Denturists, dental hygienists, assistants back dental care plan despite dentists' criticisms
Just under 50% of oral health-care providers signed up for national public insurance program
A group of oral health-care providers has banded together against what they call misinformation about the Canadian Dental Care Plan (CDCP) being spread in part by the associations representing dentists.
"I don't understand how dentists are saying it's an administrative burden when they haven't even registered or tried to submit a claim," said Kelly Mansfield, president of the Canadian Dental Assistants' Association. "We're not seeing any issues."
The national associations for dental assistants, hygienists and denturists say their professions have had positive experiences overall with the program, which started covering seniors on May 1.
The groups plan to offer an online information session this Tuesday for dental professionals, hosted by the Canadian Health Coalition, an advocacy group for public health care. They hope to dispel what they call myths about the CDCP and encourage more dentists to sign on.
Dental associations, which represent dentists, have continued to raise concerns about the national insurance program. Many of their associations' presidents — dentists themselves — have said they will not sign up to treat CDCP patients through their own clinics.
The $13-billion Canadian Dental Care Plan helps cover the cost of dental procedures for low- and middle-income residents who don't have private insurance plans.
Health Canada says just under 50 per cent of all oral health care providers have now signed up for the program — 12,000 in total. They include dentists, independently practising hygienists, denturists and dental specialists.
Health Canada said it could not give CBC News a breakdown by provider type, but other oral health associations say they are seeing high rates of participation compared to dentists.
About 70 per cent of eligible independent hygienists are taking part, said Sylvie Martel, director of dental hygiene practice at the Canadian Dental Hygienists Association.
"We embrace the program," she said. "It's not perfect, but it is helping so many vulnerable Canadians that have never stepped foot in a dental clinic before.
"We hear so much misinformation, so much of the negative. Dentistry is the one that is probably providing more of that negative message."
Martel said dental associations have argued the program is complicated, time consuming and an administrative burden.
"What we've heard from our members is, really ... it is no different than processing a dental claim from another dental insurance company," she said.
Denturists are also signing up at a higher rate than dentists, with about 80 per cent of them participating, said Denturist Association of Canada president Jaro Wojcicki, who runs a denture clinic in Penetanguishene, Ont.
Some denture offices are being asked to verify claims by showing their chart notes from their appointments, something private insurance usually doesn't ask, Wojcicki said. That is adding some extra work for staff.
"I don't really mind the idea, mostly because it's them just making sure I've done what I said I did," he said. "It's taxpayers funds."
However, certain denturists are being asked to verify their claims more than others, an issue the Denturist Association of Canada has raised with Health Canada.
"Overall, I think it's been very, very positive as far as denturists go," he said, adding they are being reimbursed within 48 hours, which is faster than some private insurance plans.
"For me and my practice, it's been excellent. Patients are coming in, they're excited, they're thrilled, they're thankful. Most of them are very emotional."
Wojcicki said there have been issues with "patient experience" when dentists aren't part of the program.
"If there are dentists that aren't accepting the program, that have a mutual patient with myself, when I refer that patient back to the dentist and they're not accepting the CDCP, it does create a little bit of friction," he said.
"I really encourage providers to really do their own research, talk to their colleagues and really make an educated decision instead of just maybe relying on what the associations are saying," he said.
The Canadian Dental Association, which represents dentists, says the misinformation is being caused by the federal government. The association says Ottawa's lack of clarity about how the program works is leading to confusion and anger among patients, which dental clinics are often on the receiving end of.
The association says dental offices are also spending significant time clarifying with patients what dental work is covered through the CDCP — time the group argues could be better spent on providing dental care.
It has put out its own public education program it says is meant to address Canadians' misconceptions about the plan.
In a statement issued to CBC News, the association's president Dr. Joel Antel acknowledged the work Ottawa has done to simplify the plan's terms and conditions, improve the treatments it covers and address concerns about patient privacy.
"We are optimistic these changes may encourage more dentists to consider participating," Antel wrote.
"Each dentist will have to decide whether to participate in the CDCP and what is best for their practice and their patients."
Dentists are moving the goal posts, says advocate
The founder of a group advocating for publicly-funded dental care says the pushback from dentists today is similar to opposition from doctors when universal health care was introduced in the 1960s.
"Dentists know they can't come out and just straight-up be against this program because they would come across as very out of touch," said Dr. Brandon Doucet, a Halifax dentist and founder of the Coalition for Dental Care.
"Basically, what they're doing is saying, 'We can't support the program.' Health Canada will hear them out, address those concerns, and then they'll just move the goal post and say they still don't support the program."
Doucet said the CDCP is incredibly friendly to dentists and their private businesses, in part because it allows them to "balance bill" — to charge patients any extra the government program doesn't cover.
"This treats dentists very fairly, but there's been a lot of misinformation being spread about the program in the dental community, so a lot of dentists don't know that."
Without buy-in from more dentists, the program can't work, he warned.
"If dentists don't sign up for this program and people gain coverage but aren't able to use it, the program is going to be viewed as a failure," he said.
"It's going to be easier for the Conservatives to take this program away, whether that be in whole or in part. And the dental associations and many dentist colleagues of mine are happy to go along with this and use their leverage to make this program a failure, despite millions of Canadians desperately needing it."
The Conservative opposition would not answer CBC's questions about what the party would do with the CDCP if it were to form government.
"The latest attempt by Trudeau's flailing government proves they have botched the program from the start," a spokesperson for Conservative health critic Stephen Ellis wrote in a media statement.
"It is clear the Trudeau government is incapable of administering basic government programs, let alone the flagship dental program they have been promising for months."
Do you have questions about how Canada's new dental care plan may affect you? Send an email to ask@cbc.ca.
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