐ dents who don't have private dental coverage.

As of May 1, eligible se‐ niors 70 and older are cov‐ ered and registration has opened for seniors 65 and older. To date, 1.9 million se‐ niors have been approved for the plan.

Lee began treating patien‐ ts on May 1 and has seen about 20 seniors through the CDCP.

Seventy-nine year old Morton Brisard was one of his first patients. He booked an appointment the first day he was covered.

"We are so happy," Bris‐ ard said, adding he hadn't seen a dentist in five years because of the cost.

"The dentist is expensive, so that is why I wait, I wait, I

wait, till the problem was very bad," he said. "Every morning when I wake up I have blood come from my mouth."

Dr. Lee said most of the seniors he's seen under the CDCP have been in a similar state, having avoided visiting an oral health care provider for years because they didn't have private insurance and couldn't afford to pay out of pocket.

"I've been reminded time and time again of the moral and ethical duty to serve, with every one of these pa‐ tients that comes through," he said.

The federal government said that 46,000 claims have been processed under the

CDCP to date.

Lee said his clinic has been reimbursed for the pro‐ cedures within 48 hours by Sun Life, the insurance com‐ pany that Ottawa contracted to administer the plan.

"It's been seamless," Lee said. "It's been no different than regular insurance."

For most of the proce‐ dures he's done, Lee said, the federal government is reim‐ bursing him at about 80 to 90 per cent of what the On‐ tario Dental Association rec‐ ommends. That's similar to private plans, he said, where dentists charge their patients the difference.

WATCH: First phase of national dental care plan begins

But provincial dental asso‐ ciations across Canada have raised concerns about the CDCP, arguing the national program requires dentists to agree to unnecessary terms and conditions.

Ottawa has attempted to deal with those complaints. It announced recently that oral health care providers can be‐ gin accepting patients and billing directly to the plan starting July 8, without regis‐ tering as a provider.

"We want this program to work," said Dr. Brock Nicoluc‐ ci, president of the Ontario Dental Association.

The auditing process also allows Sun Life to request in‐ dividual patient records, which isn't something other insurance programs require and could lead to privacy is‐ sues, Nicolucci said.

"We are committed to working with the Health Canada to get this right. And we hope it doesn't take much longer," he said.

Dr. Carlos Quiñonez, di‐ rector of dentistry at Western University in London, Ont. and an expert in dental pub‐ lic health, said he's optimistic about the program's prospects for success, espe‐ cially as dentists and their patients get used to the new system in the weeks and months ahead.

"Based on my discussions with leaders in dentistry and dentists alike, there seems to be a sense that we are mov‐ ing in the right direction with respect to discussions with the federal government," Quiñonez said.

"That gives me hope that in the end, this will just be another public dental care plan within the country that is remunerating fairly, that covers the services that pa‐ tients need, and that is just part and parcel of delivering dental care in our country."

At a cost of $13 billion over the next five years, the CDCP is being rolled out gradually through 2025, starting with seniors first.

In June, the program will expand to people with dis‐ abilities and teenagers. An in‐ terim dental plan has been covering kids under the age of 12 since December 2022.

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