Dental coverage is one of the most valued components of an employee benefits package. It helps employees maintain their oral health, manage the cost of routine dental visits, and protect themselves and their families from unexpected dental expenses.

However, not all dental plans are created equal.

Some plans focus primarily on routine cleanings and fillings, while others provide more extensive protection for gum disease, crowns, bridges, dentures, orthodontics and other complex dental procedures.

Understanding the difference between these services can help employers select a benefits plan that meets their employees’ needs and help employees understand what their coverage actually provides.

1. Preventive dental coverage: Keeping your teeth healthy

Preventive dental services are designed to help maintain healthy teeth and gums while identifying potential problems before they become more serious.

These services are often covered under the preventive or basic dental category of an employee benefits plan.

Recall examinations

A recall examination is the routine dental checkup that patients receive when returning to their dentist.

During a recall exam, the dentist evaluates the condition of the teeth, gums and surrounding oral tissues. They look for cavities, gum disease, changes in existing restorations and other potential concerns.

Recall exams are different from a complete examination, which is typically performed when a patient first visits a dentist or requires a comprehensive reassessment.

Many dental plans limit recall examinations to once every six or nine months, although the exact frequency depends on the plan.

Polishing

Polishing removes surface stains and plaque from the teeth using a polishing instrument and paste.

It can help improve the appearance of teeth and support routine oral hygiene.

Polishing is commonly included with a professional cleaning, but insurance plans may have separate frequency limits for polishing and scaling.

Scaling

Scaling is the process of removing plaque, tartar and other deposits from the teeth.

Even with regular brushing and flossing, hardened deposits can accumulate in areas that are difficult to reach at home.

A dental hygienist uses specialized instruments to remove these deposits and help prevent gum inflammation and periodontal disease.

Dental plans often measure scaling in units of time rather than simply covering a single cleaning.

For example, a plan may provide a certain number of scaling units per benefit year. The number of units required depends on the patient’s oral health and the amount of buildup present.

Root planing

Root planing is a deeper cleaning procedure that removes plaque, tartar and bacterial deposits from the root surfaces of teeth.

It is commonly recommended when a patient has periodontal disease, particularly when pockets have developed between the teeth and gums.

Unlike routine scaling, root planing may require treatment below the gumline and can involve multiple appointments.

A plan that provides additional scaling and root planing coverage can be particularly valuable for employees who require ongoing periodontal care.

Bitewing X-rays

Bitewing X-rays are small dental images that show the upper and lower teeth together in a specific section of the mouth.

They are particularly useful for identifying:

• Cavities between teeth that cannot easily be seen during a visual examination.
• Changes in the bone supporting the teeth.
• Problems developing beneath existing fillings.
• Early signs of dental disease.

Bitewing X-rays are commonly taken during routine dental appointments, but the frequency depends on the patient’s oral health and the coverage limitations of their dental plan.

Fluoride treatments

Fluoride helps strengthen tooth enamel and can reduce the risk of cavities.

Professional fluoride treatments are often recommended for children, but adults may also benefit from them, particularly if they have an elevated risk of tooth decay.

Some plans provide fluoride coverage for children only, while more comprehensive plans may also cover adults.

New patient examinations

A new patient examination is generally more comprehensive than a routine recall exam.

It allows a dentist to establish a baseline of the patient’s oral health, review dental history and identify existing or potential treatment needs.

Plans may cover new patient examinations differently from recall exams, and some may limit comprehensive examinations to once every several years.

Emergency examinations

Emergency dental examinations are used when a patient experiences an unexpected dental problem.

Examples include:

• Sudden tooth pain.
• A broken or chipped tooth.
• Swelling or infection.
• Dental trauma.
• A damaged filling or crown.

Emergency exams are important because they allow a dentist to identify the cause of the problem and recommend appropriate treatment.

Coverage for an emergency examination does not necessarily mean the treatment required afterward is fully covered. The associated procedure will generally be assessed under its own benefit category.

2. Understanding periodontal coverage

Periodontal coverage focuses on the health of the gums and the structures supporting the teeth.

Gum disease can progress gradually, and treatment may become more complex if it is not addressed early.

Periodontal minor

Minor periodontal services generally include less extensive treatment of gum-related conditions.

Depending on the plan and the dental procedure involved, this may include certain localized treatments, periodontal assessments or maintenance services.

Periodontal major

Major periodontal services generally involve more extensive treatment of periodontal disease.

Examples may include surgical treatment of the gums, procedures to address deeper periodontal pockets, and other treatments intended to restore or maintain the structures supporting the teeth.

The exact procedures classified as minor or major vary by insurer and dental fee code.

Combined maximums

One of the most important distinctions in dental coverage is whether periodontal services have a separate maximum or share a maximum with other dental services.

Consider the following example:

Benefit type	Annual maximum
Basic dental	$1,000
Major dental	$1,500
Combined basic and major	$2,000

If a plan has separate basic and major maximums, an employee may have access to the full amount under each category.

However, if the plan has a combined maximum, expenses under the included categories draw from the same pool of available benefits.

For example, if an employee has a $2,000 combined maximum and uses $1,200 for basic dental services, only $800 remains for other services included in that maximum.

Always check whether periodontal coverage is separate, included in basic dental, or included in a combined basic and major maximum.

This can make a significant difference for employees who require extensive gum treatment.

3. Basic dental coverage: Fillings, root canals and accidents

Basic dental coverage is intended to treat common dental problems and restore teeth that have been damaged by decay, infection or injury.

Fillings

Fillings are used to repair teeth damaged by cavities.

The dentist removes the decayed portion of the tooth and fills the space with a restorative material.

Most dental plans cover fillings under basic dental, although the reimbursement percentage, eligible materials and frequency limitations may vary.

For example, a plan may reimburse 80% of eligible filling expenses, leaving the employee responsible for the remaining 20%.

Root canals

A root canal is a procedure used to treat a tooth when the pulp inside the tooth becomes infected or damaged.

The dentist removes the affected tissue, cleans the inside of the tooth and seals it.

Root canals are often covered under basic dental or endodontic services.

A root canal may also require a crown afterward to protect the remaining tooth structure. The root canal and crown may be assessed under different benefit categories.

Accidental dental coverage

Accidental dental coverage helps protect employees when dental damage results from an unexpected accident.

Examples include a tooth being damaged during a fall, sports injury or other accidental event.

Depending on the plan, coverage may include repairs to teeth, fillings, crowns or other necessary dental treatment.

Accidental dental coverage may have special provisions, such as:

• A separate maximum for accidental dental treatment.
• A requirement that treatment be completed within a specified period.
• A definition of what qualifies as an eligible accident.
• Restrictions relating to pre-existing dental conditions.

Employees should review the policy wording carefully because accidental dental coverage may not apply to every broken or damaged tooth.

4. Major dental coverage: Crowns, bridges, dentures and implants

Major dental coverage is designed to help pay for more extensive restorative procedures.

These procedures can be significantly more expensive than routine cleanings or fillings, making major dental coverage an important consideration when comparing employee benefits plans.

Crowns

A crown is a protective covering placed over a tooth.

Crowns are often recommended when a tooth has been significantly damaged by decay, fracture or a previous dental procedure.

They help restore the tooth’s shape, strength and function.

Crowns may be made from porcelain, ceramic, metal or a combination of materials.

They are commonly required after certain root canal treatments, particularly when a tooth needs additional structural support.

Bridges

A dental bridge replaces one or more missing teeth by attaching an artificial tooth to adjacent teeth or other supporting structures.

Bridges can restore chewing function and improve the appearance of a patient’s smile.

They may be an alternative to removable dentures or dental implants.

Because bridges can involve multiple teeth and laboratory work, they can be a significant dental expense.

Inlays and onlays

Inlays and onlays are custom-made restorations used when a tooth requires more repair than a standard filling but does not necessarily need a full crown.

An inlay fits within the boundaries of the tooth’s biting surface.

An onlay extends over one or more of the tooth’s cusps, providing additional coverage and support.

These restorations are often made from ceramic, porcelain or other restorative materials.

Coverage depends on the insurer’s definition of eligible major restorative services.

Veneers

Veneers are thin coverings placed over the front surfaces of teeth.

They are generally used to improve the appearance of teeth that are discoloured, uneven, chipped or otherwise aesthetically undesirable.

Veneers are often considered cosmetic procedures, which means they may be excluded from many employee benefits plans.

Some plans may provide limited coverage for certain restorative procedures that resemble veneers, but this depends on the specific dental codes and policy wording.

Employees should not assume that veneers are covered simply because their plan includes major dental benefits.

Dental implants

Dental implants are used to replace missing teeth.

An implant is a surgically placed fixture that supports an artificial tooth, crown or other restoration.

Implants can provide a long-term solution for missing teeth, but the overall treatment can be expensive.

When reviewing dental coverage, it is important to distinguish between:

• The surgical placement of the implant.
• The implant fixture itself.
• The abutment that connects the implant to the restoration.
• The crown or artificial tooth placed on top.

Some plans exclude implants entirely. Others may provide limited coverage for specific components or procedures.

An implant exclusion does not necessarily mean that all alternative tooth replacement options are excluded.

Partial and complete dentures

Dentures are removable appliances used to replace missing teeth.

A partial denture replaces some missing teeth while allowing the patient to retain their remaining natural teeth.

A complete denture replaces all teeth in the upper or lower arch.

Dentures can help restore chewing function, speech and appearance.

Coverage may include the initial denture, replacement dentures, repairs, adjustments, relines and rebases.

However, many plans have specific replacement frequency limitations.

Denture repairs

Denture repairs help restore a damaged denture to a usable condition.

Examples include repairing a fracture, replacing a damaged component or adding a tooth to an existing partial denture.

Denture repair coverage can be particularly important for employees who rely on dentures every day.

A plan may cover repairs separately from the maximum available for new dentures, depending on its design.

5. Orthodontic coverage: Braces and teeth alignment

Orthodontic coverage helps pay for treatment intended to correct the alignment of teeth and jaws.

Orthodontic treatment may include:

• Traditional metal braces.
• Ceramic braces.
• Clear aligners.
• Other orthodontic appliances.

Orthodontics is often one of the most expensive dental benefits an employee can use.

Some plans provide orthodontic coverage for dependent children only, while others extend coverage to adults.

A plan may also have a lifetime maximum rather than an annual maximum.

For example, a plan could provide 50% reimbursement for eligible orthodontic treatment, up to a $2,000 lifetime maximum.

This means the employee may receive up to $2,000 in total orthodontic benefits over the period of coverage, rather than receiving $2,000 every year.

Children-only orthodontic coverage

Children-only orthodontic coverage is a common plan design.

It provides orthodontic benefits for eligible dependent children while excluding adult orthodontic treatment.

This can be an important distinction for families with children who may require braces or other corrective treatment.

When comparing plans, employers should review:

• The maximum eligible age for dependent children.
• The reimbursement percentage.
• The lifetime maximum.
• Whether the plan covers traditional braces, clear aligners or other appliances.
• Whether treatment must begin while the child is eligible.
• Whether pre-existing or ongoing orthodontic treatment is covered.

Orthodontic benefits can provide meaningful financial assistance, but the lifetime maximum may only cover a portion of the total treatment cost.

6. Extensive dental coverage: What makes a plan more comprehensive?

When comparing dental benefits plans, the difference between a standard plan and an extensive plan is not necessarily the number of services listed.

It is often the amount of coverage available, the reimbursement percentage, and the procedures that are eligible.

An extensive dental plan may provide:

Coverage feature	Why it matters
Higher basic maximum	Provides more protection for fillings, root canals and other common procedures
Higher major maximum	Helps with crowns, bridges and other expensive restorative work
Separate periodontal maximum	May provide additional protection for gum disease treatment
Higher scaling units	Supports employees who need more frequent or extensive cleanings
Orthodontic coverage	Helps families manage the cost of braces and other alignment treatment
Implant coverage	May help with eligible implant-related procedures
Broader denture coverage	Helps with replacement, repair and maintenance of dentures
Higher reimbursement percentage	Reduces the employee’s share of eligible expenses

An extensive plan may also have a higher annual maximum, but this does not automatically mean every dental procedure is covered.

For example, a plan could offer a $2,000 annual maximum while excluding implants, veneers and orthodontics.

Another plan could have a $1,500 annual maximum but provide a separate orthodontic lifetime maximum.

The best way to compare plans is to review the actual coverage categories and limitations rather than focusing only on the annual maximum.

7. What do Canadian dental guidelines recommend annually?

One of the most common questions employees ask is:

“How often should I visit the dentist, and how much dental coverage should I have?”

There are two important distinctions.

First, dental professionals make recommendations based on the patient’s individual oral health.

Second, insurance companies establish their own coverage frequency limits.

These are not necessarily the same thing.

Routine dental care

The Canadian Dental Association emphasizes the importance of regular dental examinations and professional oral care. However, there is no single annual schedule that is appropriate for every patient.

The appropriate frequency depends on factors such as:

• The patient’s risk of cavities.
• The presence of gum disease.
• Existing dental restorations.
• Oral hygiene habits.
• Medical conditions that may affect oral health.
• The dentist’s clinical assessment.

For some patients, a six-month recall schedule may be appropriate. Others may need more frequent appointments, while patients with lower risk may be able to attend less frequently.

The following table provides a general illustration of common dental benefit plan frequencies. It is not a universal clinical recommendation.

Dental service	Common plan frequency
Recall examination	Every 6–9 months
Polishing	Every 6–9 months
Bitewing X-rays	Every 6–12 months, depending on the plan
Fluoride treatment	Every 6–12 months
Scaling	Based on eligible time units
Root planing	Based on clinical need and eligible units
Complete examination	Often every 3–5 years
Orthodontics	Usually subject to a lifetime maximum

For example, the Canadian Dental Care Plan has its own frequency limitations, including one recall examination in any 12-month period, while some private benefit plans permit more frequent recall examinations. These are plan rules, not a universal recommendation for how often everyone should receive care. Canada+1

What about the Alberta Dental Fee Guide?

The Alberta Dental Association publishes a suggested dental fee guide to help patients understand the fees associated with common dental procedures.

The guide is reviewed annually.

It provides a reference point for dental fees, but it does not establish how often a patient should receive treatment or how much an insurance plan must cover.

Dentists set their own fees, and they may charge more or less than the suggested guide.

This is important when reviewing dental coverage because a plan may reimburse a percentage of an eligible fee guide amount rather than the full amount charged by the dentist.

For example:

• Dentist’s charge: $200
• Eligible fee guide amount: $180
• Plan reimbursement: 80%

The plan would reimburse $144, leaving the employee responsible for $56.

The employee’s portion includes both the 20% coinsurance and the difference between the dentist’s charge and the eligible fee guide amount.

8. Why dental coverage matters for small businesses

For a small business, dental coverage can be an important part of attracting and retaining employees.

Employees may value benefits that help cover routine care for themselves and their families, but they may also appreciate protection against more expensive procedures.

A well-designed dental plan can help employees:

• Maintain regular dental visits.
• Identify dental problems earlier.
• Manage the cost of fillings and root canals.
• Access periodontal treatment when needed.
• Reduce the financial burden of crowns, bridges and dentures.
• Access orthodontic coverage for eligible children.

Employers should consider their workforce when selecting a plan.

A business with younger employees and growing families may place a high value on orthodontic coverage and children’s preventive care.

A business with an older workforce may place greater importance on major restorative services, periodontal coverage, crowns and dentures.

There is no single dental plan that is best for every business. The objective is to find a balance between meaningful coverage and a premium that the business can sustain.

Final thoughts: Look beyond the annual dental maximum

When reviewing an employee benefits plan, it is easy to focus on the annual dental maximum.

However, the maximum is only one part of the picture.

The reimbursement percentage, eligible procedures, frequency limitations, periodontal coverage, orthodontic benefits and major dental provisions all influence the value of a plan.

A plan with a higher maximum may still provide less protection for a particular employee if the treatment they need is excluded or subject to a separate limitation.

For Alberta employers, understanding these differences can help make the process of selecting employee benefits more straightforward.

For employees, understanding their dental coverage can help them make informed decisions about their oral health and avoid unexpected out-of-pocket expenses.

The goal of dental coverage is not simply to pay for a cleaning. It is to help employees maintain their oral health and manage the cost of dental treatment throughout their lives.

Educational information only. Dental plan coverage, eligible procedures, frequency limitations and reimbursement amounts vary by insurer and policy. Patients should consult their dentist for clinical recommendations and their benefits provider for confirmation of coverage. This article does not constitute dental or insurance advice.