Ontario (ON)
Ontario Health Coverage
Dental Care

Dental In Hospital

The following procedures are covered if they are performed in an operating room by a dental surgeon appointed to the dental staff of the hospital:

1. impacted teeth extracted from two or more quadrants of the mouth if the patient is medically at risk;
   • alveoplasty and gingivoplasty
   • sulcus deepening, ridge extension and management of hypertrophic and hyperplastic tissues;
2. multiple surgical exposure of impacted teeth when two or more quadrants of the mouth are involved if the patient is medically at risk;
   • treatment of traumatic injuries to soft tissues within the mouth
   • incision and drainage of abscess of dental origin
   • closed reduction of fractures of mandible and maxilla
   • surgical management of intra-osseous cyst larger than 1.5 cm
   • excision of intraoral tumors larger than 1.5 cm
   • removal of root or foreign body from maxillary antrum
   • repair and closure of antro-oral fistula
   • closed reduction of tempro-mandibular dislocation
   • sialolithotomy
   • excision of ranula, larger than 1.5 cm
   • open reduction of fractures of the maxilla or mandibles
   • surgical correction of prognathism or micrognathism
   • condylectomy
   • therapeutic or diagnostic alcohol nerve block
   • avulsion of nerve (mental, infraorbital or inferior dental)
   • open reduction of tempro-mandibular dislocation
   • mandibulectomy
   • maxillectomy
   • cleft lip repair
   • neural surgery
   • T.M.J. dysfunctions
   • General Anesthetic for covered and prior approved dental surgery
3. the following procedures are also covered if they are performed in conjunction with at least one of the preceding list of covered procedures:
   • exposure of tooth for orthodontic treatment
   • frenectomy
   • surgical management of intraosseous cyst smaller than or equal to 1.5 cm
   • intra-oral biopsy
   • excision of intro-oral tumors smaller than or equal to 1.5 cm in diameter
4. benefits are not provided for surgical removal of teeth unless there are medical complications. It is a condition for the performance and payment of this insured service that:
   • hospitalization is certified as medically necessary and there is prior approval by the plan
5. General Anaesthetic used in conjunction with non-approved surgical extractions or surgical exposure of unerupted teeth will not be payable under the Provincial Plan

Dental Out of Hospital

No coverage is provided .

Cleft Lip and Palate Assistance Program

The Ministry of Health pays 75 % of the costs of specialized dental treatment for children and young people with cleft lip and palate.

To be eligible for assistance, patients must be under 21, register at a designated clinic of their choice and attend a multidisciplinary assessment program.

Specialized dental services include consultations, prosthetics, orthodontics, dental orthopaedics, feeding therapy supervision, and preventive endodontic and periodontic treatment and restorative services.

The program is funded through hospital clinics located in various centres in Ontario.

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