The CDCP and data: You don’t improve it if you don’t measure it

Canada’s oral health system at a crossroads

In recent decades, Canada has taken significant steps to expand health coverage and reduce financial barriers to care for vulnerable populations. Yet, until very recently, oral health has remained largely siloed from broader health policy, leaving millions without reliable or affordable access to basic dental services. The rollout of care for eligible patients under the Canadian Dental Care Plan (CDCP) represents an unprecedented commitment to closing this historic gap, and an opportunity to embed oral health more firmly within Canada’s broader health equity goals.  

As of May 27, 2025, just over a year since its rollout, the CDCP has approved coverage for more than 4 million eligible Canadians, with approximately 50% (2,000,722) already having initiated care through a national network of more than 25,000 participating providers.¹ This milestone reflects a promising start for a program that aspires to eventually serve up to 9 million Canadians, many of whom have historically lacked consistent access to preventive and restorative dental services.¹ However, this early success conceals an uncomfortable truth: beyond these headlines of enrollment and participation figures, the program’s publicly available data remains minimal. Oral health professionals, researchers, policymakers, and even participating providers lack regular, transparent access to detailed information about who is being served, what care is being delivered, what gaps persist, and whether care is improving health outcomes over time. The initial cost analysis developed by the Office of the Parliamentary Budget Officer was based on an oral health survey done in 2007–2009.² There is need to gather data on the current oral health needs of Canadians to analyze program performance and oral health status of Canadians. 

The stakes of inaction

This absence of robust, accessible data is not a minor oversight; it is a fundamental threat to the CDCP’s sustainability and credibility. In a climate of persistent fiscal pressures and competing health spending priorities, governments are under increasing pressure to demonstrate tangible returns on investment for large-scale public programs. If the CDCP’s outcomes cannot be measured clearly and linked to improved health, cost savings, and equitable access, it risks becoming a target for piecemeal budget cuts and restrictive eligibility changes. Provinces have seen this pattern before in fragmented dental programs whose impact could not be demonstrated because data collection and analysis were treated as afterthoughts rather than core pillars of program design.^{3, 4}

Read related article: The Canada Dental Care Plan: Missing pieces – A commentary on the national dental program

Need for transparency is of utmost importance; more specifically, timely, credible, and actionable data that are shared transparently and used to drive continuous improvement can boost program performance while upholding public trust. Current utilization of the basket of services needs to be analyzed to assess its effectiveness in providing appropriate care and treating disease in the population covered under this program.^5,6

A living program demands a living evidence base

The CDCP is not a static benefit; it is a dynamic, evolving platform meant to adapt to the changing needs of its target populations which includes seniors, children, low-income families, and people living with disabilities. Each group brings unique risk factors, care needs, and access barriers that cannot be addressed by a one-size-fits-all design. Understanding these differences requires more than occasional national health surveys or broad population estimates. It demands routine, detailed analysis of claims data, patient characteristics, provider participation, care patterns, and outcomes.

International experience underscores this point. In the United States, routine analysis of dental claims data under Medicaid and private insurance plans has driven improvements in care quality, cost efficiency, and health equity. For example, one study demonstrated that standardized quality measures based on claims data can be used to monitor preventive care delivery among children with private dental insurance, highlighting gaps and variation that would not be visible without such data.⁷ Similarly, another found that combining claims and self-reported data provides a more complete picture of the true burden of oral disease and unmet need, enabling smarter targeting of limited resources.⁸ Moreover, well-documented studies have shown that targeted preventive interventions such as the provision of topical fluoride or dental sealants produce measurable cost savings by reducing future restorative treatment needs.^{9, 10} Other research demonstrated how tracking restorations in children and adolescents over time helps identify high-risk groups and target prevention efforts more effectively.¹¹ These approaches rely not on expensive new data systems but on intelligent use of claims data that already exist, the very kind the CDCP collects through its standard national claim forms.

Beyond cost: Data for better health and broader impact

While cost containment is crucial, the value of robust data extends far beyond fiscal stewardship. Dental care is increasingly understood as a key entry point for addressing broader health concerns, from the impact of periodontal disease on diabetes and cardiovascular conditions^12-15 to the benefits of early childhood caries prevention for lifelong health and social equity.^{14, 16} A modern dental care program must therefore serve not just as a payer of claims but as a producer of knowledge about how oral health intersects with other health and social outcomes.

Other countries illustrate what is possible when dental care data are treated as a public health asset. In the United Kingdom, the NHS Dental Statistics series provides regular, granular reporting on treatment volumes, patient demographics, preventive services, and regional variations—enabling policymakers and researchers to monitor access gaps and quality shortfalls in near real time.¹⁷ Australia’s Child Dental Benefits Schedule (CDBS) similarly integrates claims monitoring with national surveys to adjust eligibility rules, calibrate benefit levels, and strengthen outreach to underserved communities.¹⁸

Canada has the same opportunity but only if the CDCP’s data are collected, analyzed, and reported systematically and collaboratively.  Failure to do so will waste a historic investment, while a robust claims-based measurement system can make the CDCP a foundation for evidence-informed policy, targeted community interventions, and sustained improvements in population oral health.

Framework for action

The CDCP marks a historic commitment to improving access to dental care for millions of Canadians who have long faced financial, geographic, and systemic barriers to basic oral health services. While early enrollment numbers are encouraging, the plan’s success will ultimately depend on its ability to demonstrate measurable results: better oral health outcomes, fair access for all eligible groups, and value for public investment.

This paper proposes a practical, phased roadmap for strengthening the CDCP through robust, transparent use of data. The roadmap shows how routine, standardized measurement can support informed decisions, continuous improvement, and greater public trust in a large-scale dental benefit. In particular, proven approaches like the Dental Quality Alliance (DQA) in the U.S. demonstrate that standardized, claims-based quality measures can turn routine administrative data into powerful tools for tracking access, quality, prevention, and cost-effectiveness.^{19, 20} The CDCP is well positioned to follow a similar path, as its national claim form already collects detailed information on patient demographics, services delivered, provider characteristics, and costs, providing a foundation for evidence-based program management that goes far beyond what occasional national surveys alone can offer. To turn this potential into practice, the roadmap sets out three clear phases, each building on the previous stage to move from basic tracking to integrated, predictive insight that can inform national policy and local community action.

Phase One: Establishing a Baseline (Immediate Goals, Year One): The first step is to build a reliable, up-to-date picture of how the CDCP is working on the ground. This includes mapping:

• Who is delivering care (generalists, specialists, geographic distribution).
• Who is receiving care, broken down by priority groups; seniors, families with low incomes, Indigenous communities, newcomers, and people living with disabilities.
• Where gaps remain in provider availability and patient uptake.

A robust baseline will reveal whether the plan is reaching those who need it most and highlight communities that require targeted outreach or additional provider incentives.

Basic claims-based measures can immediately track the mix of preventive, diagnostic, and restorative services providing early signals about whether the plan is shifting care toward prevention, as intended.^{7, 9} These insights should be shared in clear, public-facing reports so that policymakers, providers, and the public see how the plan is performing and where improvements are needed.

Phase Two: Closing Gaps and Expanding Measures (Intermediate Goals, Year Two): Building on this baseline, the next phase focuses on using early data to refine plan design and expand quality monitoring. Priorities include:

• Analyzing differences in care patterns, such as treatment completion rates, referral pathways, and regional variation in service use.
• Identifying barriers faced by specific groups, like people with disabilities who may fall outside standard eligibility definitions or struggle to find accessible providers.
• Developing more advanced quality measures that link preventive interventions like sealants, fluoride varnish, caries risk management to changes in future treatment needs and costs.^{10, 11}

Insights from this phase should guide adjustments to benefits, risk-based care pathways, and provider supports. For example, better targeting of high-risk populations for early childhood caries interventions could reduce the need for costly surgical care later.^11,12 Transparent feedback loops between data and program design will help sustain provider engagement and public confidence.

Phase Three: Integrating and Innovating (Long-Term Goals, Year Three and Beyond): As the data framework matures, the CDCP can evolve from a stand-alone benefit to a national oral health improvement system. Linking claims data with other health and social datasets will reveal how oral health connects to broader determinants such as income, housing stability, and education.Longitudinal analysis can track patient outcomes over multiple years, supporting cost-effectiveness studies and predictive models that test how new policies or benefit changes could improve access and outcomes before they are implemented.

This final phase also supports local innovation. Many cities already use neighborhood-level mapping of health and social risk factors to guide community programs. Adding detailed CDCP data—such as untreated childhood caries rates by neighborhood—can enable targeted outreach, onsite screenings, and preventive treatments in schools and early childhood settings.⁹

Crucially, this broader view aligns the CDCP with Canada’s other national oral health initiatives, including the Oral Health Access Fund and the National Oral Health Research Strategy, to create a coordinated, evidence-based approach to tackling oral health inequities.

Conclusion

By following this practical, phased roadmap, the CDCP can deliver more than expanded coverage on paper. It can become a living, learning system—one that measures what matters, responds to real needs, and continuously evolves to deliver lasting improvements in oral health and health equity for millions of Canadians.

As other countries have shown, good data is not just a reporting requirement—it is the foundation for smarter care, stronger accountability, and greater trust in public investment.

References

1. Canada Government. Canada Dental Care Plan Summary Data  May 23, 2025. https://www.canada.ca/en/services/benefits/dental/dental-care-plan/statistics.html Government of Canada; 2025.
2. Sourang D, Worswick, A. Cost Estimate of a Federal Dental Care Program for Uninsured Canadians. In: Officer OotPB, editor; 2020. p. 1 – 20.
3. Abrams S.H., Did The CAHS Report, Improving Access to Oral Health Care for Vulnerable People Living in Canada, Really Address the Underlying Issues? Ontario Dentist 2014;91(10):18 – 19
4. McConnachie I. The Pediatric Dental Perspective on the CAHS Report Improving Access to Oral Health Care for Vulnerable People Living in Canada Ontario Dentist 2014;91(10):20 – 21
5. Abrams, S.H., McConnachie, I. Review of the Canadian Dental Care Plan Dental Benefits Guide Effective November 1, 2024 2024. p. 51.
6. McConnachie I, Abrams, S. H., . The Canada Dental Care Plan: Missing pieces – A commentary on the national dental program. OraL Health 2025;115(7):36 – 40
7. Choi SE, Kalenderian E, Normand SL. Measuring the quality of dental care among privately insured children in the United States. Health Serv Res 2022;57(1):137-44.
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9. Jackson HJ, Yepes JF, Scully AC, et al. Topical fluoride impact in future restorative dental procedures: A claim study. The Journal of the American Dental Association 2023;154(10):876-84.
10. Dasanayake AP, Li Y, Kirk K, Bronstein J, Childers NK. Restorative cost savings related to dental sealants in Alabama Medicaid children. Pediatr Dent 2003;25(6):572-6.
11. Hummel R, van der Sanden W, Bruers J, van der Heijden G. The relationship between claimed restorations and future restorations in children and adolescents: An observational follow-up study on risk categories for dental caries. PLOS ONE 2021;16(11):e0259495.
12. Chen ZY, Chiang CH, Huang CC, et al. The association of tooth scaling and decreased cardiovascular disease: a nationwide population-based study. Am J Med 2012;125(6):568-75.
13. Jeffcoat MK, Jeffcoat RL, Gladowski PA, Bramson JB, Blum JJ. Impact of periodontal therapy on general health: evidence from insurance data for five systemic conditions. Am J Prev Med 2014;47(2):166-74.
14. Beil H, Rozier RG, Preisser JS, Stearns SC, Lee JY. Effects of early dental office visits on dental caries experience. Am J Public Health 2014;104(10):1979-85.
15. Meurman JH, Bascones-Martinez A. Oral Infections and Systemic Health – More than Just Links to Cardiovascular Diseases. Oral Health Prev Dent 2021;19:441-48.
16. Ahmed I, McGivern S, Beymer MR, et al. Age of First Oral Health Examination and Dental Treatment Needs of Medicaid-Enrolled Children. JDR Clin Trans Res 2021:23800844211057793.
17. Brocklehurst PR, Price, J. Dental Public Health Intelligence – Time for Better Data. Community Dental Health 2013;30(3):147 – 48.
18. Health AIo, Welfare. Oral health and dental care in Australia. Canberra: Australian Institute for Health and Welfare; 2024.
19. Alliance DQ. User Guide for Adult Measures Calculated Using Administrative Claims Data In: Alliance DQ, editor. Dental Quality Measures https://www.ada.org/resources/research/dental-quality-alliance/dqa-dental-quality-measures: American Dental Association; 2025. p. 1 – 58
20. Alliance DQ. User Guide for Pediatric Measures Calculated Using Administrative Claims Data. In: Measures DQ, editor. https://www.ada.org/resources/research/dental-quality-alliance/dqa-dental-quality-measures 2025. p. 1 – 55.

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About the authors

Dr. Diptee Ojha is a dentist and a health services researcher. She is the Founder and Principal Consultant for Scientia Principle Consulting LLC. She previously served as the Director of the Dental Quality Alliance.

Dr. Ian McConnachie is a retired pediatric dentist with an ongoing career of involvement at the local, provincial and national levels in multiple dental organizations.

Dr. Stephen Abrams is a GP dentist. He also does research on caries detection and management. He works with the dental associations on access to care and the CDCP.