Dentist
A dentist is a licensed healthcare professional who diagnoses, treats, and helps prevent conditions affecting the teeth, gums, and mouth. Dentists play a key role in maintaining oral health through preventive care, restorative treatments, and patient education. Common services include cleanings, fillings, crowns, root canals, extractions, and oral examinations.
In the context of dental insurance, only services performed by a licensed dentist or an approved dental specialist are eligible for reimbursement. Insurance plans typically require that the dentist be licensed in the province or territory where treatment is provided and follow the provincial dental fee guide when billing. Dentists may also refer patients to specialists such as orthodontists, endodontists, periodontists, or oral surgeons for more complex procedures.
Regular dental care provided by licensed professionals helps prevent more serious health problems and ensures that claims are processed smoothly under your insurance plan.
Example:
If you visit a licensed dentist for a filling that costs $250, and your plan covers 80 percent for basic restorative services, your insurer reimburses $200 and you pay $50.
What to Watch For:
Confirm that your dentist is licensed and in good standing with the provincial dental association. Some plans require that the dentist use specific claim forms or electronic systems for direct billing. If you receive treatment outside of Canada, coverage may depend on whether the dentist’s qualifications meet your insurer’s standards.
