CDCP And Its Hidden Costs – A Dental Office Perspective
- Bruno Gressi
- Jul 28
- 3 min read
At By The Lake Dental, your favourite dental office in Ajax and Scarborough, we’re committed not only to improving access to oral health, but also to providing our patients and communities with clear, accurate information. That’s why we’re sharing important insights about the new Canadian Dental Care Plan (CDCP) and how it’s creating confusion for both patients and dentists.
Although promoted as free, the CDCP often leaves patients facing unexpected fees. The eligibility criteria establish parameters for coverage, requiring some patients to handle out-of-pocket co-payments.
The CDCP is available to Canadians who do not have private dental insurance.
Applicants must have a family net income under $90,000 per year.
Families earning under $70,000 are supposed to receive full coverage. However, because the CDCP government fee guide is outdated, lagging years behind most provincial fee schedules, patients are often required to pay the difference out of pocket. Even basic services, like cleanings, may require co-payments.
Those earning between $70,000 and $89,999 receive partial coverage, with 40%–60% of treatment costs covered.
“Most people don’t realize they’ll still have to pay,” says Dr. Anita Gartner, President of the British Columbia Dental Association.
Many are surprised to learn that complex procedures like root canals, crowns and dentures require pre-approval, and more than half of these requests are being denied by Sun Life, the plan’s administrator. Additionally, many dental clinics are struggling to access coverage details quickly, which delays treatment and disrupts care planning.
Key Concerns from Dentists:
The CDCP is not fully free. Many patients still pay out of pocket.
Only 30–50% of pre-authorized treatments are being approved.
Complex treatments (e.g., root canals, dentures, crowns) require pre-approval and many are denied.
Patients earning $70,000–$90,000 are required to pay 40%–60% of treatment costs.
Miscommunication has led patients to believe all care is covered, which isn’t the case.
The plan’s long-term sustainability is being questioned.
The federal fee schedule is lower than provincial rates, so patients often pay the difference.
A High Rate of Rejected Treatments
While the CDCP was created with the intention of improving access to care, many patients are facing unexpected barriers when it comes to more complex treatments. Between November 2024 and June 2025, Health Canada reported that 52% of pre-authorization requests for complex dental procedures were rejected. This includes essential work such as crowns, root canals, and partial dentures; services often required by those who’ve gone without dental care for years.
Dentists across Canada are expressing concern about the unusually high rejection rate, especially when compared to private insurance plans. These denials often come after weeks, or even months, of delays while clinics await responses or requests for additional documentation like X-rays and dental charts.
The system, administered by Sun Life, has been overwhelmed with an "avalanche" of submissions since the CDCP expanded in June 2025 to include adults aged 18 to 64. This surge has led to long wait times, software glitches, and a growing backlog in some provinces. Many patients are left in limbo, unsure of whether their needed care will be covered, or surprised to learn it won’t be at all.
Though the federal government has made recent efforts to streamline the pre-authorization process and educate providers, confusion persists. Dental professionals stress that while the plan is helping many underserved Canadians, it's far from “free,” and a significant number of patients are still left with unexpected costs or denied care.
For more information you can read these articles:
Canadian Affairs article titled “The Unseen Costs of Canada’s ‘Free’ Dental Care”
