A growing number of Ontario dental practices are choosing not to participate in the Canadian Dental Care Plan (CDCP) as the 2026-2027 benefit year begins, citing fee schedule gaps, preauthorization denial rates above 50%, and rising administrative burden. The opt-out trend raises serious questions about patient access — particularly in rural Ontario and underserved GTA communities.
As of July 2026, the Canadian Dental Care Plan has entered its second full benefit year with coverage running from July 1, 2026, to June 30, 2027. The program, which is now open to all eligible Canadians without age restrictions, has enrolled over 3.4 million members. According to a recent Canadian Dental Association (CDA) survey, 67% of dental professionals support the CDCP's goals and 74% agree the program is improving access to dental care. Yet behind those headline numbers, a quieter trend is reshaping how the program functions on the ground: an increasing number of dental practices — particularly in Ontario — are choosing to limit or end their CDCP participation.
Why Providers Are Stepping Back
The decision to opt out of the CDCP is not ideological for most Ontario dentists. It is financial and operational. Three factors dominate the conversation:
Fee Schedule Gaps
The CDCP fee schedule, administered by Sun Life, pays below the Ontario Dental Association (ODA) suggested fee guide for many procedures. While the gap varies by service, practices report that the CDCP reimbursement for common procedures like examinations, cleanings, and restorations does not cover the full cost of delivering care when overhead, staffing, and supply costs are factored in. For a practice in Toronto, Mississauga, or Markham where commercial rent, hygienist wages, and instrument costs are among the highest in the country, accepting below-ODA-guide fees on a growing portion of the patient base can erode profitability to unsustainable levels.
The ODA has repeatedly flagged fee adequacy as a core concern. At its 2026 Annual Spring Meeting, ODA leadership identified CDCP fee alignment as one of the top priorities for advocacy with the federal government. The gap between what the CDCP pays and what it costs to deliver care in Ontario's most expensive markets is not a rounding error — it is a structural issue that grows more acute as the CDCP patient base expands.
Preauthorization Denial Rates
According to Health Canada data reported by CBC News, 52% of preauthorization requests for dental work between November 2024 and June 2025 were denied. While more recent denial rates have not been publicly released for the 2026-2027 benefit year, providers report that the preauthorization process remains a significant operational burden. An Ottawa-area dentist described the experience to media as receiving "rejection after rejection without any details or instructions as to why such a pre-determination was rejected."
Each denied preauthorization represents not just lost revenue but lost clinical time — the time spent examining the patient, preparing the treatment plan, submitting documentation, following up on the denial, potentially resubmitting, and explaining the outcome to a patient who believed their dental care was covered. For a busy practice processing dozens of CDCP claims weekly, this administrative cycle diverts resources from patient care.
Pro Tip: Practices that continue to participate in the CDCP should designate a single team member as the CDCP claims specialist responsible for tracking preauthorization submissions, following up on denials within 48 hours, and maintaining a log of denial reasons by procedure code. Pattern recognition from this data can improve approval rates by ensuring documentation meets Sun Life's specific requirements the first time.
Administrative Complexity
Beyond preauthorization, CDCP participation adds layers of administrative work that private insurance claims do not require. Patient eligibility verification, coordination of benefits with private plans, and CDCP-specific documentation requirements all consume front desk and administrative time. For solo practitioners or small practices with lean administrative teams — common throughout suburban and rural Ontario — this overhead can tip the cost-benefit calculation toward opting out.
The Patient Access Consequence
When providers opt out, patients bear the cost. CDCP members in areas with fewer participating dentists face longer wait times, longer travel distances, and in some cases, the inability to find a participating provider at all. This is not a hypothetical concern — reporting from Prince Edward Island has already documented CDCP patients being pushed to appointment dates in 2027, and New Brunswick's dental society has flagged staffing shortages that limit the profession's capacity to absorb CDCP demand.
In Ontario, the geographic distribution of the problem is uneven. Urban centres like Toronto, Vaughan, and Brampton have enough dental practices that CDCP patients can typically find a participating provider, though wait times may be longer than for privately insured patients. Rural and northern Ontario communities, however, face a compounding challenge: they already have fewer dental practices per capita, and the practices that exist are often the small operations least able to absorb CDCP's administrative overhead and below-guide fees.
The Ontario government's proposed scope-of-practice expansion for dental hygienists and denturists, announced earlier in 2026, could partially alleviate access pressure by allowing more types of providers to deliver certain CDCP-covered services. However, this expansion remains in the regulatory consultation phase and is not yet in effect.
What the CDA and ODA Are Doing
The Canadian Dental Association has taken a measured public position, acknowledging the CDCP's goals while advocating for changes to improve its operational viability for providers. The CDA has consistently called for fee schedule adjustments that reflect the actual cost of care delivery, streamlined preauthorization processes, and better communication about denial reasons.
The ODA has been more direct. Under the leadership of its 153rd president, Dr. Janet Leith, who took office on June 1, 2026, the ODA has identified CDCP sustainability as a headline advocacy priority. Dr. Leith's agenda emphasizes the need for the federal government to engage with organized dentistry on fee adequacy before more practices reach the financial tipping point where participation becomes untenable.
Neither organization has recommended that members opt out of the CDCP. The professional consensus remains that the program's goals — expanding dental care access to Canadians who previously lacked coverage — are worth supporting. The tension lies in whether the program's economic design makes continued participation viable for the practices expected to deliver that care.
What Ontario Practice Owners Should Consider
For practice owners evaluating their CDCP participation strategy, several factors deserve analysis beyond the fee schedule alone:
- Patient base composition. If CDCP patients represent less than 10% of your patient base, the financial impact of below-guide fees is manageable. If CDCP patients represent 25% or more — increasingly common in communities with lower median incomes across Scarborough, Etobicoke, and North York — the fee gap has a material impact on overall practice revenue.
- Capacity utilization. A practice with unfilled appointment slots benefits from CDCP patients even at lower fees — the marginal cost of seeing one more patient in an otherwise empty chair is minimal. A practice running at full capacity, by contrast, may find that CDCP patients displace higher-paying privately insured patients.
- Community positioning. In some communities, being the practice that accepts CDCP patients creates significant goodwill and word-of-mouth referrals. Patients who discover your practice through CDCP may bring family members with private insurance, recommend your practice to colleagues, and become long-term patients whose value extends well beyond their initial CDCP-covered visit.
- Administrative investment. Practices that have already invested in systems and staff training for CDCP claims processing face lower marginal administrative costs per claim than practices starting from scratch. The sunk cost of building CDCP competency may argue for continued participation.
Pro Tip: Run a quarterly CDCP profitability analysis that compares your CDCP revenue per hour of chair time against your privately insured revenue per hour and your target overhead percentage. This gives you a data-driven basis for setting limits on CDCP appointment volume rather than making an all-or-nothing participation decision.
Looking Ahead: The 2026-2027 Benefit Year
The CDCP's second benefit year brings both expanded eligibility — the program is now open to all eligible Canadians regardless of age — and the same unresolved structural tensions. Health Canada reports that 3.4 million Canadians renewed their coverage for the new benefit year, but previous reporting has also noted that more than 2 million approved CDCP members have not yet seen a dentist, suggesting that the program's access challenges extend beyond provider participation to patient engagement.
For Ontario's dental profession, the path forward likely involves negotiation rather than mass opt-out. The CDA and ODA have the institutional weight to push for fee schedule adjustments, and the federal government has a political interest in the program's success. But the window for adjustment is narrowing — every practice that opts out makes it harder for remaining participants to manage demand, creating a cycle that could undermine the program's viability in the provinces and communities where it matters most.
Frequently Asked Questions
Q: What percentage of Ontario dental practices currently participate in the CDCP?
Exact current participation rates for Ontario specifically have not been publicly released by Health Canada or Sun Life for the 2026-2027 benefit year. Nationally, the CDA has reported that the majority of dental practices remain enrolled in the program. However, participation does not equate to active acceptance of CDCP patients — some enrolled practices limit the number of CDCP appointments they offer. The ODA has flagged provider retention as a priority concern for the current benefit year.
Q: Can a dental practice accept some CDCP patients without accepting all of them?
Yes. Practices can participate in the CDCP while limiting the number of CDCP-covered appointments they offer per week or per month. This allows practices to manage the financial impact of below-guide fees while maintaining some level of access for CDCP patients. There is no requirement to accept unlimited CDCP patients once enrolled, though practices should communicate their availability clearly to avoid patient frustration.
Q: What should CDCP patients do if they cannot find a participating dentist in their area?
CDCP members can use the program's provider search tool on the Canada.ca CDCP portal or contact Sun Life directly to locate participating providers. In areas with limited availability, patients may need to expand their geographic search radius. Patients experiencing access difficulties should document them and report to their Member of Parliament, as patient access data informs the federal government's evaluation of whether the program requires structural changes.
EBIKO Dental will continue monitoring CDCP participation trends and their implications for Ontario dental practices. For Canadian dental supply needs, visit ebiko.ca.