Does the CDCP Cover Crowns, Dentures & Oral Surgery in Brampton?
Yes, under the Canadian Dental Care Plan’s Major Services category, crowns and dentures and oral surgery are covered for eligible patients – as long as the treatment is medically necessary and preauthorized before your appointment.
A small cavity may need a filling. But what happens when a tooth is badly cracked, several teeth are missing, or an infection requires surgery? That is where the Canadian Dental Care Plan’s major services may help.
The CDCP covers several forms of major restorative care, removable dentures and oral surgery when the service meets the plan’s rules. Some treatments require preauthorization before the plan will confirm coverage. Others do not. The details matter, especially when you are trying to understand what will be covered and what you may need to pay.
This is the third article in our CDCP series from Keshavarz Dental Clinic in Brampton. If you are new to the program, begin with our guide to getting approved for the CDCP in Brampton, then read our overview of the basic dental services covered by the Canadian Dental Care Plan. This article explains the more involved treatments patients often ask us about.
What Does the CDCP Consider a Major Dental Service?
The Government of Canada organizes eligible dental care into service categories. For this article, the main major dental service categories are:
• Major restorative services, including eligible crowns, cores, posts and crown repairs
• Removable prosthodontic services, including complete and partial dentures, repairs, relines and rebases
• Oral surgery, including eligible extractions and certain procedures involving infections, cysts, tumours or jaw injuries.
Coverage is not automatic simply because a treatment is recommended. The service must meet CDCP clinical criteria, frequency limits and documentation rules. Your coverage must also be active on the date of treatment.
One Important Detail: Preauthorization
Preauthorization means Sun Life reviews a proposed service before dental treatment and confirms whether it qualifies for CDCP coverage. It does not decide whether the treatment is right for you. That clinical decision remains between you and your dentist.
Crowns, many posts and cores, partial dentures, over-dentures and certain other services require preauthorization. Some complete dentures and other eligible procedures may not. Requirements can also vary by procedure code and clinical situation, which is why a personal assessment matters.
Major Restorative Services: Crowns, Posts and Cores
When too much healthy tooth structure has been lost, a filling may no longer be strong enough. Major restorative treatment is designed to rebuild or protect the tooth so you can chew more comfortably and reduce the risk of further damage.
Dental Crowns
A dental crown covers the visible portion of a damaged tooth. It can restore the tooth’s shape, strength and function after a large fracture, extensive decay or another clinically significant problem.
The CDCP may cover an eligible single-unit crown for patients age 18 and older when the tooth and surrounding tissues meet the plan’s clinical requirements. Crowns used only to improve appearance are not covered. Preauthorization is required, and approval is not guaranteed.
The current CDCP frequency limits are:
• Up to four crowns in any 120-month period per patient
• One crown on the same eligible tooth in any 96-month period
Those limits are important, but they are not the whole story. Sun Life also reviews the condition of the tooth, existing disease, supporting bone and other clinical details before confirming coverage.
Cores, Posts and Crown Repairs
A badly damaged tooth may need a core buildup to replace missing structure beneath a crown. In some cases, a post is placed inside a root-canal-treated tooth to help support that core.
The CDCP includes eligible cores, posts and post removal. Some require preauthorization, while a prefabricated post without a core may not. The plan also includes certain repairs to crowns and rebonding or recementation of crowns and posts, subject to its limits.
That matters because a loose crown does not always need to be replaced. Sometimes, repairing or recementing it is the more conservative option. We examine the tooth first, explain what we find and recommend the approach that best protects your oral health.
Dentures Covered by the CDCP
Missing teeth can change how you eat, speak and smile. They may also place extra stress on the teeth that remain. Removable dentures can replace several teeth or a complete arch, depending on your needs.
Complete Dentures
The CDCP covers eligible complete dentures, including standard and temporary options. Transitional or provisional complete dentures and complete immediate dentures generally do not require preauthorization. Immediate overdentures do require it.
An immediate denture is inserted shortly after teeth are removed, helping you avoid going without teeth during the first stage of healing. Because the shape of your gums changes as they heal, follow-up adjustments may be needed.
Partial Dentures
A partial denture replaces some missing teeth while using the remaining teeth and oral tissues for support. Initial placement of eligible partial cast or acrylic dentures requires preauthorization.
The CDCP also covers certain services that help maintain the fit and function of dentures, including:
• Denture repairs
• Relines, which reshape the inside surface of a denture
• Rebases, which replace the denture base while keeping the existing teeth
• Tissue-conditioning liners used to improve comfort while irritated tissue heals.
Dentures are not a “set it and forget it” appliance. Your mouth changes over time. If a denture begins to move, pinch or make chewing difficult, have it checked rather than trying to live with the problem.
Oral Surgery Covered by the CDCP
Some dental conditions cannot be treated with a filling, crown or denture alone. The CDCP covers a range of eligible oral surgery services, subject to the plan’s criteria and limits.
Removal of Teeth and Roots
Coverage may include routine or surgical removal of teeth and roots, including eligible wisdom tooth extractions. The exact service depends on the position of the tooth, the surrounding bone, symptoms and other clinical findings.
If you have ongoing pain, swelling or signs of infection, contact a dental office promptly. Waiting can allow a manageable problem to become more complicated.
Cysts, Tumours, Infections and Jaw Injuries
Eligible oral surgery services may also include:
• Surgical removal of certain cysts or tumours in the mouth or jaw
• Incision and drainage of eligible dental infections
• Treatment related to fractures of the jaw
These conditions require careful diagnosis. Depending on what a dental examination or checkup and imaging show, your dentist may treat the problem or refer you to an oral and maxillofacial surgeon.
How CDCP Preauthorization Works at Our Brampton Dental Clinic
You should not have to decode government benefits language while dealing with a sore tooth. When preauthorization is required, our dental team helps you organise the clinical information and explains what happens in five easy steps:
1. Assessment: Your dentist examines your mouth, discusses your symptoms and takes the necessary X-rays or other records.
2. Treatment plan: We review your options, including the benefits, limits, likely costs and reasonable alternatives.
3. Submission: Our dental team sends the required treatment plan, images and clinical notes to Sun Life.
4. Coverage decision: Sun Life reviews the request against CDCP criteria and confirms whether the proposed service is eligible for coverage.
5. Scheduling and billing: After the decision arrives, we review it with you, schedule approved care and submit eligible charges directly to the CDCP.
We will explain your estimated out-of-pocket cost before treatment. Depending on your adjusted family net income, the CDCP may require a co-payment of 0%, 40% or 60% of the CDCP fee. You may also owe the difference if a dental office’s fee is higher than the amount covered by the CDCP. We will help you determine a clear estimate which helps keep surprises out of the treatment room, where they are rarely welcome.
CDCP Major Services ( Crowns, Dentures & Oral Surgery) FAQs
These answers reflect current federal guidance. The Ontario Dental Association’s CDCP resource is another helpful place for patients to learn more.
Are dental crowns covered under the CDCP?
Yes. The CDCP may cover eligible single-unit crowns for patients age 18 and older when they are medically necessary and meet the plan’s clinical criteria. Crowns require preauthorization and are not covered for cosmetic reasons alone.
How many crowns does the CDCP cover?
The CDCP currently limits coverage to four crowns in any 120 months per patient and one crown on the same eligible tooth in any 96 months. Approval still depends on clinical eligibility and preauthorization.
Does the CDCP cover dentures and denture repairs?
Yes. The CDCP covers eligible complete and partial dentures, along with certain repairs, relines, rebases and tissue-conditioning liners. Partial dentures and some overdentures require preauthorization. Some complete dentures do not.
What oral surgery procedures does the CDCP cover?
Eligible services may include tooth and root removal, surgical treatment of certain cysts or tumours, incision and drainage of infections, and care related to jaw fractures. Coverage depends on the procedure, clinical findings and CDCP rules.
What does preauthorization mean under the CDCP?
Preauthorization means Sun Life must review a proposed service and confirm that it meets CDCP coverage criteria before treatment begins. Your dental clinic submits the required records on your behalf. A preauthorization decision confirms coverage, not whether a treatment is clinically appropriate.
Will I have to pay for major dental services under the CDCP?
Your share depends on your adjusted family net income, the CDCP fee for the service and the dental office’s fee. Even patients with a 0% CDCP co-payment may have an additional amount to pay if the clinic’s fee is higher than the CDCP amount. Ask for an estimate before treatment.
How long does CDCP preauthorization take?
Processing time can vary based on the service and whether Sun Life needs more information. Our dental clinic submits a complete file to help prevent avoidable delays, but it cannot guarantee the review timeline or approval.
Ready to Book Your CDCP Dental Service in Brampton?
If you have been putting off a crown, dentures or an emergency dental service because the cost felt uncertain, let’s start with a conversation. We accept new CDCP patients in Brampton and nearby areas. Our team can assess your needs, explain your treatment choices, submit required paperwork and review expected costs with you before care begins.
Visit Keshavarz Dentistry at 40 Finchgate Blvd., Suite 121, Brampton, ON. Call (905) 791-3867 or schedule an appointment online. We will help you understand the next step, without the jargon or last-minute surprises.
