The Canadian Dental Care Plan can cover a significant portion of your dental care – if you know what’s actually included. Knowing you’re eligible is step one. Knowing what procedures are covered, what your co-payment will be, and what to watch out for before your appointment is what actually lets you use the plan without surprises.
This article breaks down CDCP coverage procedure by procedure – cleanings, fillings, root canals, extractions, dentures, and more – along with what the plan does not cover, how balance billing works, and how families and seniors can get the most from their benefits at The Dental Team’s Ontario locations.
CDCP Eligibility: The Quick Version
To use the CDCP, you must meet four criteria: you’re a Canadian resident, you have no access to private dental insurance (including through an employer, spouse’s plan, or pension), your adjusted family net income is under $90,000, and you’ve filed your most recent tax return and received your notice of assessment.
Your income tier determines how much of the CDCP-established fee the plan covers:
- Under $70,000: 100% of the CDCP fee schedule – no co-payment
- $70,000 to $79,999: 60% covered – you pay 40%
- $80,000 to $89,999: 40% covered – you pay 60%
One important distinction: these co-payment tiers apply to the CDCP’s own fee schedule, not necessarily what your dentist charges. If your dentist’s fees are higher than the CDCP rate, you pay both your co-payment and the difference. More on that in the balance billing section below.
For a complete breakdown of eligibility rules, the enrollment process, and annual renewal requirements, see the full Canadian Dental Care Plan guide.
What CDCP Covers: Procedure by Procedure
The CDCP covers seven categories of dental services. Here’s what each one includes in plain terms, along with what patients most commonly ask about within each category.
Preventive and Diagnostic Care
This is the most-used category for most CDCP members, and it covers the routine appointments most people think of as their “regular dental visit.”
- Dental exams – comprehensive exams, recall (checkup) exams, specific exams for a particular concern, and emergency exams are all covered. Frequency limits apply – adults are generally limited to one recall exam per year under standard CDCP parameters.
- X-rays – bitewing X-rays and other diagnostic imaging are covered within specified frequency limits. Certain types of X-rays taken too recently may not be covered again without preauthorization.
- Dental cleanings (scaling) – professional cleanings are covered. Scaling is billed in time units, and the number of units covered annually depends on your clinical needs as documented by your dentist.
- Fluoride treatments – covered for eligible patients, particularly children and adults with documented elevated cavity risk.
- Dental sealants – covered for children and adolescents on permanent molars as a preventive measure.
The cost of a dental cleaning in Ontario without insurance ranges from $150 to $300 – for CDCP-eligible patients, this is fully or partially covered depending on their income tier.
Basic Restorative: Fillings
Dental fillings are covered under the CDCP as a basic restorative service. This includes both composite (tooth-coloured) and amalgam fillings, and no preauthorization is required for standard filling procedures.
What determines your cost: the CDCP fee schedule sets a rate for each type of filling based on the number of surfaces involved. A single-surface filling is reimbursed at a lower rate than a multi-surface filling. If your dentist’s fee matches the CDCP rate, you pay only your income-tier co-payment. If your dentist charges more, you pay the difference on top of your co-payment.
Endodontic Services: Root Canals
Root canal treatment on a tooth that has not previously had a root canal is covered under the CDCP without preauthorization. The clinical need must be documented by your dentist, but for a straightforward first-time root canal, you can generally proceed without waiting for advance approval.
Two situations that do require preauthorization:
- Root canal re-treatment – if a tooth has already had a root canal and needs to be retreated, preauthorization from Sun Life is required before your dentist can proceed.
- Post and core – the internal structure sometimes placed inside a root canal-treated tooth before a crown is a separate covered item that requires preauthorization.
The crown that typically follows a root canal is covered separately under major restorative services and also requires its own preauthorization. It is not automatically included with the root canal approval.
Periodontal Treatment: Gum Disease Care
Periodontal services – treatment for gum disease – are covered under the CDCP. This includes scaling and root planing (deep cleaning below the gumline), which is the most common non-surgical treatment for periodontitis. Periodontal maintenance visits following active treatment are also covered within frequency limits.
More involved periodontal procedures, including surgical interventions, may require preauthorization. Your dentist will flag this if it applies to your treatment plan.
Major Restorative: Crowns and Dentures
Crowns are covered under major restorative services when they are clinically indicated – meaning the tooth has been damaged to a degree that a filling is insufficient to restore it. Crowns require preauthorization, and the clinical documentation your dentist submits must support the need.
Dentures – both complete dentures (full upper or lower replacement) and partial dentures (replacing some missing teeth) – are covered under the removable prosthodontics category. Dentures also require preauthorization and must be clinically justified.
Dental implants are not covered under the CDCP. If tooth replacement is needed, the plan covers dentures and in some cases bridges, but implant-supported restorations are excluded entirely.
Oral Surgery: Extractions and Wisdom Teeth
Tooth extractions – including simple extractions and surgical extractions of impacted teeth such as wisdom teeth – are covered when clinically indicated. The clinical need must be documented. Complex surgical extractions may require preauthorization, particularly when sedation is also involved.
Sedation
Sedation is covered under the CDCP when it is clinically necessary – typically for patients with documented dental anxiety, young children, or procedures of significant length or complexity. Preauthorization is generally required. Routine sedation for convenience is not covered.
What CDCP Does Not Cover
The CDCP covers most routine and medically necessary dental care. The exclusions are specific, and most fall into three categories: cosmetic procedures, certain tooth replacement options, and orthodontics.
- Dental implants – not covered under any circumstances. The plan covers dentures and bridges as tooth replacement, but implants and implant-supported crowns or bridges are excluded entirely.
- Teeth whitening – excluded as a cosmetic procedure. Professional whitening, bleaching trays, and related treatments are not covered regardless of how they are presented.
- Orthodontics – braces, Invisalign, and other orthodontic treatment are not currently covered under the CDCP. This is a notable gap for families with children who need alignment treatment.
- Cosmetic veneers – veneers placed for aesthetic reasons are excluded. Veneers placed for restorative clinical reasons may be assessed case by case, but purely cosmetic placement is not covered.
- Procedures above the CDCP fee schedule – this is not a category exclusion, but it functions like one in practice. The CDCP reimburses at its own federal fee rate. If your dentist charges more than that rate for a covered procedure, the difference is your responsibility regardless of your income tier.
What Balance Billing Means and How The Dental Team Handles It
Balance billing is the gap between what your dentist charges for a covered service and what the CDCP’s fee schedule reimburses for that service. It’s the most commonly misunderstood aspect of the plan, and it catches patients off guard more than anything else.
Here’s how it works in practice: say a dental cleaning is billed at $200 by your dentist. The CDCP fee schedule sets the covered rate at $160 for that service. The CDCP pays its portion of the $160 based on your income tier – say 100% if you earn under $70,000. That means the CDCP pays $160. You still owe the $40 difference, even though you have 100% coverage. That $40 is balance billing, and it applies regardless of your co-payment level.
Not every dental office charges above the CDCP fee schedule. Some participating providers agree to follow the CDCP fee grid for covered procedures, which means patients at those offices have no balance billing exposure.
At The Dental Team, our front desk verifies your coverage through Sun Life before treatment begins. We confirm your co-payment level and flag any balance billing that would apply to your specific treatment – so you know what you owe before your appointment starts, not after. No surprises.
If cost is a concern, the most reliable thing you can do before any covered appointment is ask your dental provider two questions: do they participate in the CDCP (direct billing to Sun Life), and do their fees align with the CDCP fee schedule for the procedures you need.
How to Maximize CDCP Benefits for Families and Seniors
The CDCP covers eligible household members – not just the applicant. If you have children under 18 in your household, they are covered under your eligibility. Spouses and common-law partners who also meet eligibility criteria can each have their own coverage. Understanding how the plan applies across your household helps you make the most of it.
For Families
Children and adults in the same household can each access the full range of covered services within the CDCP frequency limits. A few things worth knowing for family planning:
- Frequency limits reset annually. Many covered services have annual limits – one recall exam per year, scaling within specified units per year, X-rays at set intervals. Book preventive appointments on a consistent schedule so you don’t lose coverage windows.
- Children’s sealants are covered. Dental sealants on permanent molars are a covered preventive service for children – an effective cavity prevention measure that many families don’t realize the CDCP pays for.
- Coordinate appointments. Booking family appointments at the same practice allows the front desk to verify all members’ coverage together and flag any preauthorization requirements ahead of time.
- Annual renewal affects the whole household. CDCP coverage requires annual renewal. Missing the renewal deadline ends coverage for all household members. The current renewal deadline is June 1, 2026, with coverage ending June 30 if not renewed.
For Seniors
Seniors 65 and over are covered under the same four eligibility criteria. The CDCP applies equally to seniors, though a few considerations are particularly relevant for older adults.
Dentures, which are among the most common restorative needs for seniors, are covered under the plan with preauthorization. Root canals and crowns – also more common as teeth age – are covered with the appropriate documentation and preauthorization where required. Periodontal treatment for gum disease, which affects a significant proportion of older adults, is also covered.
Seniors who also receive benefits through provincial programs like Ontario’s Healthy Smiles Ontario or the Ontario Seniors Dental Care Program may have their coverage coordinated between programs rather than duplicated. Your dental office can help clarify how coordination applies to your situation.
For a detailed breakdown of how the CDCP applies specifically to older Canadians, including coordination with provincial plans, see the complete information on free dental care for seniors in Canada.
Frequently Asked Questions About CDCP Coverage
Does CDCP cover dental fillings?
Yes. Fillings – both composite and amalgam – are covered under basic restorative services with no preauthorization required. Your co-payment depends on your income tier, and if your dentist charges more than the CDCP fee schedule, you pay the difference. Multi-surface fillings are reimbursed at higher rates than single-surface fillings because they involve more tooth structure and procedure time.
Does CDCP cover root canals?
Yes, for first-time root canal treatment on a tooth. Root canal re-treatments on previously treated teeth require preauthorization. The crown that typically follows a root canal is covered separately under major restorative services and also requires preauthorization – it’s not automatically included with root canal approval.
Does CDCP cover dental cleanings?
Yes. Professional cleanings (scaling) and exams are covered under preventive and diagnostic care. Scaling is billed in time units with annual limits. Patients with more significant buildup or gum disease may require more units, which your dentist documents clinically. The co-payment for cleanings follows the same income-tier structure as all other CDCP services.
Does CDCP cover dentures?
Yes, both complete and partial dentures are covered under removable prosthodontics with preauthorization. Dental implants are not covered. If you need tooth replacement and are CDCP-eligible, dentures and bridges are the covered options under the plan.
What happens if my dentist charges more than the CDCP rate?
You pay the difference – this is called balance billing. It applies regardless of your co-payment level and is separate from your income-tier co-payment. To avoid unexpected costs, ask your provider before your appointment whether their fees align with the CDCP fee schedule for the services you need. The Dental Team confirms this with patients before treatment begins.
We’re a CDCP Provider – Book Your First Covered Appointment
The Dental Team is a registered CDCP participating provider at all locations across Milton, Mississauga, and Brampton. We direct-bill Sun Life so you never have to submit your own claims or wait for reimbursement. Before any treatment begins, our team verifies your active coverage, confirms your co-payment level, and identifies any balance billing that applies – so you walk in knowing exactly what your appointment will cost.
If you have your CDCP member card and want to know what it covers before you book, call any of our offices and we’ll walk you through it. If you’re not yet enrolled and think you may qualify, we can point you in the right direction on that too.
Contact The Dental Team for more information about compassionate dental care services, or book directly at the location nearest to you.
