OTTAWA – Billed as one of the largest social programs in Canadian history, some patients of the national dental care plan are still facing significant barriers accessing care, or once they’re in the chair, being able to afford it. A new report from the Canadian Dental Association (CDA) published Tuesday – “From Coverage to Care: An Evidence-informed Assessment of the Canadian Dental Care Plan” – finds that just two years in, there’s still major room for improvement. “In my own practice, I’m seeing so many new patients come in who have never been to the dentist ever before in their lives. So that’s something amazing to see … But even before the CDCP, there was a problem of workforce shortage in our field,” said Ottawa dentist Dr. Isha Moza. “And with the influx of millions of new patients and the added administrative load of the program, we are feeling that staff shortage even more.” As part of a phased rollout, the federal government began accepting claims for dental coverage for seniors in May 2024. One year later, the eligibility for the Canadian Dental Care Plan (CDCP) expanded to include Canadians of all ages. While the latest federal data touts that 7.5 million Canadians have been enrolled since the program was launched, the breakdown per enrolment year – and how many people actually received care – tells a different story. For the 2025-26 enrolment period, 6.5 million patients were enrolled, with 3.9 million receiving care. For the 2026-27 enrolment year, the number enrolled slipped to 4.7 million and so far, just over 900,000 of them have had a claim approved. When it was initially launched, the government estimated that once fully implemented, up to nine million Canadians would be able to access more affordable dental care. So far, throughout the entirety of the CDCP’s existence, 4.8 million people have had a claim approved. Of those who have been able to receive care, 37 per cent report still facing financial barriers, something the report indicated is because the CDCP’s fees are set below the actual cost of care, “leaving part of the bill with patients.” “Some patients can’t afford to pay out of pocket, and that just delays treatment for them,” Moza said. “Sometimes they just can’t go ahead with treatment, so it’s definitely affecting access to care for that population of Canadians.” Another issue identified was that 50 per cent of complete preauthorization requests are denied, and only 17 per cent of dentists say most recommended care has been covered for their patients, a sign that “patients face gaps in coverage for needed treatment,” the report suggested. As the federal government indicated from the start, not all applicants are eligible for 100 per cent coverage. The program reimburses a percentage of eligible expenses, depending on applicants’ income level, with the remainder being a patient copay. But confusion at the chair persists. The CDA found that 59 per cent patients “expected care to be completely free, and dental offices are often left explaining coverage appointment by appointment.” To qualify, you have to be a Canadian resident with no access to dental insurance; have an adjusted family net income of less than $90,000 and have filed your tax return for the previous year. After previous dental care was paid for under the CDCP, administrators told patient Ethan Grant that he wasn’t eligible. That sparked a lengthy and ongoing paperwork saga trying to reconfirm his eligibility, which left him putting a recent emergency root canal on a credit card. “I was able to kind of save myself for the time being, but I still have a $1,200 bill now that I have to pay over time with interest,” he said, noting he still needs a second root canal and is getting by on pain killers until he can get that resolved. “Whether or not I’ll be reimbursed for what I had to pay is another thing,” he said. Still, he added the experience hasn’t turned him off the benefits of the CDCP. “Any kind of support that you can get from the government, I’ll take … especially when it comes to health care and dental care. I mean, nobody wants to be in excruciating pain every day while you’re trying to go to work or carrying out your tasks.” Providers are also facing challenges. Among them, as the report noted, are lingering administrative burdens and 7,200 vacancies for hygienists and assistants. What is working for patients? The program covers a range of oral-health services, such as cleanings, X-rays, cavity fillings, dentures and root canals. But Health Canada has sought to emphasize that the CDCP is not a formal insurance plan. The report found that for those who have accessed the program, 88 per cent reported having a positive experience, and 57 per cent said their oral health had improved. As a result of its creation, the share of Canadians reporting having no dental care coverage dropped from 35 per cent to 25 per cent. After initially facing challenges in getting oral dentists, dental hygienists and denturists to enroll, more than 90 per cent of dentists in Canada are now taking part. During the early phases of the CDCP, providers had reservations about the program, its administrative burden and the reimbursement structure. Now, this report found that 70 per cent of dentists support it. “Coverage on paper only helps a patient if there is a dental team available to provide the care,” said CDA president Dr. Kirk Preston in the report’s forward. Calls to improve care, design The CDA issued more than 30 recommendations for ways to improve the program, broken down into three priority areas. The first is patient care. Their overarching call is for the CDCP to better align the coverage available with patients’ needs and clearly state the kinds of services covered before a patient is in the chair. The second centres around how the program is designed. The CDA would like to see the fees associated with the CDCP better reflect the real cost of the care provided and keep the public coverage complementary to existing coverage plans. Also under this umbrella is a recommendation to ease the preauthorization and administrative barriers. The third major call is for the federal government to develop an overall oral-health strategy that would include reviewing the existing program and its effectiveness, but also include initiatives aimed at strengthening the dental workforce, such as further protecting dental student training and improving oral-health data. “In New Brunswick, where I practise, and in many regions like it, shortages place real pressure on care delivery. When a practice cannot staff a chair, it is the patient who waits,” Preston said. Preston and other advocates are on Parliament Hill Tuesday to spread this message and meet with MPs in hopes of influencing policy change based on the report’s findings. Speaking to CTV News between meetings, he said the reaction has been positive. While noting that overall the program has been “quite successful,” there still are a number of improvements they’d like to see made. “We’ve been trying to communicate our concerns, which really are the concerns of patients and dentists across the country, to the MPs,” Preston said. Minister open to improvements The federal health minister’s office was asked for comment on these findings and whether the majority Liberals intend to take any of the recommendations offered to improve a program that was central to the last government’s supply-and-confidence agreement with the federal NDP. In an emailed statement, a spokesperson for Health Minister Marjorie Michel focused on the positive findings from the CDA’s report, noting that Canadians are saving an average of $1,000 a year on dental costs. “At the same time, we know there is always more work to do,” said press secretary Alexandre Bergeron. “The CDCP is still a relatively new program, and we are listening to patients and oral health providers to understand what is working and where we can improve.” Echoing this sentiment in a later scrum with reporters, the minister thanked the CDA for the report and said she would work with them on the recommendations. “Is it perfect? No,” Michel said. “But we are fixing as, you know, as we are moving forward and having feedback, we are taking action.”
