OTTAWA — The national dental care program is showing signs of improvement, according to industry representatives. However, misconceptions persist among patients regarding the program's costs. Dr. Bruce Ward, president of the Canadian Dental Association, noted that early government messaging emphasized "free dentistry" and "free dental care." This has led many patients to believe that the program incurs no costs.

Former Prime Minister Justin Trudeau and former Health Minister Mark Holland frequently referred to the Canadian Dental Care Plan as "free dental care," a sentiment echoed by the New Democrats, who advocated for the program's establishment. In reality, patients may face co-pays that can reach up to 60 percent of the total costs.

Ward's concerns are shared by others in the dental industry, who report that patients are frustrated upon receiving bills. David Brown, president of the Ontario Dental Association, stated, "We kept trying to stress with the government, ‘You’ve got to change the narrative and what you’re saying to the public.'"

The dental care plan was launched in phases, initially covering children and seniors in May 2024. It expanded in May 2025 to include individuals of all ages with household incomes under $90,000 who lack private insurance. Those with incomes below $70,000 receive full coverage, while those earning between $70,000 and $90,000 are responsible for 40 to 60 percent of the established fees. Additionally, clinics may charge more than the fees set by the Canadian Dental Care Plan, depending on provincial guidelines.

Brown highlighted that unexpected costs and early administrative issues have created challenges for dental clinics. "There has been a lot of extra work, front desk people hired, time spent explaining to patients," he said.

Data from Health Canada indicates that many claims are being denied. Patients requiring complex treatments or care exceeding the plan's limits must obtain pre-authorization from the program's administrator, Sun Life. Clinics are required to submit treatment plans and supporting evidence, such as X-rays, for approval. Unfortunately, more than half of these claims have been denied. Between November 2024 and May 31, only 29 percent of pre-authorization claims were accepted, while another 29 percent were denied, and 42 percent were deemed incomplete.

Ward noted that the pre-authorization process was initially slow, resulting in a backlog of claims. He added that clinics often lacked clarity from the federal government regarding what was missing from incomplete submissions. In response, Health Canada has begun providing more feedback to care providers about denials and the necessary documentation.

Over half a million claims have been denied for services like cleaning and scaling, with an additional 363,000 denials for exams and X-rays. Common reasons for rejection include patients reaching their coverage limits or duplicate claims for the same procedure.

Donna Wells, manager of professional practice with the Canadian Dental Hygienists Association, expressed concern that the plan only covers four units of scaling, equating to one hour of a hygienist's time. She stated, "This is not sufficient for the majority of adult patients," particularly those who have not seen a dentist in years due to lack of insurance. Some hygienists have stopped seeking pre-authorization for additional scaling due to the lengthy process.

Wells added, "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."

Conservative health critic Dan Mazier criticized the high rate of claim denials, suggesting it indicates 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," he stated.

Mazier also raised concerns about the program's administrative costs, which Health Canada reported at $472.9 million as of March 31. The government had budgeted $13 million for the first five years of the dental care initiative, with ongoing funding of $4.4 billion.

Despite initial hesitance among dentists to participate, Health Canada reported that only 17 providers have fully withdrawn from the program, while over 25,000 remain active. Ward emphasized the positive relationship between the Canadian Dental Association and Health Canada, noting that the government has been receptive to 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.