Spitting mad over dental fees: Alberta's top dentist answers your questions

Dental fees are a hot topic in Alberta after the dental college and association releases a widely panned fee guide that has Albertans steaming mad.

President of Dental College gets a failing grade from callers after fee guide released to withering reviews

A new dental fee guide is having a negative impact on many Albertans, who feel it doesn't go far enough in reducing the country's highest dental fees. (Getty Images)

Albertans have lots of questions about the new dental fee guide.

Alberta Dental Association and College Council president Dr. Mintoo Basahti spoke to CBC Calgary's Alberta @ Noon host Judy Aldous about the new dental fee guide implemented by the Alberta Dental Association and College Council, which reduces "recommended" fees by an average of three to five percent.

Here's a portion of the interview. It has been edited for length and clarity.

Q: Health Minister Sarah Hoffman feels that it doesn't go far enough. Does this fee guide go far enough?

A: As far as the minister's concerns about the guide only being three per cent — I think she's referring to a narrow part of it. If you take a look at the Dental Fee Guide Report that the minister's office released in December 2016 … the average [dental fee] is about 3-4 per cent lower. But if you look at the higher fees on that same report and then (look) on our new fee guide, there's about a 20-30 per cent difference —  so that's what we're focusing on: trying to draw those high fees down to a more acceptable level.

Q: But if you look at those fees in the new guide, you charge $75 for a first visit and British Columbia charges $43. How can you explain such a discrepancy?

A: There's a couple of differences. First of all, British Columbia has a loss leader model. They have a number of their initial entry fees almost much lower than probably their cost of producing those services and if you look at their higher  fees farther down in their fee guide — actual treatment fees — they tend to be much higher. It's just a different model. 

Q: We spend more on dental care in this province than anywhere else in the country. Will we continue to do that?

A:  We're probably still maybe 20 per cent, 15 per cent above British Columbia, but if you take a  look at dentists' take-homes (salaries) in Alberta, it's consistent with British Columbia, and elsewhere across the country.  It's not as if those higher initial fees are translating into higher take home [salaries]. The [high price] driver is our costs of providing those services are higher and one of the biggest costs for our [dental] practices is the cost of labour. The hygenist salaries in Alberta are anywhere from 30 to 35 per cent higher than in British Columbia and same thing with our dental assistants —their salaries are 20 to 30 per cent higher. 

Q: Won't non-binding fees put onus on patients to negotiate fees down?

A: I don't think the onus should be on patients (to negotiate lower fees). The onus should be on the practitioners.

Callers to Alberta @ Noon also had comments for Basahti.

Q: I had a friend with a lot of toothwork to be done, and she could not afford Alberta dentists, so she flew to Mexico, had a lot of work done, came home  —  and paid for her whole trip with the money she saved. I just think it's outrageous that Alberta dentists are doing that to people. 

A:  I have yet to see really good work come out of other jurisdictions like that — especially Mexico. At the end of the day, do citizens want to have high quality care that they can count on? The amount of work we've seen where patients have atrocious infections, implants that are failing … it may be cheaper there, but you're accessing something that can't be done for that same price here.

Q:  I can buy a ticket on Westjet seat sale, and fly to Winnipeg … get my dental work done, and fly back [and it's] less expensive than [getting dental work done] in Alberta…and I just think that's atrocious.

A: In British Columbia and Manitoba, the fees are lower, because the practitioners there have lower operating costs. In Alberta, what I hope we can do is…if our practitioners can lower their costs providing those services and lower their fees, then citizens won't have to travel. That's a failure on our part when citizens want to and have to leave the country or the province to get their dental work done, and that's why we're working towards trying to lower these fees. My role as president of Alberta Dental Association and College first is public interest. We've acknowledged that Alberta dental fees are higher than in the rest of the country and we need to lower them, but we need to lower them in a way that we don't damage that access to care.