Dentists, hygienists unsure how national free dental care plan will work

Letters have started to arrive in the mailboxes of Canadian seniors inviting them to sign up for free dental care, but those who provide the services say they're concerned whether the program will be administratively and financially viable for them to take part.

"If our questions aren't answered and our concerns aren't addressed, I don't know if dentists are going to want to sign up for this program," said Dr. Brock Nicolucci, president of the Ontario Dental Association.

By 2025, Canada's national plan will provide dental care to all low- and middle-income Canadians, a program dentists and public health-care experts have advocated decades for. Weeks ago, the federal government announced that seniors would be the next to qualify for the program, starting in May.

But Ottawa had few details yet on what the program will look like for dental care providers. It's still unclear how dentist will sign up, how the billing process will work, and whether what Ottawa pays for scaling, filings, extractions and other services will match what current private insurance plans pay.

Nicolucci points to existing public dental care plans run by provinces for low-income children and seniors. Some in Ontario pay as little as 18 per cent of the suggested fee, making it financially hard for dentists to take part, he said.

"That's a great concern."

Canada's health minister has said the $13-billion federal dental program will compensate dentists "fairly." Ottawa has signed a $747-million contract with insurance giant Sun Life to help administer the plan. 

Minister Mark Holland said Canada's dental care plan will follow a model similar to the non-insured health benefits for First Nations and Inuit, a current federal program that pays for some health services, including dental, that other provincial and private plans don't cover.

But Nicolucci said even existing public dental care programs that compensate dentists often require so much paperwork that it's not something dental clinics can easily handle, especially as they struggle with a shortage of support and administrative staff.

That's a concern for Canada's dental hygienists, too.

"We want to make sure that there's a reduced administrative burden, that there's not a heavy reliance on predetermination or pre-authorization," said Ondina Love, CEO of the Canadian Dental Hygienists Association.

Love said hygienists have been told they can sign up for the program in February. Dental care providers meet weekly with federal officials to hash out the plan specifics, she said.

"The devil is really in the details. That's what the government is working on right now, is finalizing the fee structure and what services are provided," she said.

"The introduction of any plan of this nature will invariably run into some challenges," said Dr. Carlos Quiñonez, a dental public health specialist at Western University in London, Ont.