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The Canada Dental Care Plan (CDCP) is set to begin providing coverage next month — but it’s unclear whether enough dentists will sign up to provide care to the 1.6 million seniors already signed up.

Health Canada would not give CBC News a figure for how many oral health care providers have signed up for the CDCP since applications opened on March 11. The department will only say “thousands” have signed up.

According to their national associations, there are approximately 26,500 dentists, 1,700 independent hygienists and 2,400 dentists practicing in Canada – 30,500 in all.

“I’m hearing that enrollment is slow,” said Dr. Heather Carr, president of the Canadian Dental Association. “I don’t think it’s as high as we would hope for this plan to be successful.”

The $13 billion Canada Dental Care Plan, announced in December, will provide low- and middle-income Canadian residents with dental insurance if they do not have private coverage.

Eventually, the national program will apply to a quarter of Canadians, but Ottawa is gradually introducing eligibility, starting with seniors first. (There has been an interim dental plan for children under 12 since December 2022.)

Older people who are learning their dentists do not participate

Some seniors who have been approved for coverage find that their dentists are not participating.

“I was angry. I was very angry,” said Karen Trimingham, 82, who lives in Yarmouth, NS, where she has seen the same dentist for 16 years. “I didn’t think they would turn me away 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 enrolled in the program.

“I have to keep paying. I will do as little as possible with the dentist I have,” he said. “Instead of having this tooth replaced that I lost a couple of months ago, I’ll go with the gap.”

Victoria senior Joanne Thibault, 68, said her dentist will not be involved either.

“It really annoys me that the federal government came out and announced a dental plan, but they didn’t do their homework to get it in place so my dentist could be a part of it,” he said.

“I’m not leaving my dentist. I want the federal government to do their job and sort this out with them so it can do its job.”

Association presidents do not sign their own clinics

Canadian dentists, hygienists and dentists have broadly supported the idea of ​​a national public dental care plan, which they say will help provide essential oral health care to the neediest people who would otherwise have to pay on their loss.

But the presidents of some provincial dental associations – who are practicing dentists themselves – have told CBC News they don’t plan to offer the program in their own dental offices.

They say that Ottawa has still not provided enough details for a program that is to be launched in a few weeks.

They also say they are troubled by the fact that Ottawa requires 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 requires the dentist to sign an agreement that is seven pages long with many unknown factors and unnecessary terms and conditions.”

Dental health care providers say they are also concerned about imposing a lot of new paperwork on an already overburdened administrative staff.

“My staff have told me in no uncertain terms that they don’t want to do the program because they can’t handle the extra burden it brings,” said Dr. Rob Wolanski, president of the BC Dental Association.

The CDCP is modeled on Uninsured 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 patients and patient communities, as well as providers,” said Dr. Daron Baxter, president of the Manitoba Dental Association.

“One of the main reasons is the intense administrative burden which often leads to delays in the provision of care.”

Dentists also still do not know how the CDCP will coordinate with other plans offered by states and territories.

Last minute consultation

Provincial dental associations say Ottawa only began consulting 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 into a program that maybe we should be putting the brakes on?”

The federal government, they say, also initially presented the plan as “free” dental care – which it isn’t.

The program covers only certain types of dental work and pays dental health care providers at a lower rate than the fees recommended by provincial and territorial guidelines published by dental societies. Dentists say they don’t know exactly how much the federal government will pay them for providing care. Those amounts change every year; the CDCP 2024 guidance has not yet been published.

There is also a significant co-pay for those with a household net income 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 could sweeten the deal to attract more dental care providers to join.

“We are working hard on creating an alternative portal that will allow dentists to participate directly. When a patient comes in front of them, to put the information in, and be able to put that claim in,” Holland told reporters during a stop in Winnipeg this week.

Holland compared the CDCP to the introduction of universal health care in Canada, which he says also brought challenges.

“There’s a lot of fear, it’s a new program, I get that,” Holland said.

“But conversation by conversation, it has been moving very positively, and I believe we are going to have exceptionally strong numbers.”

Do you have questions about how Canada’s new dental care plan may affect you? Send an email to [email protected].

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