Dental program improving, industry says, but misconceptions about ‘free’ care persist

Dr. Melvin Lee, left, performs a tooth extraction for patient Robert McFarlane, as team member Sofia Christow-Filleul assists, at his dental clinic in Ottawa on Wednesday, Aug. 7, 2024. THE CANADIAN PRESS/Justin Tang

OTTAWA — The rollout of the national dental care program is improving, industry representatives say -- but political statements are still driving a misconception among patients that the program will cost them nothing.

“When the plan was initially announced, the government of the day continually talked about free dentistry, free dental care,” said Dr. Bruce Ward, president of the Canadian Dental Association.

Former prime minister Justin Trudeau and former health minister Mark Holland referred more than once to the Canadian Dental Care Plan as “free dental care” -- as did the New Democrats, who pushed for the program’s creation.

In fact, patients’ co-pays can range up to 60 per cent.

Ward’s concerns were echoed by others in the industry who say they’re encountering patients who are upset and angry about getting a bill.

“We kept trying to stress with the government, ‘You’ve got to change the narrative and what you’re saying to the public,”’ said David Brown, president of the Ontario Dental Association.

The plan was launched in phases and was opened first to children and seniors in May 2024.

It was expanded last May to cover people of all ages with household incomes under $90,000 and no private insurance.

Patients with household incomes under $70,000 are fully covered, but those who earn between $70,000 and $90,000 pay between 40 to 60 per cent of the established fees.

Clinics can also charge more than the Canadian Dental Care Plan’s fees, depending on their provincial fee guides.

Brown said patients facing unexpected costs, coupled with early administrative hiccups in the program, have caused headaches for clinics.

“There has been a lot of extra work, front desk people hired, time spent explaining to patients,” he said.

Data provided to Parliament by Health Canada indicates many applicants claims are being denied.

Patients who need complex treatments, or care that costs more than the plan normally allows, need to get pre-authorization through the program’s administrator, Sun Life. Clinics have to provide a treatment plan and evidence like X-rays to get approved.

Those claims have been denied more than half the time.

Just 29 per cent of pre-authorization claims made between November 2024 and May 31 were accepted. Another 29 per cent were denied, while 42 per cent were deemed incomplete.

Ward said the pre-authorization process was slow in the early days, leaving a large backlog of claims. Clinics were also being left in the dark by the federal government about what was missing from incomplete claims, he added.

Health Canada said it’s now giving care providers more feedback about denials and more information about what they need to submit.

More than half a million claims have been denied for things like cleaning and scaling, and another 363,000 have been denied for exams and X-rays.

The most common reasons cited for rejection were patients reaching their coverage limits, or claims for the same procedure being filed more than once.

Donna Wells, manager of professional practice with the Canadian Dental Hygienists Association, said the plan covers only four units of scaling -- one hour of a hygienist’s time -- “which is not sufficient for the majority of adult patients.”

That’s a problem for patients who haven’t visited a dentist in years due to a lack of insurance. Wells said some hygienists have simply given up on trying to get pre-authorization for more scaling because of how long it takes.

“We’re ecstatic about this program, but we know that it’s not sufficient yet. It’s not where it could be when it comes to the preventive side,” she said.

Conservative health critic Dan Mazier, who asked Health Canada for the data, said the high number of claim denials is evidence that Canadians “were misled” about the program.

“It’s become very clear the Liberals sold Canadians a false bill of goods in their so-called dental care plan,” Mazier said in a statement.

Mazier also took issue with the administrative cost of the program, which Health Canada said was $472.9 million as of March 31.

The Liberals budgeted $13 billion for the first five years of dental care, with $4.4 billion in ongoing funding.

Initial uptake was slow among dentists when the program launched, but Health Canada said only 17 providers have withdrawn fully and more than 25,000 are participating.

Ward said the Canadian Dental Association has a good working relationship with Health Canada, which has been willing to hear their concerns.

“I love that I can finally treat some of my patients who would normally only come in and get something extracted, if it was really hurting them. Now they have the option of saving that tooth,” he said.

This report by The Canadian Press was first published Sept. 19, 2025.

Sarah Ritchie, The Canadian Press