In December 2023, the government of Canada introduced a new dental benefit program for millions of uninsured Canadians, and more than 600,000 have already applied for it.
The plan is aimed at helping people maintain tooth and gum health and prevent and treat oral health care issues and diseases.
Health Canada shared the services available under the Canadian Dental Care Plan (CDCP) on Thursday.
“The CDCP will be larger than any other permanent government benefit program to date as it aims to improve access to dental care for up to 9 million uninsured Canadians,” commented the Minister of Public Services and Procurement Jean-Yves Duclos.
“This is about fairness and health equity, and by covering essential services, we’re ensuring that cost is no longer a barrier to oral health,” said Minister of Citizens’ Services Terry Beech.
Most services offered by the program will be available in May, but services requiring preauthorization and prior evaluations from an oral health provider will become available in November 2024. Examples of such services include getting crowns or initial placement of partial dentures and procedures requiring general anesthesia.
Health providers participating in the benefit program will directly bill Sun Life to ensure timely reimbursement and avoid out-of-pocket costs. It’s the client’s job to confirm the eligibility of the services under the CDCP in case there are costs not covered by it.
“People covered under the CDCP may have to pay an outstanding amount such as a co-payment or additional charges, which would be paid directly to their oral health provider,” Health Canada shared. “CDCP fees will be reassessed annually to account for new evidence, inflation, and changes in costs over time.”
Here’s what’s included in the plan, per Health Canada’s latest update:
Diagnostic and preventive services
Intended to evaluate your oral health status, keep your teeth, gums and mouth healthy, and prevent cavities and gum disease. Services covered include:
- a range of dental exams, including complete, routine, specific and emergency exams
- cleaning (scaling and polishing)
- fluoride applications
These are intended to treat decayed or fractured teeth. Services covered include:
- permanent fillings
- temporary fillings
- pain control for diseased teeth
- other treatments for cavities
These are intended to treat teeth that are severely decayed, infected or broken. Services covered include:
- root canal treatments
- pulpectomies (first step of a root canal treatment)
- procedures to reduce infection and provide temporary pain relief
- retreatment of previously completed root canal treatment (requires preauthorization)
These are intended to treat areas around the teeth, including gums and bone supporting the teeth. Services covered include:
- cleaning under the gumline
- treatment of abscesses
- bonding for mobile teeth (requires preauthorization)
- post-surgical evaluations (requires preauthorization)
- non-surgical gum disease management
These are intended to restore teeth with a more extensive procedure when teeth are too damaged to be restored by basic fillings.
- posts and post-removal
- repairs to crowns and rebonding of crowns and posts
- crowns (requires preauthorization)
- cores (to support crowns) (requires preauthorization)
- posts for crown (requires preauthorization)
Removable prosthodontic services
Intended to replace missing teeth. Services covered include:
- complete dentures, including standard and temporary dentures
- denture repairs, relines, and rebases
- placing lining in dentures to condition oral tissues (for comfort and healing)
- complete immediate and overdentures (requires preauthorization)
- initial placement of partial dentures (requires preauthorization)
- replacement of partial dentures
Intended to remove teeth or tumours or fix other problems in the mouth and jaw requiring surgical intervention. Services covered include:
- removal of teeth and roots
- surgical removal of tumours and cysts
- surgical incisions, including draining
- treatments for jaw bone fractures
Additional services are provided in support of another service. Services covered include:
- minimal sedation (conscious)
- moderate sedation (requires preauthorization)
- deep sedation (requires preauthorization)
- general anesthesia (requires preauthorization)
Some orthodontic services will be added to the CDCP starting in 2025. They will only be covered in cases of medical need based on stringent criteria and will include a maximum spending limit.
If you’re uninsured in Canada and want to learn more about this dental benefit program, visit this link.