Services covered by Healthy Smiles Ontario
A resource guide about the Healthy Smiles Ontario program for clients. The guide includes information on what services are covered, how to enrol, how to replace lost cards and how to update your client information.
Introduction
Healthy Smiles Ontario
Healthy Smiles Ontario is a free dental program for eligible children and youth 17 and under. Good oral health is important to the overall health of children and youth. It’s very important to start seeing a dentist when your child is 12 months old and to keep going regularly. Healthy Smiles Ontario covers regular check-ups, preventive care and treatment.
Why oral health is important
Cavities and gum disease can be painful and can lead to serious infections, affecting the growth of adult teeth. Pain can result in loss of sleep, affect a child’s ability to eat, and can also affect their ability to learn and attend school.
With Healthy Smiles Ontario you can prevent oral health problems before they start!
Getting enrolled
Who is eligible
Children and youth 17 and under may be eligible if:
- They are residents of Ontario; and
- They are members of a household that meets the income eligibility requirements.
NOTE: Children and youth 17 and under are automatically eligible and automatically enrolled in Healthy Smiles Ontario when they or their family receive: Ontario Works, Temporary Care Assistance, the Ontario Disability Support Program or Assistance for Children with Severe Disabilities.
Children and youth with other dental insurance coverage are no longer automatically excluded.
How long is a client eligible for services
Once enrolled children and youth 17 and under will receive dental coverage for:
- up to one benefit year (August 1st to July 31st), or
- 12 months from the date of enrolment for those enrolled for emergency and essential care, or
- up to their 18th birthday
Most Children and youth 17 and under enrolled in Healthy Smiles Ontario will be automatically re-assessed each benefit year and annual notices about their enrollment status will be sent by mail.
How to apply
Visit ontario.ca/healthysmiles or visit your local Public Health Unit.
If you have any questions, please call the ServiceOntario INFOline toll-free at:
ServiceOntario toll-free:
ServiceOntario TTY toll-free:
Once a child’s enrollment has been confirmed, they will receive a Healthy Smiles Ontario dental card. The dental card must be presented to a dental provider at each visit to receive dental care under the Program.
NOTE: You can apply online or by using a program application form. However, to apply online you must have some specific information available.
Who may apply online
To apply online you will have to:
- Enter your Social Insurance Number or Temporary Taxation Number
- Ensure that you and your spouse/common law partner (if applicable) have filed your taxes in the most recent taxation year.
- If you have a spouse or common-law partner, they must be with you to complete the online application.
- Provide an email address. If you have a spouse or common-law partner, their email address must be different from your email address.
- Enter your electronic signature(s) at the end of the application.
If you don’t have a Social Insurance Number or haven’t filed your taxes for the most recent taxation year you can still apply.
You can access the Program Application Form online, at a ServiceOntario centre, or through your local Public Health Unit.
You can also visit ontario.ca/healthysmiles or visit your local Public Health Unit for more help.
Emergency dental care
The Healthy Smiles Ontario Program also provides dental care for children and youth with emergency and/or essential dental conditions from families who would experience financial hardship if they had to pay for treatment.
There are different eligibility requirements for children who need emergency and/or essential care. For these services applicants must be assessed for an emergency or essential dental need and must also attest to financial hardship to access emergency or essential care under the program.
Applicants can apply at a participating dental provider’s office if they have an emergency and/or essential dental condition, or at a public health unit. They can also contact their local public health unit for help, including finding a participating dental provider.
These clients will receive dental coverage for emergency and/or essential services for 12 months from their date of enrollment. They will have to re-apply at the end of 12 months, and will be re-assessed.
Visit your nearest Public Health Unit to find out about available services.
What services are covered
Healthy Smiles Ontario provides routine, preventive, and emergency and essential treatment services to eligible children and youth. Services covered for clients may vary depending on the oral health of the child/youth.
An examination or assessment by a qualified dental provider will determine the type and frequency of services a child or youth may need.
Covered services include (for example):
- examinations/assessments
- radiographs (x-rays)
- preventive services
- restorative services
- endodontic services
- periodontal services
- prosthodontic services
- oral surgery services
- anaesthesia
The information below describes the services that are covered for eligible children and youth and how often they are covered – depending on what an individual child needs.
Examinations and assessments
Examinations/assessments enable dental providers to determine the health of the mouth and to screen for signs of disease.
| Type of exam | Frequency of coverage |
|---|---|
| First Dental Visit | Any child age 3 and under will be covered for their first dental visit |
| New Patient Exam | 1 per 5 years |
| Recall (check-up) Exam | 1 per 6 months |
| Specific Exam (for a specific problem that is not an emergency) | 1 per 12 months |
| Emergency Exam | Unlimited |
X-rays (radiographs)
Dental providers use x-rays to diagnose cavities or infection.
| Type of X-ray | Frequency of coverage |
|---|---|
| Periapical | Up to 8 per 12 months |
| Bitewing (to diagnose cavities) | Up to 2 per 6 months |
| Occlusal | 1 per 12 months |
| Panoramic | 1 per 24 months |
*required x-rays are always covered in emergency situations.
Preventive services
Preventive services help prevent cavities and gum disease.
| Service | Frequency of coverage |
|---|---|
| Polishing | Up to 2 times per year |
| Fluoride | Up to 4 times per year |
| Sealants | Limited to permanent (adult) molars |
| Scaling (cleanings) | For children 11 years and younger, up to 15 minutes per year. For children 12-17 years of age, up to 30 minutes per year. *A child/youth may be eligible for more time if a dental provider determines it is needed |
Restorative services
Restorative services repair broken teeth or teeth that have cavities.
| Service | Frequency of coverage |
|---|---|
| Temporary Fillings | Unlimited |
| Permanent Fillings | There are some age restrictions for primary (baby) teeth—ask your dental provider. |
| Crowns (caps) | Some types of crowns are only covered for permanent (adult) teeth in special circumstances—ask your dental provider. |
Endodontic services
Endodontic services treat infections and relieve pain. Root canals are one of the most common endodontic services.
| Service | Frequency of coverage |
|---|---|
| Root canals | There are some age restrictions for primary (baby) teeth—ask your dental provider. Only covered once per tooth. |
Periodontal services
Periodontal services treat gum conditions, including gum disease and conditions resulting from certain medical treatments or medications.
| Service | Frequency of coverage |
|---|---|
| Periodontal surgery (gum surgery) | Depending on the type of surgery, there may be limitations—ask your dental provider. |
Prosthodontic services
Prosthodontic services replace missing teeth.
| Service | Frequency of coverage |
|---|---|
| Dentures | Some types of dentures are only covered for permanent (adult) teeth—ask your dental provider. |
| Bridges | Only for the replacement of permanent (adult) front teeth. |
Oral surgery services
Oral surgery services include removing teeth or any abnormal tissue in the mouth.
| Service | Frequency of coverage |
|---|---|
| Extractions | Unlimited |
Anaesthesia
Anaesthesia services help to relax patients or put them to sleep during a dental procedure so that they do not feel any pain or discomfort.
| Service | Frequency of coverage |
|---|---|
| Unconscious or conscious sedation (patient is fully asleep or awake) | From 15 minutes to 2.5 hours per 12 months (depending on the type and amount of dental treatment needed). *A child/youth may be eligible for more time if a dental provider determines that it is needed |
What services are not covered
Healthy Smiles Ontario does not cover cosmetic or aesthetic services such as teeth whitening or dental implants.
Where to access dental care
- if you have a dentist, contact their office to find out if they participate in Healthy Smiles Ontario.
- if you do not have a dentist, contact your local Public Health Unit.
- visit to ontario.ca/healthysmiles to find out which Public Health Unit serves your area
Client support
Changing your account information
It is important that clients’ records are up-to-date. You can use a change of information form to update your program account information
Download a Change of Information Form
This form allows you to:
- correct existing applicant information
- change current client(s) information
- change contact information
- change marital status and/or spousal information
- change household income
- withdraw consent to disclose tax information
Note: If you are currently receiving Ontario Works, please speak to your Ontario Works case worker to change your information. You do not need to use a change of information form.
Note: If you have received Emergency and Essential Services, please contact the program administrator (Accerta) to change your information: You do not need to use a change of information form.
Local:
Toll-free:
Lost or misplaced cards?
If you have lost or misplaced a dental card, please call the ServiceOntario INFOline toll-free at:
ServiceOntario toll-free:
ServiceOntario TTY toll-free: