The Dental Plan Worked. The Delivery System Now Needs to Catch Up.

From: Tarn Dhillon 

To: Healthcare and labour market policy decision-makers 

Date: September 23, 2026 

Re: The Dental Plan Worked. The Delivery System Now Needs to Catch Up. 

The Canadian Dental Care Plan has done what it set out to do. As of mid-2026, roughly 6.6 million Canadians have signed on and more than 4.3 million have used the benefit. Meanwhile, more than 19,000 oral health providers are on board. For a country where dental access has historically tracked income and employer benefits more closely than clinical need, that is a genuine policy achievement, and it deserves to be recognized as such. 

The harder question is what comes next. There are 6.6 million approved patients, while roughly a quarter of the eligible provider pool remains outside the plan. The constraint on access has shifted. It is no longer primarily financial. It is operational. 

A meaningful share of new CDCP patients are presenting for the first time in years. That produces a predictable clinical pattern: Not just routine cleanings, but conditions left to progress while care was unaffordable. Advanced decay, longstanding infection, deferred restorative work. 

This is precisely what would be expected if cost, not awareness, had been the barrier. It also means the demand entering the system is heavier per patient than steady-state demand. A backlog of deferred care does not enter a practice as an even flow of appointments. It arrives concentrated, and it consumes more chair time per patient than the schedule was built for. 

This tension is not a surprise. In a 2018 analysis for the C.D. Howe Institute, economists Åke Blomqvist and Frances Woolley examined gaps in access to dental care and argued that expanding public coverage would close equity gaps only if paired with sufficient delivery capacity. Coverage without capacity, they warned, risks reproducing access problems in a new form. 

The response of dental providers has varied. Some practices have simply extended wait times, which is the path of least resistance and the one most likely to reproduce the problem the CDCP was designed to solve. A patient fully covered but waiting 11 weeks for a preventive appointment is still, functionally, a patient without access. 

Others have restructured triage. At my practice, scheduling was reorganized in early 2026 to route new CDCP-eligible patients toward earlier preventive dental appointments rather than standard recall queues. The reasoning is straightforward: a newly covered patient who waits three months for a first appointment often returns with a more expensive problem than the one they originally called about. Front-loading prevention for that cohort reduces downstream restorative volume, which in turn frees capacity. 

Other groups have expanded delegated care, shifting preventive and hygiene work to dental hygienists and assistants operating at full scope, where provincial regulation permits it. 

The common thread is that practices absorbing CDCP volume successfully are treating capacity as something to be actively reallocated rather than a fixed constraint. But practice-level adaptation has limits. 

Although there are reasonable concerns around access as the system absorbs so many new patients, the appropriate response is not to question the expansion and objectives of the policy. Policymakers should finish the job. 

The following ideas should be top of the list: 

Measure dental wait times nationally. Canada tracks surgical wait times as a matter of routine. It does not track dental wait times at all. Without that data, policymakers cannot distinguish between regions where capacity is genuinely constrained and regions where provider participation is the binding issue. This is the least expensive intervention available and the prerequisite for targeting the others. 

Expand independent scope of practice for dental hygienists. Preventive care is where CDCP demand is concentrated and where delegated care is clinically appropriate. Several provinces still restrict independent hygienist practice in ways that constrain preventive visits. This is provincial regulatory territory, but federal-provincial coordination could accelerate it. 

Review fee schedule alignment. Provider participation is the plan's central dependency. Where CDCP reimbursement diverges meaningfully from provincial association guides, practices face a quiet incentive to cap CDCP volume. Monitoring participation rates against fee gaps by region would identify where that dynamic is developing before it becomes an access problem. 

The CDCP resolved the affordability barrier for millions of Canadians, and the enrollment numbers demonstrate that the demand was real and previously unmet. The productivity and health benefits of that expansion follow naturally from access itself. 

To fully realize those benefits delivery must adapt. Closing the remaining gap in preventive dental access will depend less on enrollment totals and more on whether capacity, measurement, and regulatory scope keep pace with the coverage that has already been achieved. 

Tarn Dhillon practices at Westgate Dental Centre in Richmond, BC, where his work focuses on preventive dental care and long-term patient health. He holds a Bachelor of Science in Biology and a Doctor of Dental Medicine from the University of British Columbia. 

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The views expressed here are those of the author. The C.D. Howe Institute does not take corporate positions on policy matters.