What is a Fee Guide?
The Alberta Dental Association & College (ADA&C) produces an annual suggested fee guide for dentists in Alberta. This document outlines over 1,600 dental codes and code descriptors related to specific elements of dental treatment. It also provides suggested fees that serve as a guide only; dentists are not required to follow the guide or any fee schedule.
Many dental plan carriers will base plan coverage on fees and codes within this guide. In some cases the coverage is based on previous year's guides (going back a year or more). Note:Dental plan providers do not work with the ADA&C to develop the guide.
Are dentists required to follow the provincial fee guide?
No. While many dentists will follow a number of fees within the guide, there is no requirement to do so. Dental offices consider a number of variables when determining costs for their office. A dental office may bill some, or all codes, based on the suggested fee guide. Check with your office and ask for an estimate before proceeding with treatment.
Why does my dentist charge more than the provincial fee guide?
There is no requirement for dentists to charge the suggested fees outlined in the dental fee guides. Dentists determine costs for their office based on the factors influencing their individual practice.
How are dental fees determined?
Dentists are governed by the Health Professions Act. Like hospitals, dental clinics must adhere to strict regulatory standards to ensure a high standard of patient safety and care. Dentists essentially operate mini hospitals and are responsible for a number of costs related to providing dental care.
Specialized equipment; approved materials; sterilization and safety protocols; trained and licensed professional staff; external laboratory fees and practice location factor into the overhead costs of running a dental practice. The complexity of treatment for each patient also determines treatment fees.
Dentists have to consider all of these factors in determining their treatment fees.
Is there anything I can do to limit the cost of dental care?
Regardless of the fees charged for specific procedures, regular preventative dental hygiene cleaning is still the best way to maintain good dental health in the long run.
Patients can reduce their hygiene appointment costs by practising good dental health habits at home: brush and floss daily; limit sugary drinks and snacks; do not smoke.
It is important to diagnose problems before they become more complex and costly. Dental disease is progressive and unlike a cold will not resolve itself. The cost of prevention is always far less than the cost of neglect.
Can I get an estimate for treatment before going to the dentist?
Treatment recommendations are developed by the dentist beginning with an examination of the mouth. The dentist will examine the patient, review their health history, and discuss any symptoms or concerns the patient may be experiencing. If your dentist identifies an issue in your mouth, they will discuss this with you along with their treatment recommendations.
Depending on the treatment options presented, further discussions related to materials, the extent of the care required, whether or not laboratory fees factor into care, etc. can influence the estimate. Your dentist can work with you to review treatment alternatives and provide a cost estimate for the treatment plan before proceeding. Note: A dentist can only provide an estimate. As with any medical-based procedure treatment planning can change over the course of treatment; this can have an influence on cost.
Can I get a second opinion; the cost estimate seems high?
It is important that you feel comfortable in proceeding with any dental treatment. Your dentist is there to support your health and answer any questions you may have, including why they are recommending the treatment presented and/or any related to cost.
If you are concerned with any factors relating to a proposed treatment plan, you are welcome to seek a second opinion. It is important to understand that there will be an additional cost associated with this as the second dentist will need to conduct an examination and consult with you to develop treatment options.
Why can't a dentist provide a second opinion without an examination?
In order to provide an opinion related to dental care, a dentist must understand all the factors that are influencing a patient's health. A crucial part of this is an examination of the mouth to identify and diagnose any dental disease.
Questions you might ask your dentist:
Why are they recommending the treatment options presented—what is/are the benefit/s to your oral/overall health?
Are there alternative treatment options available?
What are the implications of refusing or delaying treatment?
Is there anything you can change in your mouth care to prevent similar issues in the future?
What is required on my part to maintain the dental treatment recommended?