CDCP Coverage in 2026: What the Canadian Dental Care Plan Covers and What You May Pay

The Canadian Dental Care Plan (CDCP) is the federal dental program for Canadian residents who do not have access to private dental insurance and whose adjusted family net income is under $90,000. It is a real help for many families and seniors, but “covered” does not always mean “free”. What you pay depends on your income band, the services you need, the plan’s own fee schedule and the rules the plan sets for each procedure.

This guide summarizes the rules published by the Government of Canada, including the CDCP Dental Benefits Guide that took effect on April 1, 2026. Program details change, so treat it as an orientation and confirm your own coverage before treatment.

Who qualifies for the CDCP?

According to the Government of Canada, you must meet all four requirements:

• No access to dental insurance. This includes coverage through your job, a pension plan, a family member’s plan, a professional or student organization, or a policy you bought. Having access counts even if you never use it.
• Tax returns filed. You, and your spouse or common-law partner if you have one, must have filed a Canadian tax return for the previous year.
• Income under $90,000. Your adjusted family net income must be below $90,000.
• Canadian residency. You and your partner must be residents of Canada for tax purposes.

Coverage through a provincial or territorial social program does not automatically rule you out, because the programs can coordinate. You must also confirm your eligibility every year, so a family that qualified last year should not assume it still does.

How much will you pay? The co-payment bands

The CDCP pays a percentage of its own established fee for each covered service. The percentage depends on your adjusted family net income:

Two details matter here. First, the percentages apply to the CDCP fee, not to the clinic’s usual fee. Second, a dental office can charge more than the CDCP fee. When it does, the difference may be billed to you, on top of any co-payment. The government’s own factsheet of co-payment and additional-charge examples is worth reading before a larger treatment.

A simple example

Say a filling has a CDCP fee of $100 and the clinic’s fee is $120. If your income is under $70,000, CDCP pays $100 and you may owe the $20 difference. If your income is between $70,000 and $79,999, CDCP pays $60, your co-payment is $40, and you may also owe the $20 difference. The numbers are invented to show the arithmetic. Real fees vary by procedure and province.

What does the CDCP cover?

The coverage page groups covered care into these categories, when an oral-health provider recommends it:

• Diagnostic and preventive: exams, X-rays, scaling (cleaning), polishing, fluoride and sealants
• Basic: fillings, root canal treatment and periodontal (gum) treatment
• Major: some crowns, removable dentures and oral surgery such as extractions
• Anesthesia and sedation, with conditions

Orthodontic services are listed as currently not available.

Frequency limits

Every service has a limit, measured over rolling periods rather than a calendar year. Some limits from the April 2026 guide:

• Exams: up to 3 exams in any 12 months, including 1 recall exam in 12 months and 1 complete exam in 60 months. Emergency exams have no frequency limit.
• X-rays: up to 8 small intraoral images in 12 months; a complete series or a panoramic image once in 60 months.
• Cleaning (scaling): ages 17 and over can have up to 4 units of scaling, combined with root planing, in any 12 months. Ages 12 to 16 have 1 unit and ages 0 to 11 half a unit. Polishing is half a unit in 12 months at all ages.
• Fluoride: once in 6 months for children and teens, once in 12 months for adults.
• Crowns: 4 in any 10 years per person and 1 in any 8 years per tooth.
• Dentures: a standard complete denture or cast partial denture once per arch in 8 years; an acrylic partial denture once per arch in 5 years; relines once in 2 years.

A “unit” of scaling is a block of clinical time, not a visit. Someone with healthy gums may use one or two units a year, while someone with gum disease may need more than the plan allows. If your hygienist recommends care beyond the limit, ask whether preauthorization is possible or what the extra time would cost.

Which services need preauthorization?

Preauthorization means your dental office sends the plan a treatment request with supporting records, such as X-rays, and waits for approval before treatment. The coverage page lists these services as needing it:

• Crowns, and the posts and cores that support them
• Partial dentures, and immediate or overdentures
• Root canal re-treatment
• Bonding for loose teeth and post-surgical evaluations
• Conscious sedation, deep sedation or general anesthesia
• Any service beyond its frequency limit

Most approvals are valid for up to 12 months, and some preventive and gum-care approvals for up to 24 months. You must still be eligible on the day of treatment. Approval is not automatic: requests are reviewed against clinical criteria, and some are declined.

In practice, preauthorization adds time. If you need a crown on a cracked tooth, your dentist may protect the tooth first and complete the crown once the plan responds.

What is not covered?

The benefits guide lists exclusions. Some of the most common ones patients ask about:

• Dental implants and all implant-related procedures
• Bridges and other fixed prosthodontics
• Veneers, three-quarter crowns, and ceramic or composite inlays and onlays
• Teeth whitening and other cosmetic treatment
• Mouth guards and night guards
• Bone grafts, crown lengthening and jaw joint (TMJ) therapy
• Orthodontics, which is currently not available

You can still choose an excluded treatment, but you pay its full cost. Agree on the cost in writing before treatment, so there are no surprises.

How billing works

CDCP is administered by Sun Life. Participating providers bill the plan directly, and a member cannot submit a claim for reimbursement. If an office asks you to pay the full bill and “claim it later”, that will not work under CDCP. You pay only your co-payment, any difference between the clinic’s fee and the CDCP fee, and the cost of anything not covered.

Offices can check your coverage before treatment with an electronic estimate or through Sun Life’s provider tools. Asking for that estimate is the easiest way to see your real out-of-pocket cost.

Questions to ask before treatment

Ask the dental office:

1. Can you see me under CDCP, and will you bill the plan directly?
2. Is my coverage active today, and what is my co-payment level?
3. For each recommended procedure, what is the clinic’s fee and what will CDCP pay?
4. Does any part of the plan need preauthorization, and how long will that take?
5. Is anything recommended outside CDCP coverage, and what are the alternatives?

Our article on what to bring to a CDCP dental appointment has a checklist for the visit itself.

Covered care is not the same as the right care

The plan decides what it will pay for. Your dentist’s job is to explain what your mouth needs. Sometimes those match. Sometimes the best option for a tooth, such as a bridge or an implant, is outside the plan, or the plan’s limits are lower than your gum health needs. A good treatment discussion covers the clinical options, what the plan pays for each, and what happens if you wait. You can then choose with the full picture.

CDCP at Regal Heights Dental Centre

Our Canadian Dental Care Plan page explains how CDCP estimates, co-payments and appointments work at our St. Clair West office. Program participation and rules can change, so please contact our team to confirm that we can see you under CDCP before you book, and bring your member details to the visit.