The Canadian federal dental care program, which has recently expanded to cover the majority of uninsured Canadians, is facing pressure and criticism due to significant delays in approvals and unprecedented rejection rates.

According to data from the Canadian Ministry of Health, 52% of pre-approval requests submitted between November 2024 and June 2025 were rejected, despite most routine services not requiring prior approval.

Dr. Bruce Ward, a dentist in Vancouver and president of the Canadian Dental Association, said that doctors are facing unprecedented confusion:

“There is a lot of confusion for doctors who send the documents we usually send to private insurance companies, but they come back rejected… This is a much higher rejection rate than we expect with private plans.”

Ward pointed out that pre-approvals are usually required for expensive and complex procedures, such as crowns and partial dentures. In these cases, clinics must provide additional supporting documents, such as X-rays and dental charts, to prove medical necessity before treatment is completed.

He added:

“Many people have been waiting for a long time for crown installation approvals… There was a huge influx of pre-approval requests sent at once, causing a significant backlog at the insurance company.”

It is noted that Sun Life, contracted by the federal government to manage the program, is the entity responsible for receiving and processing claims and approvals.

Waiting weeks… and sometimes months

Ward said that some clinics wait weeks or even months for a response, only to be told afterward that additional documents are required, which adds to the confusion and prolongs treatment times for patients.

Despite these challenges, several dental care providers explained that the program has already provided an important opportunity for patients who previously could not afford care:

“Yes, there are problems, but they are slowly improving… This historic step allows many to receive treatment they could not afford before.”

Overview of the program

The government program, which costs several billion dollars, covers Canadians from families with incomes under $90,000 who do not have private dental insurance. Last June, the program expanded to include the age group 18 to 64, leading to a huge wave of treatment requests.

With the increasing workload, some clinics reported difficulties in meeting patient appointments and a rise in administrative burden, which prompted the Canadian Dental Association to call on the government for more resources and clarifications to speed up procedures.

Expected impact and gradual improvement

While the Ministry of Health indicates that the vast majority of claims face no issues, the challenge remains in handling the more complex procedures. Observers expect that it will take several more months to adjust the pace of transactions and achieve greater system stability.