How often do you think about your teeth? Until there’s an ache or pain, most people don’t think about their teeth until something bothers them. The mouth, often referred to as the “gateway to the body,” has been linked to a host of systemic issues ranging from cardiovascular disease and diabetes, making regular dental checkups more critical than imagined. Dental health isn’t just about teeth—it’s a critical part of overall health.

Health Canada reported more than 2.4 million Canadians have been approved to receive coverage under the Canadian Dental Care Plan (CDCP), an estimate of more than $442 million in dental expenses covered. More than 75% of dental care providers are participating in this federal program.

“Since May, the CDCP has transformed the lives of hundreds of thousands of Canadians by making oral health care more accessible and affordable. Each day, more patients are benefiting from the work of dedicated oral health providers,” Minster of Health Mark Holland said in a prepared statement.

Access to Care

A highly anticipated initiative, the CDCP, aims to improve access to care for people without dental benefits, leading to better oral and overall health. This plan primarily benefits children from low-income households and those receiving social assistance, with nearly 650,000 eligible Canadians already receiving care, in what some have called one of the largest social programs in Canadian history.

Services that could be covered under the program, if recommended by an oral health provider, include: preventive services, diagnostic services, restorative services, endodontic services, prosthodontic services, periodontal services and oral surgery services.

While enrollment has been met with enthusiasm from those seeking care, early concerns arose due to administrative burdens, reimbursement structures and the challenges of enrolling dental professionals. However, Health Canada acknowledged that over the summer, steps were taken to make the plan easier for providers leading to a reported 82% participation rate among active oral health care providers.

To minimize and reduce out-of-pocket expenses, participating providers must agree to bill Sun Life directly and accept payment for services covered under the CDCP. Providers will receive reimbursement from Sun Life within 48 hours initially, with plans to reduce this timeframe to 24 hours.

Bridging the Gap

This significant milestone follows a 2010 report by Health Canada revealing a then remarkable decrease in dental decay levels, as revealed by the Canadian Health Measures Survey conducted by Statistics Canada. The results showed that 75% of Canadians visited a dental clinic annually and 86% did so at least once every two years. This starkly contrasts with the early 1970s, when barely half of the population consulted a dentist on an annual basis.

Employer-provided insurance remains a significant source of dental care. According to Frontiers in Oral Health, “Approximately 60% of individuals receive dental care through employer-provided insurance, while 35% pay for their own care.”

The Inuit Oral Health Survey, conducted in 2008-2009, found that compared to non-Indigenous Canadians, more Inuit reported poor oral health, higher frequency of food avoidance and oral pain. Fewer than half made a visit for dental care, even though very few reported that costs were a factor in avoiding a visit or accepting recommended treatment.

The Canadian Dental Association (CDA) has acknowledged that while Canada generally excels in oral health compared to other countries, significant equities remain. The CDA’s 2022 study Bridging the Financial Gap in Dental Care, emphasized that financial barriers, as well as non-financial obstacles, make it challenging to access dental care. The CDA encouraged the federal government to develop a comprehensive federal oral health strategy addressing the broader challenges facing those with oral health issues.

Ginette Petitpas Taylor, Minister of Veterans Affairs and Associate Minister of National Defence, recently echoed the importance of improving dental access, stating the government’s efforts are making dental care more affordable and accessible. “This change reduces out-of-pocket costs for families and speeds up reimbursements, making dental services more accessible and affordable across the country,” she said. “It’s another concrete step towards fairness for every generation.”

Tim Hennessy

Editor, at the International Foundation of Employee Benefit Plans  Favorite Foundation Product: Plans & Trusts Benefits-related topics that interest him the most: retirement security and mental health Personal Insights: Tim enjoys spending time with his family, watching movies, reading, writing, and running.

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