What services are covered
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Services covered
The Canadian Dental Care Plan (CDCP) will help pay a portion of the cost for a wide range of oral health care services.
Note: Some services and additional treatments beyond established frequency limits will require preauthorization by the CDCP. This means your provider will recommend treatment and the CDCP will assess if the treatment will be covered. This pre-approval must happen before you can receive the treatment. The decision will take into consideration your oral health history and medical conditions. Services and additional treatments requiring approval in advance will be available in November 2024.
Examples of services that could be covered under the CDCP when recommended by an oral health provider, include:
Diagnostic and preventive services
These are services to check your oral health status, keep your teeth, gums and mouth healthy, and prevent cavities and gum disease and detect mouth conditions (like cancer) earlier. CDCP covers:
- dental exams, including complete, routine, specific and emergency exams
- x-rays
- cleaning (scaling)
- fluoride applications
- sealants
Basic services
Restorative services
These services treat cavities and broken teeth. CDCP covers:
- permanent fillings
- temporary fillings
- pain control for diseased teeth
- other treatments for cavities
Endodontic services
These services treat teeth that are severely decayed, infected or broken. CDCP covers:
- root canal treatments
- pulpectomies (first step of a root canal treatment)
- procedures to reduce infection and relieve pain
- re-treatment of previously completed root canal treatment (requires preauthorization)
Periodontal services
These services treat areas around the teeth, including gums and bone. CDCP covers:
- cleaning under the gumline
- treating abscesses
- bonding for mobile teeth (requires preauthorization)
- post-surgical evaluations (requires preauthorization)
- non-surgical gum disease management
Major services
Restorative services
These services restore teeth when they’re too damaged to be fixed with basic fillings. CDCP covers:
- posts and post removal
- repairs to crowns and re-bonding of crowns and posts
- crowns (requires preauthorization)
- cores (to support crowns) (requires preauthorization)
- posts for crown (requires preauthorization)
Removable prosthodontic services
These services replace missing teeth. CDCP covers:
- complete dentures, including standard and temporary dentures
- denture repairs, relines and rebases
- placing lining in dentures to condition oral tissues (for comfort and healing)
- complete immediate and overdentures (requires preauthorization)
- partial dentures (require preauthorization)
Oral surgery
These services remove teeth or tumours and fix other problems in the mouth and jaw that need surgery. CDCP covers:
- removal of teeth and roots
- surgical removal of tumours and cysts
- surgical incisions, including draining
- treatments for broken jaw bones
Anesthesia or sedation services
These are services to sedate you and control your pain while another service is being performed. CDCP covers:
- minimal sedation (conscious)
- moderate sedation (requires preauthorization)
- deep sedation (requires preauthorization)
- general anaesthesia (requires preauthorization)
Orthodontic services
These are not available yet. In 2025, we’ll add orthodontic services to the CDCP. These services will only be covered in cases of medical need based on strict criteria. There will be a maximum spending limit for them.
For more information on services covered, consult the CDCP Dental Benefits Guide.
How much will be covered
The CDCP will reimburse a portion of the cost of your treatment, but it may not pay the full amount. You may have to pay additional charges directly to the oral health provider, if:
- your adjusted family net income is between $70,000 and $89,999
- the cost of your oral health care services are more than what the CDCP will reimburse for these services, or
- you and your oral health provider agree to services that the CDCP doesn’t cover
Reimbursement for services
Only oral health providers get reimbursed for services covered under the CDCP.
If you are covered by the CDCP, you shouldn’t pay the full cost upfront, but you may have to pay any additional charges directly to the oral health provider.
Please contact us if you have questions or require support.
Co-payments
You may have a co-payment based on your adjusted family net income. A co-payment is the percentage of the CDCP fees that isn’t covered by the CDCP, and that you will have to pay directly to the oral health provider. Your co-payment is based on your adjusted family net income.
| Adjusted family net income | How much will the CDCP cover | How much you will cover |
|---|---|---|
| Lower than $70,000 | 100% of eligible oral health care service costs will be covered at the CDCP established fees. | 0% of the CDCP established fees. You may face additional charges as described below. |
| Between $70,000 and $79,999 | 60% of eligible oral health care service costs will be covered at the CDCP established fees. | 40% of the CDCP established fees. You may face additional fees as described below. |
| Between $80,000 and $89,999 | 40% of eligible oral health care service costs will be covered at the CDCP established fees. | 60% of the CDCP established fees. You may face additional fees as described below. |
Additional charges
The CDCP fees may not be the same as what providers charge. You may have to pay fees in addition to the potential co-payment if:
- the cost of your oral health care services are more than what the CDCP will reimburse for these services
- you agree to receive care that the plan doesn’t cover
Before receiving oral health care, you should always ask your oral health provider about any costs that won’t be covered by the plan. Make sure you know what you’ll have to pay directly to your oral health provider ahead of receiving treatment.
Examples of co-payments and additional charges
The following examples are all based on 2 units of scaling, which is 30 minutes of teeth cleaning.
No co-payment
Jane is 86 and lives in a retirement home. Her daughter helped her apply to the CDCP as soon as she was eligible. Jane has an adjusted family net income of $32,000. This means that she does not have a co-payment under the plan.
- Jane has an appointment to get her teeth cleaned
- Her provider charges $145 for 2 units of scaling
- The CDCP established fee for 2 units of scaling is $134
- The CDCP will pay Jane’s provider $134
- Jane must pay the remaining $11 to her provider
40% co-payment
Sam and Anne are both self-employed, and have 3 children under the age of 18. Their family adjusted net income is $76,000. This means that Sam and Anne have a 40% co-payment.
- Sam has an appointment to get his teeth cleaned
- His provider charges $145 for 2 units of scaling
- The CDCP established fee for 2 units of scaling is $134
- Sam must pay the remaining $11 to the provider, plus his co-payment
- Sam’s co-payment is $53.60 (40% of $134)
- The CDCP will pay Sam’s provider $80.40 (60% of $134)
- Sam’s total payment to his provider is $64.60 ($11 plus $53.60)
60% co-payment
Kate, aged 67, lives with her partner Mary. They have an adjusted family net income of $82,000. This means that they have a 60% co-payment.
- Kate has an appointment to get her teeth cleaned
- Her provider charges $145 for 2 units of scaling
- The CDCP established fee for 2 units of scaling is $134
- Kate must pay the remaining $11 to the provider, plus her co-payment
- Kate’s co-payment is $80.40 (60% of $134)
- The CDCP will pay Kate’s provider $53.60 (40% of $134)
- Kate’s total payment to her provider is $91.40 ($11 plus $80.40)
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