LETTER: New dental care plan could use some revisions

“CDCP and the care provided within it are not the exclusive purview of dentists”

Burlington Today received the following open letter regarding the Canadian government’s new Canadian Dental Care Plan.

The Honorable Mark Holland, Minister of Health
The Honorable Terry Beech, Minister of Citizen Services
canadian government

Dear Secretary Holland and Secretary Beach,

As an independent dental hygienist, I applaud the Canadian government's recent launch of the new Canada Dental Care Plan (CDCP).

Actions to improve oral health have been shown to have a positive impact on the overall health of disadvantaged groups.

Independent dental hygienists play a critical role in providing preventive and therapeutic oral health services and educating Canadians, and help improve access to care for those who need services most.

CDCP and the care provided therein are not the exclusive purview of dentists.

Specifically, scaling, cleaning, polishing, sealants, and fluoride services are provided solely by dental hygienists within a dental office or, increasingly frequently, independently in their own offices.

Independent dental hygienists provide services in health clinics, long-term care facilities, homes, schools, and through mobile clinics to children and their parents, seniors, residents of long-term care facilities and group homes, and northern, rural, remote communities across Canada. and Aboriginal communities with limited local access to dental or dental hygiene services or no access to the oral health services they need and deserve. (“Independent Dental Hygiene Practice Spotlight,” Canadian Association of Dental Hygienists)

To this end, I would like to raise some of my concerns about CDCP;

  1. CDCP communications, including those to many recent federal residents, focus primarily on “dentists” and fail to mention the important preventive role hygienists play in keeping teeth and surrounding tissues healthy, as well as educating Canadians on oral health methods and practices to avoid the need for a dentist in the future Treatment is expensive.
  2. CDCP’s “go to the dentist” message demonstrates a lack of vision and accuracy in communications from CDCP services and elected representatives, including you, who have accepted responsibility for promoting critical community health and disease prevention services, and undermines the reach of your message everyone.
  3. Independent dental hygiene practices are primarily owned and operated by women, while dental offices are still primarily owned and operated by men. As of 2021, 98% of dental hygienists and 99% of dental assistants are women, and 60% of dentists are men (“Women in Dentistry – The Changing Dental Workforce,” Canadian Dental Association). The undue focus on “dentists” in CDCP communications poses a serious disadvantage to thousands of professional (mostly female) small business owners who continue to work to recover economically from the costs associated with coronavirus-related shutdowns and implement needed COVID protocols and safety systems and the impact of leisure time, purchasing additional PPE and encouraging patients to resume post-COVID oral health services.
  4. The CDCP fee schedule also provides that services provided by an independent dental hygienist will be paid less than the fee paid to a co-located dentist.
  5. Dentists can enjoy benefits such as economies of scale for purchasing dental care groceries (polishing pastes, sterilization kits, polishing cups, biological indicators, etc.), bank loan discounts, and other benefits not available to independent dental hygienists. As a result, independent operators bear costs that their colleagues do not. This practice further disadvantages frontline service workers, who are predominantly women.
  6. Finally, CDCP coverage, which stipulates 7.5 minutes of debridement (scaling) once a year for children under 11 years old, 15 minutes for children 12 to 16 years old, and 60 minutes for adults, is completely inadequate to meet the needs of children and the elderly. My professional experience is that this population requires at least 6 debridement procedures (1.5 hours) per year. While it is possible to request additional units for patients under the CDCP, and independent dental hygienists have a professional responsibility to do so in order to provide patients with adequate treatment, it is entirely unreasonable for small business owners to shoulder the administrative burden and uncompensated time of this important request. Untenable.

I am asking you, as Minister of Health and Minister of Citizen Services, to revise the CDCP Fee Guidelines to ensure that independent dental hygienists are paid the same for their services as hygienists who work for dentists.

I also ask that CDCP’s communications be more inclusive and accurate and that references to “dentist” be changed to “oral health care provider.”

My colleagues and I look forward to hearing about the steps your office is taking to correct these issues as we continue to work together to improve the health of our most vulnerable Canadian communities.


Melanie Bianco, RRDH
Aldershot Dental Hygiene
Burlington, Ontario

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