Canadian Dental Plan – RCSD – Frequently Asked Questions About Dental Crowns and Cast Partial Dentures

Article written by Dr. Dan Munteanu, DMD

Are dental crowns covered by the Canadian dental plan?

Yes, 4 crowns per period of 10 years are covered with pre-authorization for 18 years and older. However there are many conditions that need to be met in order for it to be approved.

First, basic treatments need to be done meaning there must not be any decay or gum disease present. If the tooth had an infection, it must be healed before the pre-authorization is done. Furthermore the tooth needs to be damaged or weak enough that a filling won’t be able to be used instead and not too damaged that a crown won’t last. To be more specific, for a regular tooth that still has its nerve all surfaces of the tooth need to be absent but the tooth still needs to have a strong base outside of the bone for a crown to be able to last and good bone support. For a tooth that lost its vitality and has a root canal done, the criteria is a bit less stringent and the absence of three continuous surfaces of the tooth is sufficient for admissibility.

Finally, if the tooth is too damaged outside of the bone and would require additional treatments to pull it a bit outside of the bone (orthodontics) or cut the bone a bit around it to create enough retention for a crown, it is not eligible for a crown. If you are unsure of your situation, our dentists are highly trained on the inside outs of the Canadian dental plan and will be happy to guide you.

Does the Canadian dental plan cover Crowns for Cracked teeth syndrome or worn teeth?

This condition is where a tooth has a small crack which causes pain on chewing. Generally speaking the plan does not cover this condition if the only symptom is sensitivity. It also does not cover crowns for worn teeth. Furthermore it does not cover night guards to control bruxism and clenching during the night which are the initial causes of this problem. That said, if your dentist documents and presents his case that the reason for treatment is not solely to treat sensitivity but for other reasons the plan might be approved.

These cases need to be well documented and presented with a lot of information including pictures to evaluators. An experienced dentist that knows the limits of the plan will be helpful in these cases.

Does the Canadian dental plan cover replacing my old crowns?

The plan covers repairing old crowns using restorative materials. Your dentist does not need authorization for that. However, to replace the crown, the tooth underneath needs to correspond to the eligibility of a crown. In other words it needs to be quite destroyed. Also, keep in mind that if you had a dental bridge, the plan will not cover the replacement but might cover the replacement of the bridge pillar elements with regular crowns if these meet the criteria.

Does the Canadian dental plan cover crowns on implants?

No, without any exceptions.

Why is my crown pre-approval with the Canadian dental plan taking so long?

The RCSD plan, even though it is managed by a private insurer (Sunlife) has much more stringent requirements and demands a lot of information from the dentist in order to approve it. Initially plans that were sent required more information from the dentist. To remedy this we have created protocols at Centre Dentaire Blanc to send all the possible information required from the beginning to the insurance so the process is accelerated and you can have your treatment sooner.

Are partial dentures covered by the Canadian dental plan?

Yes. Partial dentures are the way to replace teeth through the Canadian dental plan because dental bridges and dental implants are not covered.

However, basic treatment needs to be done before such as control of your caries and gum disease.

Finally, you must have at least one tooth missing to replace in front OR 2 teeth missing in the back on the same side not counting the second and third molars. If the space has closed partially in time it will not be counted as a missing tooth.

What types of partial dentures are covered by the Canadian dental plan?

Partial dentures are traditionally made in Cr-Co alloy. However, metal free options exist and are made in PEEK or Titanium. These dentures are covered by the plan however might have higher laboratory fees and you might be required to pay the difference in cost.

Partials can be also held in place by dental implants or more advanced attachments called precision attachments that hold on to crowned teeth. These add-ons will not be covered by the Canadian dental plan but a basic partial could be fabricated that could eventually be upgraded with implants.