Waitlists lowered for seniors dental care program

In the third quarter of the year the waitlist was at 79 compared to 203 in the first quarter

Waitlists have lowered in Guelph for the seniors dental care program, but barriers remain for another local dental program because some dental offices are requiring the federal dental program be used as the primary insurance.

Since the Canadian Dental Care Plan (CDCP) was introduced, waitlists for the Ontario Seniors Dental Care Program have dropped because of it, said in a Wellington-Dufferin-Guelph Public Health (WDGPH) report.

The first quarter of the year saw 203 on the waitlisted, 101 in the second quarter and in the third quarter, 79 for OCDCP.

This program is for low-income older adults age 65 and older and is funded by the province. Free coverage includes check-ups for scaling, fluoride and polishing, repairing broken teeth and cavities, x-rays, removing teeth or abnormal tissue, anesthesia, treating infection, pain, gum conditions and diseases.

The amount of take-up of the CDCP program by dental offices isn’t a concern like it once was since offices see a higher reimbursement when patients use both CDCP and the Healthy Smiles Ontario (HSO) program.

WDGPH helps in delivering OSDCP and HSO. This program is for eligible children under 18-years-old. It is free and provides preventive dental services and supports screening for urgent and emergency dental needs.

When HSO is used as the only insurance, dental offices are “… getting less than 50 per cent of what is the current fee guide for covered treatments,” said Rita Isley, vice-president and community health chief nursing officer at WDGPH.

Benefits of HSO and CDCP can be coordinated. When this happens the dental office receives almost full compensation for the work, said Isley. With the Ontario programs there had been a long standing issue around the fees. “And in a lot of circumstances the dentists who take people under HSO and even under our seniors program are losing money instead of even breaking even when they take those patients and use those programs for their compensation,” she said.

“That was one of the concerns we had before, was the fact that dentists weren’t taking it up because it was costing them money,” said George Bridge, board of health chair, in response. “So I think that it’s great that this is working out better now.”

For CDCP, the eligibility is for those who don’t have access to dental insurance, have an adjusted family net income of less than $90,000, are Canadian residents for tax purposes and have filed a tax return the year before.

The program rolled out with older adults 70 and older, and then applications started for older adults over the age of 65 in May and then for those with a Disability Tax Credit certificate and children under age 18 in June.

What WDGPH has been seeing more recently is dental offices moving away from accepting HSO as primary insurance and requiring CDCP as the primary insurance.

“So this has resulted in some barriers especially for families who may have not heard of CDCP and have not applied. And if you add two to three month wait time before they are actually receiving their card that can be a big gap in terms of accessing care,” said Meghan Wiles, acting manager of the dental program at WDGPH, in her presentation.

It’s an issue for children who have urgent dental care needs so those challenges are still being navigated and WDGPH will continue to learn how the federal program can work with local programs, she said.

WDGPH pointed out the gaps in CDCP like for children whose families are new to Canada and haven’t filed taxes yet. Although having both CDCP and HSO would have dentists be more fully reimbursed for services “it creates barriers to care for those who have private dental insurance and are therefore not eligible for the CDCP as well as for those who have not yet applied for the CDCP and have urgent dental needs,” read the report.

With the seniors dental program the Ministry of Health has requested public health units track CDCP for the OSCDCP delivery report for the last quarter of the year.

The information in the report to be included is: