Some dentists in the Canadian Forces are getting paid tens of thousands of dollars more as specialists, even though their classification isn't recognized by the Canadian Dental Association or provincial licensing boards.
Speciality status means about a 20 per cent increase in pay compared to a general dentist's salary in the military. For a lieutenant colonel, for example, that represents nearly $50,000 extra a year.
Specialists make between $200,000 and $305,000, according to pay rates published on the Department of National Defence’s website.
The military has 19 advanced general dentists, according to 2013 documents obtained by CBC News.
Also known as comprehensive dentists, they take a two-year upgrading program through the U.S. army.
Murray Cuff, a periodontist who retired from the military in 2010, wrote a report raising concerns about the sustainability of the dental corps before he left. He urged the Canadian Forces Health Services to review the role of advanced general dentists (AGD).
"Overstatement of the qualifications of the AGD to the degree that they receive a premium pay is fraught with both legal and moral difficulties," Cuff wrote. "Current support by the [Canadian Forces] of a non-credible 'specialty' is a misrepresentation and, to some, may appear to constitute a fraud perpetrated on members of the CF."
There are nine nationally recognized dental specialties in Canada, including endodontics, periodontics, and pediatric dentistry, that are listed on the Canadian Dental Association’s website. Advanced general dentistry is not on the list.
Dental association backs wages
Kevin Desjardins, the director of public affairs for the dental association, supported the pay rates.
"The CDA is strongly supportive of the work carried out by the professionals of the Royal Canadian Dental Corps and we recognize that the pay levels of advanced general dentists recognize their higher levels of training and certification," he told CBC News.
According to the Provincial Dental Board of Nova Scotia, AGDs are also not recognized by provincial licensing authorities even though they have been receiving specialty pay since the 1990s.
Col. Kevin Goheen, the commanding officer of the military’s dental unit, said AGDs save the military a significant amount of money because of their ability to do a larger scope of dentistry in-house instead of sending high-end procedures to private practices.
He said they also act as mentors for junior dentists and are one of the most often deployed specialists.
But Cuff said many have assumed administrative roles and spend more time sitting behind a desk than performing dentistry.
In 2012, the last full year of data made available to CBC News, AGDs performed an average of $101,000 worth of dental procedures. From 2007 to 2012, they had among the lowest productivity numbers among specialists.
The figures are based on the Ontario Dental Fee Guide.
"I feel bad about the exceptions because there are a couple that I’m aware of with their nose to the grindstone," Cuff said. "But there are so few of those people that the numbers really speak for themselves."
The military said the pay increases were approved by Treasury Board and survived a review in 2000.
"From my perspective, there's no greater scrutiny that’s applied than what Treasury Board applies to something. If you've got their consent and their approval, then you’ve really satisfied something," said Goheen.
Cuff disputed that claim. He said because AGDs pursue senior administrative and command positions, they have served as the senior dental advisers to Treasury Board.
"I say the Treasury Board was duped," he said.