CDCH Canadian Dental Care Plan | Heritage Dental Hygiene

Canadian Dental Care Plan CDCP

At Heritage Dental Hygiene, we are proud to participate in the Canadian Dental Care Program (CDCP) and welcome eligible clients into our practice.

We believe every Canadian deserves access to oral health care, and we are here to help you understand how this program works and what it means for your dental hygiene care.

How to Apply

You can apply for the CDCP through your Service Canada portal. For step-by-step instructions, visit the Government of Canada’s CDCP application page.

Who Oversees the Program?

The CDCP is administered by Sun Life Financial.

Benefit Year

Coverage runs from July 1 – June 30. You must reapply each year, as eligibility is based on household income.

What’s Covered?

The CDCP provides coverage for a range of services. For dental hygiene, the program mostly allows for one preventive appointment per year, under its fee schedule.

At Heritage Dental Hygiene, this appointment includes an oral health exam, cleaning, polish and desensitizing fluoride.

What to Expect at Your Oral Health Exam

We complete a series of screenings and tests designed to give you a clear picture of your oral health and to support any claims made under the CDCP:

Intra- and Extraoral Screening – we check both the inside of your mouth and the external tissues (like lips, cheeks, and neck) for any areas of concern.
Oral Cancer Screening – a careful look at soft tissues to check for early changes.
Biofilm Disclosure Test – highlights where bacteria are collecting so we can guide you on prevention.
Bleeding Test - demonstrates if oral inflammation is present in your mouth
pH Testing – helps us understand cavity risk by checking acid levels in your mouth.
Gingivitis & Periodontal Screening – checks for signs of gum inflammation and disease.
Cavity Risk Screening – helps us identify areas that may need referral to your dentist.
Digital Photography & Record Collection – we take clinical photos to keep a visual record of your oral health. These records are often required by CDCP when submitting a predetermination request for additional hygiene therapy visits.

Why We Collect This Information

We know some clients wonder: “Why do you need photos or records of my mouth?” Here’s why:

The CDCP requires records (like photos or clinical notes) when we request approval for additional treatment beyond the one visit per year.
These records support your claim and help Sun Life (the CDCP administrator) understand why more treatment is recommended.
Collecting them ensures your file is complete if you want us to submit for extra coverage.

Without this information, your claim for additional treatment may be denied. That’s why we ask for your cooperation in allowing us to collect the full set of recommended records.

Why We Collect This Information

The CDCP currently provides coverage for one dental hygiene visit per year.

However, research shows that 85% of Canadians have some form of gingivitis or periodontal disease. For most people, one visit per year is not enough to stabilize gum inflammation or control periodontal disease.

To properly manage these conditions, we may recommend 3–4 visits per year.

First visit each year – billed at the CDCP fee schedule.
Additional visits (if recommended) – billed according to our ODHA fee guide, as these are not covered by the CDCP.

With your records we can request to predetermination for more coverage under the program, but at this time, about 54% of these requests are being denied.

If you choose to only attend the one visit covered under CDCP and decline further recommended care, we will kindly ask you to sign a form acknowledging that choice. This ensures you understand that without the recommended visits, gum disease and inflammation may progress, and we cannot be held responsible for that progression.

Preauthorization for Additional Hygiene Therapy

The CDCP allows us to submit a preauthorization request to Sun Life to see if extra visits will be covered.

To do this, we are required to provide detailed documentation on your behalf, which may include:

A completed claim form with treatment details.
Digital records such as intra- and extraoral photos.
Radiographs (X-rays) taken within the last 12 months (if available).
A complete periodontal chart with gum measurements.
Supporting notes about medical conditions or risk factors that influence gum disease.

What This Means for You

Submitting a preauthorization is not as simple as “sending in a form.”

Our dental hygiene and administrative team must spend up to 40 minutes gathering, reviewing, and submitting all the required documentation.

This is significant administration time for a small practice, and unfortunately, there is no reimbursement for this effort.

We are happy to help submit requests on your behalf, but we want to be transparent that:

Not all requests are approved. Current statistics show about 54% are denied.
Approval depends heavily on the completeness of your records. This is why we strongly recommend you complete your health form and allow us to collect photos and full charting at your visit.
If you prefer not to have records collected, please note that it will limit our ability to submit for additional coverage.

✨ Our promise: We will always give you the option to pursue preauthorization, but we will also be honest about the time, effort, and approval rate involved. If your additional care is not approved, you are welcome to proceed with treatment under our regular ODHA fee guide.

Claims Processing & Billing at Heritage Dental Hygiene

Here’s how the CDCP works at our office:

Direct Billing: We submit all CDCP claims directly to Sun Life on your behalf. Patients cannot submit their own claims for reimbursement.
Coverage Confirmation: Before your visit, we confirm what services are covered under your CDCP plan.
Transparency: We will always explain which services are covered, which are not, and whether any portion is your responsibility before proceeding with care.
Privacy & Protection: All information collected is used only to support your treatment and claim submission, in line with Canadian privacy legislation.

Our Commitment to You

At Heritage Dental Hygiene, our goal is to make your CDCP experience easy, transparent, and stress-free. We believe in prevention, education, and personalized care, and we are committed to guiding you beyond the minimum coverage so you can enjoy lasting oral and overall health.

✨ New clients are always welcome, and we look forward to supporting you on your journey to better oral health.