How our fees are set
We follow the Ontario Dental Association's suggested fee guide. The guide gives a suggested fee for each procedure, by its code, and it is revised each year. Using it means the fee for a given procedure here is the one most Ontario insurance plans are built around.
A few treatments include a lab fee too, since a dental lab makes the piece: a crown, a veneer or a nightguard, for example. The labs we work with are local, and their work is high quality.
Knowing the cost before we start
We want you to know the cost before we begin. After an examination we generally give you a written estimate listing each procedure and its fee. The estimate is usually sent to you, so you can go through it at home.
If there is more than one reasonable way to treat a problem, we usually set the options side by side so you can compare them. Treatment generally goes ahead once you have agreed to it.
If you have insurance
We bill your insurer directly, so you pay only the part your plan does not cover. For larger treatment we can send the estimate to your insurer first. This is called a predetermination, and the insurer replies with what it will pay.
It helps to know that what a plan pays is decided by the plan, not by us. These are the limits you will most often see:
- A percentage: many plans pay a different share for basic care than for major work such as crowns.
- A yearly maximum, after which you pay in full until the plan year resets.
- Frequency limits, such as how often a check-up or a set of x-rays is covered.
Why you may be asked to pay a difference
Our fees are the same for every patient. We charge the Ontario Dental Association's current suggested fee for each procedure whether you have a workplace plan, a government plan or no plan at all.
That includes students. We are a member of the Alumo dental network, so a student on a plan administered by Alumo starts from the same fee guide and is then given a set discount. Our student plans page explains it.
An insurer or a government program decides for itself what it will pay for that procedure, and its figure is sometimes lower than the current guide. When it is, the plan pays its amount and the remainder is yours. It comes up most often in three situations:
- Your plan reimburses on a previous year's fee guide.
- Your plan uses its own fee schedule, as the Canadian Dental Care Plan and some other government programs do.
- Your plan pays a percentage of the fee and not the whole of it.
The amount depends on the plan and on the procedure. It usually appears on your written estimate, so you can see it before you agree to treatment, and you are welcome to ask us to confirm it with your insurer first.
What decides the cost of a treatment
If your fee is different from a friend's for what sounds like the same treatment, there is usually a reason, because the work is different:
- Fillings: the number of surfaces of the tooth involved.
- Root canal treatment: the number of canals, which depends on which tooth it is.
- Crowns: the material, and whether the tooth needs building up first.
- Extractions: whether the tooth comes out simply or needs a surgical approach.
- Implants: how many, and whether bone grafting is needed first.
- Cleanings: the time needed, which depends on how much build-up there is.
If you do not have insurance
The fees are the same for you. You will receive the same written estimate, and your portion is due on the day of treatment. If you may qualify for the federal plan, please see our Canadian Dental Care Plan page.