Many Canadians will pay much more at the dentist this year as provincial and territorial dental associations update their fee guides with significant – and in some cases record-high – average increases.
Three provincial associations reached by The Globe and Mail said a combination of decades-high inflation, higher staffing costs and other rising dental practice expenses such as rent, equipment, and infection control and prevention are driving average annual fee increases of 5 per cent to almost 10 per cent.
Quebec’s dental association, the Association des chirurgiens dentistes du Qubec (ACDQ), posted the highest average cost increase: 9.8 per cent. Associations in Ontario and Newfoundland and Labrador had average increases of 8.5 per cent, and the New Brunswick Dental Society’s fee guide increase was 7.57 per cent. The rest of the provinces had 5 to 6 per cent average increases, while territorial associations had no changes.
In comparison, fee guide increases were relatively modest from 2017 to 2021, ranging between 1 and 5 per cent per year. But last year increases jumped, ranging from 3.9 per cent in Alberta to 7.35 per cent in British Columbia.
Currently, a standard dental checkup in Canada costs between $150 and $300, depending on whether it involves getting X-rays and how much time is needed for cleaning. Fillings cost from $150 to $450 each.
Dental fee guides are reference documents put out annually by provincial and territorial associations, with suggested increases for all services and procedures, from a routine cleaning to fillings, tooth extractions, root canals and major dental surgery.
Cary Chan, senior manager of corporate communications and public affairs at the B.C. Dental Association (BCDA), said in an e-mail that it’s important to note that suggested increases are just that – suggestions. Dentists can decide whether to apply some or all of the increases based on the realities of their practices, he said, adding that “the majority of [B.C.] dentists do follow some or all sections of the suggested fee guide.”
The association’s average increase for this year is 5.99 per cent, down from 7.35 per cent in 2022, but slightly higher than the five years before that, when increases ranged between 3 and 4 per cent.
Ontario Dental Association president Brock Nicolucci, who runs a practice in London, Ont., noted that a fee guide’s average increase isn’t uniform across all dental services. Dr. Nicolucci said the ODA designed its guide to keep checkups and preventative services such as cleanings and fluoride treatments as affordable as possible and avoid creating financial barriers to basic care.
Increases for those services are lower than for restorative procedures and surgeries. The ODA’s 2023 fee hike follows four years of increases that ranged between 1.72 per cent and 4.75 per cent.
“We’ve strived to do that in our history to make sure people can seek minimal treatment and preventative services,” Dr. Nicolucci said. “If you don’t catch things when they’re small and they get bigger, it gets more costly.”
The ACDQ declined The Globe’s request for comment.
Dental associations generally combine information from dentists on the cost pressures they’re facing in their practices – such as rent and utilities, equipment and supplies – with inflation data, forecasts for Canadians’ dental needs and input from economists. Some associations weight the average increase based on how often each procedure is done in a typical practice.
“This information helps us come up with suggested fees that are meant to be fair to both patients and dentists,” said Amanda Barron, executive director of the Newfoundland and Labrador Dental Association, in an e-mail.
Mr. Chan said the BCDA’s 2023 increase reflects higher staffing costs that have been “exacerbated by a general shortage of dental staff. Employee salaries have climbed to levels not seen previously.” He said staff salaries represent about 50 per cent of overall costs in a dental practice, and non-labour costs have increased as well. The ODA and NLDA also cited staffing shortages.
Dr. Nicolucci of the ODA said costs related to infection prevention and control are now some of its members’ biggest expenses, owing to stricter regulation during the COVID-19 pandemic.
Canadians without employee benefits and who aren’t yet covered by the new federal dental benefit will be most affected by any cost increases. The Canada Dental Benefit launched in December, 2022, for children under age 12 whose parents don’t have private insurance, and is expanding by the end of this year to cover uninsured Canadians under 18, seniors with an annual household income of less than $90,000 and people with disabilities.
The final expansion of the program, to working-age Canadians with annual household incomes of less than $90,000, is expected to happen by 2025. Individuals in households with incomes over that threshold – including couples or families in which each adult makes just $45,000 – will be left out.
Dave Patriarche, president of Mainstay Insurance Brokerage Inc., an Ontario employee benefits brokerage that works with small and mid-sized businesses, says costs for employers are climbing because of fee guide increases and people who have benefits going to the dentist more frequently – such as for cleanings every six months, instead of every nine months or once a year.
On its website, Sun Life Canada says it uses data in the fee guides to determine maximum amounts it will reimburse for dental services under employee benefits plans.
For people concerned about higher dental prices, the NLDA’s Ms. Barron said they should “talk to [their] dentist about treatment and payment options. Your dentist is there to help you get the care you need, so don’t be afraid to ask.”
Mr. Patriarche said that, on a case-by-case basis, some dentists may offer modest discounts to self-employed clients, people without benefits or those whose annual benefits coverage is very low.
He also said people facing an expensive procedure or service should ask their dentist to submit a pretreatment form to their insurance provider so they know how much will be covered and how much they’ll be out of pocket.
It may also be worthwhile to compare different practices. The ODA notes on its website that fees for services can vary between dentists.
People whose annual dental coverage is low, or who have a big procedure coming up, should see if their benefits have an additional health care spending account, said Jennifer Hughes, financial associate at Caring for Clients in Toronto.
Ms. Hughes also stressed the importance of an emergency savings fund for people without private insurance, in the event they need to get expensive dental work done.