For Patients
Insurance made simple
We work with all major dental insurance carriers in Ontario and submit claims electronically after treatment, so reimbursement reaches you as quickly as possible.
We work with Great-West Life, Manulife, Sun Life, Blue Cross, Desjardins, and many others. Insurance typically covers between 50 and 80 percent of treatment cost depending on the category of care and your specific plan.
We verify your coverage before treatment rather than after, so you know what you will owe before you agree to anything.
Ways to pay
At the Appointment
Straightforward payment on the day, with your insurance claim submitted electronically on your behalf.
Automatic Monthly Billing
Spreading the balance across regular monthly payments rather than a single sum.
Insurance Plus Financing
Combining your coverage with a flexible financing plan for the portion insurance does not cover.
No Insurance
We go through the payment plans available, and whether the Canadian Dental Care Plan applies to you, so that cost is planned rather than a reason to wait.
Insurance questions
What does my plan usually cover? +
Most plans cover preventive care — cleanings, exams, and x-rays — at 100 percent, though this varies by individual policy.
What is a deductible? +
The out-of-pocket amount you pay before benefits begin. Deductibles typically reset on January 1st each year.
What do coverage percentages mean? +
They indicate what insurance pays after your deductible. Preventive care is often covered at 100 percent, basic care at 80 percent, and major work at 50 percent.
Will you submit the claim for me? +
Yes. We submit electronically after treatment to expedite your reimbursement.
What if I use my annual maximum? +
We can phase treatment across calendar years where clinically appropriate, so you make full use of two years' benefits rather than one.
How a dental plan actually pays
Dental insurance is not really insurance in the way car insurance is. It is a spending account with rules. Understanding four of those rules explains almost every surprise anyone has ever had at a dental desk.
1. The categories, and why they are paid differently
Almost every Ontario plan sorts treatment into three buckets and pays a different share of each. The percentages below are the common pattern rather than a promise about your policy — yours may differ, which is why we check it before treatment rather than after.
| Category | What is in it | Typically paid |
|---|---|---|
| Preventive and diagnostic | Exams, cleanings, x-rays, fluoride | 100% |
| Basic | Fillings, extractions, root canals, gum treatment | 80% |
| Major | Crowns, bridges, dentures, implants where covered at all | 50% |
The jump from 80% to 50% is where most of the shock happens. A crown and a filling feel like the same kind of appointment. To your plan they are not.
2. The annual maximum, which is the real limit
This is the total your plan will pay in a calendar year — commonly between $1,000 and $2,000, and largely unchanged for decades while fees have not been. It is the number that matters most and the one people know least.
Once it is used, you pay the whole cost of anything further that year. Two practical consequences. If you need a lot of work, we can often stage it across two calendar years where that is clinically sound, so you use two maximums instead of one. And if you have unused benefit in December, it does not carry over — it simply disappears.
3. The deductible
A fixed amount you pay before the plan starts paying, often $25 to $50 a year, sometimes per family. It usually resets on 1 January. Some plans waive it on preventive care.
4. Frequency limits
Plans cap how often they will pay for something: a cleaning every six or nine months, bitewing x-rays once a year, a new crown on the same tooth only after five years. These limits are set by the insurer and have nothing to do with what you clinically need. Where the two disagree, we will tell you plainly which is which — see how often you actually need a cleaning.
Why the plan sometimes pays less than the fee
The Ontario Dental Association publishes a suggested fee guide each year. Most insurers reimburse against a particular year's guide — and some are still using a guide several years old. When that happens the plan pays its percentage of an older, lower figure, and the difference falls to you even though your treatment was billed at the current rate.
It is the commonest reason a statement reads "80% covered" and the amount still does not match. Nothing has gone wrong; the two numbers are percentages of different things.
Predetermination: the way to find out first
For anything substantial, we can send the treatment plan to your insurer before it starts and ask them to confirm in writing what they will pay. It usually takes two to four weeks. For a crown, a denture, gum surgery or an implant, it is worth the wait, and we will suggest it rather than wait to be asked.
Assignment, and who gets paid
Some plans pay us directly, so you pay only your share on the day. Others reimburse you, which means you pay in full and the cheque comes to you a week or two later. Which one applies is set by your plan, not by us. We will tell you which yours is before the appointment, because it changes what you need to bring.
Two plans at once
If you and a partner both have coverage, the two can usually be coordinated — one pays first, the other considers the remainder. It often covers considerably more than people expect, and it is worth telling us about the second plan even if you assume it is the weaker one.
The Canadian Dental Care Plan
The CDCP is the federal programme for people who have no access to private dental insurance. We accept it, we submit to it, and we handle the paperwork.
You qualify if you are a Canadian resident, have filed last year's tax return, have no access to dental insurance through work, a pension, a professional association or a private policy, and your adjusted family net income is under $90,000. As of 2026 it is open to every eligible age group. You apply to the federal government, not to us.
What you pay depends on that income figure:
| Adjusted family net income | The plan pays | Your share |
|---|---|---|
| Under $70,000 | 100% | Nothing |
| $70,000 to $79,999 | 60% | 40% |
| $80,000 to $89,999 | 40% | 60% |
| $90,000 and over | Not eligible | — |
What it covers
Exams, x-rays, cleanings, fluoride and sealants. Fillings. Root canals. Gum treatment. Extractions. Complete and partial dentures. Crowns. Sedation, including nitrous oxide. It is a genuinely broad list for everyday care.
What it does not cover: dental implants, bridges, orthodontics and anything cosmetic. Orthodontic services are listed by the plan as not currently available. If implants are what you are considering, read the CDCP and dental implants before you plan around it.
Preauthorization
Several of the bigger items need approval in advance — crowns, complete and partial dentures, root canals on back teeth, complex extractions and major gum treatment. That means a treatment plan, recent radiographs, and sometimes a periodontal chart sent in and waited on. Sun Life administers it on the government's behalf, and the decision is theirs rather than ours.
One thing worth knowing: the CDCP reimburses against its own fee schedule, which is not the same as the provincial guide. Where there is a gap we will tell you the figure before treatment, not after. More on the CDCP at this practice.
If you have no coverage at all
About a third of Canadians do not, and the answer is not to go without care until something hurts.
- Check the CDCP first. It exists precisely for this, and a good number of people assume they earn too much when they do not.
- Ask for the written estimate before anything starts. Itemised, so you can see which parts are unavoidable and which could wait.
- Ask what can be staged. Some sequences genuinely can be spread over months without storing up a problem. Some cannot, and we will say so.
- Financing spreads the cost rather than deferring the treatment — interest-free plans on treatment over $1,200, longer terms for larger plans, and third-party lenders, all subject to approval.
- Do not skip the preventive appointments to save money. They are the cheapest thing we do and they are what stops the expensive things happening.
The most expensive dentistry is almost always the treatment that was postponed. A filling deferred becomes a root canal; a cracked tooth deferred becomes an extraction and an implant.
Common questions
Do you bill my insurance directly?+
Where your plan allows it, yes — we submit electronically and you pay only your share on the day. Some plans do not permit direct payment and reimburse you instead, which means paying in full and being repaid within a week or two. Which applies is set by your plan. We will tell you which before your appointment.
Why did my plan pay less than the percentage it promised?+
Usually because the insurer reimburses against an older edition of the provincial fee guide than the one the treatment was billed at, so its percentage is a percentage of a smaller number. Deductibles and annual maximums account for most of the rest. We can send a predetermination before major treatment so the figure is confirmed in writing first.
What is a predetermination and should I ask for one?+
It is the treatment plan sent to your insurer in advance so they state in writing what they will pay. It takes roughly two to four weeks. For crowns, dentures, gum surgery or implants it is worth the wait, and we will usually suggest it before you ask.
Does the CDCP cover dental implants?+
No. The Canadian Dental Care Plan covers exams, x-rays, cleanings, fillings, root canals, gum treatment, extractions, dentures, crowns and sedation, but not implants, bridges, orthodontics or cosmetic work. If implants are what you are considering, plan on the basis that the CDCP will not pay for them.
I have used up my annual maximum. What now?+
Anything further this year is yours in full, so the question becomes what genuinely cannot wait. Where it is clinically sound we stage treatment across two calendar years so you use two maximums rather than one. Where waiting would make things worse, we will say so and talk about financing instead.
My partner and I both have plans. Does that help?+
Usually quite a lot. The two can be coordinated — one pays first and the other considers what is left — and between them they often cover much more than either alone. Tell us about both, even the one you assume is weaker.
Have a question?
Call (905) 479-7777 and we will check your coverage before you commit to anything.