By Danielle 
As reports mount over high rejection rates and paperwork delays in the federal Canadian Dental Care Plan (CDCP), Health Canada says it is working to improve processing times and support dentists.
On July 6, Canadian Affairs reported that Lindy Vanamburg, director general of the Oral Health Branch at Health Canada, said 49 per cent of claims for complex dental care were denied between Nov. 1 and June 20, 2025. A week later, on July 13, CBC reported that 52 per cent of requests for pre-authorized dental work between November 2024 and June 2025 had been rejected. The questions in this Q&A were submitted to Health Canada prior to the publication of the CBC article.
In this Q&A, Health Canada responds to questions about approval rates, documentation gaps, and whether provinces have raised the alarm.
Q1. Health Canada says 49 per cent of preauthorization requests for complex care were denied. Can you break that down by procedure — for example, are crowns more likely to be denied than root canals or partial dentures?
This figure represents the percentage of denied requests for preauthorization, not for submitted claims. It’s important to note that, overall, only 1 per cent of claims submitted to the CDCP to date have been for services that require preauthorization.
The point in time average cited in the Canadian Affairs article includes: Requests with incomplete submissions, which continues to affect the denial rate, requests for services not eligible under the plan, and requests that are duplicates (e.g. may have been approved once but the subsequent ones will be denied) as well as those that are ready for full review and eligible under the plan. The approval rate varies daily or weekly depending on what is submitted.
Within the average there is also significant variation by procedure as you suggest – some that have fewer complete submissions, like crowns, or more complete submissions like partial dentures, or are exclusions from the plan (and so will always have a 100 per cent denial rate). In addition, rules vary for each clinical procedure so the approval/denial rates would be expected to vary as well.
Q2. What is the average processing time for a pre-authorization request? Has Health Canada set benchmarks or timelines for improvement?
As of the week ending July 11, over 80 per cent of preauthorizations are being processed within seven days.
We acknowledge that Sun Life has experienced a high volume of preauthorization requests since intake began in November. Health Canada sets out the rules for processing all CDCP claims, including requirements for how to adjudicate preauthorization requests. Several factors have contributed to longer than expected wait times, including an unexpectedly high volume of incomplete submissions and resubmissions, which require follow-up with providers and additional time to send and receive the information needed. Other factors include transit time for mailed in paper submissions.
Significant improvement has been seen since November when services requiring preauthorization became available. Health Canada and Sun Life continue to work to improve response time.
Read related article: The Canada Dental Care Plan: Missing pieces – A commentary on the national dental program
LISTEN: What Needs to Change for the CDCP to Work
Q3. Is Health Canada considering expanding automatic coverage to include certain urgent or routine complex procedures — like single-unit crowns on molars or front-tooth root canals — to reduce delays?
Standard root canal treatment on anterior teeth, bicuspids, and first and second molars do not require preauthorization under the CDCP.
Single-unit crowns are included in the CDCP but require preauthorization and must meet specific CDCP policy criteria.
The CDCP Dental Benefits Guide provides more information about the CDCP coverage, policies and rules. The CDCP Benefits Guide was developed by factoring in numerous considerations, including the advice of dental experts, the current oral health care context, research evidence, patterns of practices, industry trends and international comparisons, as well as comparability to and lessons learned in other longstanding federal, provincial, and territorial programs.
As part of a continuous improvement approach, the CDCP will be reviewed regularly based on data and evidence to ensure it continues to meet the needs of Canadians.
Q4. What are the most common documentation gaps that lead to incomplete submissions? Could you provide a checklist or guidance that dentists often miss?
The documentation required varies by the type of procedure (which is outlined in the CDCP Dental Benefits Guide). We have seen significant improvement in the number of complete submissions being received in recent months, but commonly missing documentation includes radiographs, periodontal charting information, and treatment plan details.
Health Canada has made tools available to help inform providers on submitting successful claims, including:
- additional checklists;
- tutorial videos to help support oral health providers in submitting a preauthorization; and
- updated narratives in the explanation of benefit statements for providers to clarify the details of the decision and, where applicable, documentation required if the submission was incomplete.
All of the preauthorization resources mentioned above are available on the Canadian Dental Care Plan provider webpage: Canadian Dental Care Plan providers: Preauthorization resources – Canada.ca
Q5. What kinds of internal discussions are taking place between Health Canada and Sun Life to streamline the authorization process?
Since the launch of the preauthorization in November 2024, Health Canada and Sun Life have and will continue to take steps to help streamline the process where possible and reduce processing times (for example, to streamline the number of adjudication steps). Health Canada has made changes to the Explanation of Benefits to include additional information on denied claims and has increased staffing.
Health Canada and Sun Life also worked together to inform oral health providers and offered tools (please see our response to Q4 for details) and information sessions to help providers learn about CDCP requirements prior to and after launch of preauthorization under the CDCP. There have been significant improvements in terms of oral health providers submitting all the needed documentation (which speeds up the review and eliminates the need for back and forth with Sun Life on a request), as well as in processing times.
Q6. Have any provinces raised concerns to your office about denial rates or patient care delays? If so, which provinces and what issues have they flagged?
No. Health Canada continues to engage regularly with provinces and territories about the implementation of the CDCP, the intersection of the CDCP with the provincial and territorial dental programs, and other items of common interest.
Q7. Are you tracking how many patients abandon treatment due to claim denials or delays? Can you share any early data or patient feedback?
Health Canada does not track this data.
Q8. Is there a correlation between claim rejection rates and provider dropout or hesitation to register? What does your data show about retention or onboarding of dental professionals?
As of May 23, 2025, over 25,600 providers are participating in the CDCP. Only 17 providers deregistered from the CDCP and have not submitted any claims since deregistering.
Q9. Budget 2023 outlined the Government of Canada’s plan to invest $13 billion over five years — including $4.4 billion ongoing — to implement the CDCP. Is the current spending on the CDCP tracking within these projections? Are there concerns about costs exceeding the planned investment?
Our costing and forecasting is robust. We are confident in our estimates and that the plan is sustainable.