Are Dental Fees Too High in Canada?

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When people find out that I’m a dentist, they often ask me: why is dental work so expensive? Why is it so much cheaper to get a dental implant in Mexico?

As a person without dental benefits, I totally agree that dental treatment might be too expensive for some people that don’t have a dental benefits plan of some sort.

Let’s look at the cost of some dental treatments in Alberta as an example. Typically, if you’re taking good care of your teeth and have no issues, you would need to go the dentist’s at least twice a year:

  1. First Visit: a recall exam, X-rays  and a cleaning (cost is about C$ 300-350)
  2. Second visit (6 months later): a cleaning only (cost is about C$ 200-250)

The total is about C$ 500-600 for two hours time.If you happen to have a couple of cavities, that would typically take an hour and cost about C$ 400. This means that the clinic hourly rate is about C$ 300. This is actually how much you would pay ANY professional such as a lawyer, accountant, etc. per hour. In fact, a plumber or electrician would charge you that much for a job that takes under 30 minutes. Not to mention that cleaning your teeth or filling cavities is much more demanding physically and mentally for the dentist than punching in numbers into a computer.

It is true that there are some procedures that cost over a thousand dollars such as:

  1. Molar root canal: C$ 1000-15000
  2. Crown: C$ 1200-1500
  3. Implant with crown: C$ 4000-5000

However, those procedures take more time and skill.

To answer the Mexico questions, the cost of running a dental office in Alberta is definitely a lot higher than running a practice in Mexico due to:

  1. Much tougher regulations from Alberta Health and the provincial regulatory body.
  2. Higher cost of human resources: a dental assistant for example averages C$25 per hour in Alberta.
  3. Higher rent especially in high exposure retail locations: at least C$40 per sqft.
  4. Higher cost of equipment and materials.
  5. Higher cost of construction to begin with. In Alberta, leasehold improvements average C$ 150-250 per sqft.

There are a few entrepreneurial and investing dentists that are rich. However, the vast majority of dentists are in the middle class of society.

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Foreign-trained Dentists in Canada

 

Up until 2010, a dentist would have to graduate from a Canadian or US dental school to be eligible for licensure in Canada.

Graduates of dental schools outside North America had to go through an advanced standing or qualifying program at an accredited North American dental school. This literally involved re-doing the last 2-3 years of dental school with regular dental students and graduating with a DMD or DDS degree.

Getting accepted at those qualifying or advanced standing programs was very competitive as there were only 70-80 spots across Canada. In order to get in, successful candidate would have to perform better than other candidates in all these competencies:
1. GPA earned in dental school in their home country
2. ACFD exam: a written exam on fundamental knowledge of dentistry
3. Interview by dental school teaching staff
4. Assessment of clinical skills: various clinical excersises on typodonts and manikins.

Successful foreign trained dentists who were accepted had to apply for loans and bank lines of credit in order to pay tuition and other expenses which were comparable to what a regular dental student would pay. A dentist in North America typically graduates with about 100-300 thousand dollars of debt.

In 2011, the government started:

  • Reciprocal accreditation of dental schools in Australia, New Zealand, and Ireland (2012).
  • Launched the Foreign trained dentists FTDs equivalency process.

The Equivalency process for FTDs consist of a set of three exams:
Part 1: Fundamental knowledge written exam
Part 2: Clinical judgement written exam
Part 3: A clinical assessment exam: excersises on typodonts and manikins

The exams cost less than ten thousand dollars, don’t involve a real patient, don’t test all clinical skills, and can be passed within one or two years. Applicants don’t have to be a Canadian citizen or permanent resident to write them. In fact, dentistry is on the express entry for immigration to Canada.

The number of successful FTDs has skyrocketed in the last few years. When the program first launched in 2011 only 44 candidates passed. In 2014, the number was over 260, which is equivalent to the graduates of 6 typical Canadian dental schools.

 

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