The Canadian Dental Care Plan (CDCP) is set to start providing coverage next month — but it’s not clear that enough dentists will enrol to provide care to the 1.6 million seniors that have signed up already.
Health Canada would not provide CBC News with a figure for how many oral health care providers have registered for the CDCP since applications opened on March 11. The department will only say “thousands” have signed on.
According to their national associations, there are approximately 26,500 dentists, 1,700 independent hygienists and 2,400 denturists practising in Canada — 30,500 in total.
“I’m hearing that the sign-up is slow,” said Dr. Heather Carr, president of the Canadian Dental Association. “I do not think it’s as high as we would hope in order for this plan to be successful.”
The $13 billion Canadian Dental Care Plan, announced in December, will provide low- and middle-income Canadian residents with dental insurance if they don’t have private coverage.
The national program will eventually apply to one quarter of Canadians, but Ottawa is rolling out eligibility gradually, starting with seniors first. (An interim dental plan has been covering kids under the age of 12 since December 2022.)
Seniors learning their dentists aren’t taking part
Some seniors approved for coverage are finding out their dentists aren’t participating.
“I was annoyed. I was really cross,” said Karen Trimingham, 82, who lives in Yarmouth, N.S., where she’s seen the same dentist for 16 years. “I didn’t think they’d refuse me because I’m a regular customer.”
Trimingham said she doesn’t want to drive hours from her rural community to find a dentist in another city who is signed up for the program.
“I’ve just got to continue paying. I’ll just go and have the minimal amount done with the dentist I’ve got,” she said. “Instead of having this tooth replaced that I lost a couple of months ago, I’ll just go with the gap.”
Victoria senior Joanne Thibault, 68, said her dentist won’t take part either.
“It really irks me that the federal government came out and announced a dental plan, but they didn’t do their homework to get the thing in place so that my dentist could be part of it,” she said.
“I’m not abandoning my dentist. I just want the federal government to do their job and to get this sorted out with them so that she can do her job.”
Association presidents aren’t signing up their own clinics
Canada’s dentists, hygienists and denturists have broadly supported the idea of a national public dental care plan, which they say will help provide essential oral health care to people most in need who otherwise would have to pay out of pocket.
But the presidents of some provincial dentist associations — who are practising dentists themselves — have told CBC News they aren’t planning to offer the program in their own dental offices.
They say Ottawa still has not provided enough details for a program due to launch in a matter of weeks.
They also say they’re troubled by the fact that Ottawa is requiring them to sign contracts in order to join the program, something that no other public or private plans require.
“The patient should have the autonomy and the right to choose their own dentist,” said Dr. Jenny Doerksen, president of the Alberta Dental Association.
“But unlike other dental plans, this federal program is asking the dentist to sign a contract that’s seven pages long with a lot of unknown factors and unnecessary terms and conditions.”
Dental health care providers say they’re also concerned about imposing a lot of new paperwork on already overburdened administrative staff.
“My staff have told me in no uncertain terms they don’t want to do the program because they just cannot handle the extra burden that comes with it,” said Dr. Rob Wolanski, president of the B.C. Dental Association.
The CDCP is modelled on the Non-Insured Health Benefits, a federal program that provides dental care to First Nations and Inuit in Canada.
“It’s a program that has faced criticism for years from both patients and patient communities, as well as providers,” said Dr. Daron Baxter, president of the Manitoba Dental Association.
“One of the main reasons is due to the intensive administrative burden that often leads to delays in delivery of care.”
Dentists also still don’t know how the CDCP will coordinate with other plans offered by provinces and territories.
Last-minute consultation
Provincial dental associations say Ottawa only began consulting with them in November, just a month before the program was announced.
“The dentists were brought in at the 11th hour,” said Dr. Brock Nicolucci, president of the Ontario Dental Association.
“Why did we start so late and are we rushing in a program that maybe we should be putting the brakes on?”
Canadian Dental Association president Heather Carr says her colleagues are ‘hopeful’ the new federal dental care program will mean better care for more Canadians, but the rollout has included ‘a great deal of confusion and a great deal of complications’ for dentists and patients.
The federal government, they say, also initially pitched the plan as “free” dental care — and it isn’t.
The program only covers some types of dental work and pays dental health care providers at a lower rate than the fees recommended by provincial and territorial guidelines issued by dental associations. Dentists say they still don’t know exactly how much the federal government will pay them for providing care. Those amounts change every year; the 2024 CDCP guide still hasn’t been published.
There is also a significant co-pay for those with household net incomes between $70,000 and $90,000.
That means most patients should still expect a bill after visiting the dentist’s chair.
Health Minister Mark Holland suggested Ottawa may sweeten the deal to entice more dental care providers to join.
“We’re working actively on creating an alternative portal that will allow dentists to participate just directly. When a patient comes in front of them, to just put in the information, and be able to put in that claim,” Holland told reporters during a stop in Winnipeg this week.
Holland compared the CDCP to the introduction of universal healthcare in Canada, which he says also came with challenges.
“There’s a lot of fear, it’s a new program, I get that,” Holland said.
“But conversation by conversation, it’s been moving very positively, and I believe that we’re going to have exceptionally strong uptake.”
Do you have questions about how Canada’s new dental care plan may affect you? Send an email to ask@cbc.ca.