Alberta’s more than 3,000 dentists have ongoing, legitimate issues about Alberta’s oral health care and suddenly, there is a new concern. Confusion, in their profession and among their patients.
“Most Albertans have access to professional dental care through some kind of private or group insurance plan,” explains Dr. Jenny Doerksen, dentist and president of the Alberta Dental Association (ADA). “There are groups, however, that have challenges accessing care, including low income populations, people with special needs and Indigenous peoples.
“While the introduction of the Canadian Dental Care Plan (CDCP) has the potential to boost and support Canadian access to dental care, there is much confusion about the plan.”
She cites a recent survey commissioned by the national, provincial and territorial dental associations, highlighting significant misconceptions among Canadian patients.
Eligibility is probably the most common misconception. The survey shows that one in four seniors, and 19 per cent of all Canadians, mistakenly believe that the federal CDCP is only for seniors and/or people living with disabilities. It is not!
Coverage is also a big part of the public misunderstanding. “Especially seniors, but many patients, assume that the CDCP covers all oral health care services, from cleanings to major surgeries,” Doerksen says. “In reality, CDCP eligible patients only receive limited treatments until preauthorization becomes available in November.”
She also mentions confusion about out-of-pocket expenses. Some 17 per cent of seniors and Canadians believe that they will not need to pay any out-of-pocket expenses when covered by the CDCP.
“Clear communication about potential out-of-pocket costs is crucial to manage patient expectations at the time of their appointment.”
In addition to impacting the dental health of Albertans, the federal CDCP has also become a political Alberta hot potato, with the mid-summer announcement by Premier Danielle Smith about the provincial government opting out of the federal plan by 2026. In a letter to Prime Minister Justin Trudeau, the Premier pointed out the confusion and duplication.
She noted that Alberta already offers the most extensive, publicly funded dental coverage in Canada.
“Approximately 500,000 Albertans benefit from these dental plans, including low income families and other vulnerable individuals such as children in care. Alberta began offering dental programs in 1973 and, since that time, has developed the expertise to successfully design, implement and maintain these much-needed programs.”
Smith also explained that the federal CDCP infringes on Alberta’s dental care programs and is a confusing duplication, replicating the coverage many Albertans already have. According to the ADA, more details and information are needed about how the CDCP would work, mostly because opting out of the federal plan would complicate an already complex coverage issue – for both dentists and patients.
Besides, as Dr. Doerksen points out, Alberta dentists are already dealing with other lingering frontline issues.
“There are numerous factors that already limit patients to seek dental professionals. Not only a lack of benefits or access to dental programs but also personal anxiety and phobia towards dentistry. Awareness about the importance of dental care is still an important issue. Many studies have shown that there is a strong link between oral health and general health.”
She adds a dental care shortage of dental hygienists, assistants, administrative staff and rising costs are also significant factors when it comes to providing oral health care.
“While dentists are caring and compassionate community members and health care professionals, they are also small business owners and employers who must cover the costs of staff wages, licensing and insurance fees, ongoing education for themselves and their team, technology, rent, utilities and equipment and supplies.”
ADA stats and figures underscore that the cost of operating a dental clinic has also increased significantly. Beyond regular inflation, dentists must also cover the cost of increased health and safety regulations from the COVID-19 pandemic, and the compressed labour market has also caused an increase in wages for hygienists, dental assistants and office administrators.
“Many patients are surprised to learn that, when dentists treat low income Albertans, we are doing so below our own costs,” she says. “While every other government and employer plan funds dental procedures at about double the rate that Alberta does, for more than seven years, we have been forced to accept the same rate that is now well below half the provincial fee guide.”
The ADA president explains that other health professions have had their operating costs considered over the last few years, while oral healthcare has been overlooked.
“Dentists are an important part of a patient’s primary healthcare team. Good oral health helps prevent serious health conditions or complications from other diseases, which reduces pressures on our overburdened acute care medical systems.”
According to ADA statistics and trends, most of provincial dental programs currently cover dental fees at about 45 per cent.
“This has been unsustainable and impractical for dentists to provide the same level of dental care to the low income Albertans,” Dr. Doerksen notes. “Ethical considerations prevent us from offering different qualities of care based on patients’ payment capabilities, but the current reimbursement rates jeopardize our ability to serve these patients effectively. We are at a sustainability crisis point for dentists.”
The ADA is cautious about Alberta’s intention to bail out from the new CDCP by 2026.
The Association has timing and other concerns that the province’s position and decision to bail out of the CDCP may be too hasty. Without further clarifying details, the ADA cautions that opting out of the federal program in 2026 would complicate an already complex issue, mostly because, at this point, no one really knows how opting out would affect both dentists and patients in Alberta.
When it comes to the duplication caused by the federal plan, Alberta dentists have concerns about the complexity, misunderstanding and confusion about two levels of government trying to provide a service to the same demographic.
Dr. Doerksen is optimistic and positive about addressing Alberta’s dental care issues and eliminating the current confusion.
“Our Association would support any plan that increases access to oral health care, is easy to use for both patients to use and also easy to administer by dentists.”
Dentists suggest that, to be successful, any plan needs to:
- Safeguard access to dental care by respecting the current workplace, school and/or group dental insurance system.
- Allow patients to choose their own dentists.
- Ensure patients can access care without needless red tape.
- Work with existing dental programs.
- Fairly compensate dental professionals.
- Help address the labour force shortages at dental offices.
“The decision to opt out of the CDCP could be beneficial if the provincial plan is adequately funded, improved and modernized,” Dr. Doerksen says, “but a transition will take at least two years, and patients and dentists cannot wait that long for funding to align with rising costs.”