Dental Hygienists Express Concerns Over Reimbursement Rates Announced for Canadian Dental Care Plan

The Canadian Dental Hygienists Association (CDHA) welcomes the next phase of the rollout of the Canadian Dental Care Plan (CDCP). Oral health providers have now received more specific details and are preparing to sign up to participate in the plan. While hopes are high that the plan will reduce barriers to accessing oral health care for vulnerable populations, there are concerns about some of the details surrounding the basket of eligible services for different populations and their unique needs and the reimbursement rates for independent dental hygienists.
Throughout the development process over the past many months, CDHA, representing more than 31,000 dental hygienists across the country, has consulted regularly with Health Canada and government officials. CDHA has advocated for the plan to cover preventive services, feature reasonable reimbursement rates for services provided, ensure cost of services are fully covered, not rely heavily on predetermination/pre-authorization of services, and offer equitable reimbursement rates for dental hygiene services whether provided by dental hygienists practising independently of a dentist or practising in a dentist/dental office.
An overarching concern is the lack of emphasis on prevention in the current iteration of the plan. There is no reimbursement for oral health education and counselling, limited number of reimbursements for oral examinations, anticariogenic treatments, and scaling and/or root planing units without pre- authorization for additional care. Dental caries is among the most common, yet preventable chronic diseases in children and adults as is periodontal disease. While the CDCP does cover treatment after disease occurs, it limits the services aimed at preventing disease before it arises, which would reduce upstream health system costs and burdens of illness.
Another concern is that the CDCP will only pay for oral health care services covered within the plan at the established CDCP fees. Based on the information released, the CDCP-established fees for dental hygienists practising independently are, on average, 15% lower than the published fees for general dentists. Furthermore, the reimbursement rate for eligible dental hygiene services provided by a dental hygienist working in a dental clinic owned by a dentist or a corporation is higher than that for the same services provided by an independent dental hygienist. Even though the plan does not encourage balanced billing, it will allow providers who do not want to absorb the difference between the CDCP reimbursement rates and the current suggested provincial or territorial fees to pass this cost along to their patients.
Many dental hygienists operate a mobile practice and are the best-placed providers to care for the most vulnerable populations, such as seniors in long-term care or in their own homes and those with physical or mental impairments, and complex medical needs. "The goal of the dental hygiene profession is very much aligned with the government’s plan to reduce barriers to access oral health care," said Francine Trudeau, president of CDHA. Canada’s dental hygienists are committed to participating in this plan to help support the estimated 9 million people expected to enroll, “but we have to get the plan right,” adds Trudeau.
CDHA and the provincial dental hygiene associations feel strongly that dental hygienists have a key role to play in providing essential oral health care under this plan. We will continue to closely monitor further developments and actively engage with government and other stakeholders to enhance the CDCP.
About the Canadian Dental Hygienists Association (CDHA)
CDHA is the national voice of dental hygienists in Canada. Representing over 31,000 dental hygienists across the country, CDHA advocates for the advancement and promotion of the dental hygiene profession while maintaining a commitment to the public's oral health. Dental hygiene is the sixth largest regulated health profession in Canada with professionals working in a variety of settings, including independent dental hygiene practice, with people of all ages, addressing issues related to oral health. For more information on oral health, visit dentalhygienecanada.ca. For more information on the work of CDHA, visit cdha.ca.