NAVIGATING YOUR DENTAL VISIT: GET THE EXPERT’S TAKE WITH DR. PAUL BHATTI, OTIP’S CHIEF DENTAL OFFICER
June 10, 2026
Walking into a dentist’s office can sometimes feel like stepping into a world of mystery.
With buzzing tools, unfamiliar jargon and bright lights, it’s easy to feel a bit overwhelmed. But fear not! By understanding the ins and outs of your dental visit and being equipped with the right knowledge, you can avoid unexpected costs and feel confident asking the right questions.
Let’s explore the world of dental care with a smile!
The OSSTF ELHT Benefit Plans pay dental benefits in accordance with the Current Fee Guide for General Practitioners in your province of residence. Most dentists in Ontario use the annual Ontario Dental Association (ODA) Suggested Fee Guide as a reference for what they can or should charge for each service. Ultimately, dental providers can set their own service fees and so charges may vary by dental provider, service or procedure.
Every year, your ELHT reviews the dental fee guide to understand its impact on coverage, especially when trying to manage consecutive fee increases that substantially impact the sustainability of your benefit plan.
Know before you go!
Dental coverage varies by plan. Make sure you understand the details of your dental coverage, including applicable co-insurance limits or benefit year maximums, before your visit by reviewing your benefits booklet. This can help you prepare for any unforeseen out-of-pocket expenses.
For example, the OSSTF ELHT Benefit Plans currently state that recall exams, and fluoride treatments are eligible for reimbursement once every nine months.
#ToothTruth! X-ray eligibility is based on frequency (i.e., every nine months up to 36 months) and the type of x-ray you get may have a different frequency limit compared to others!
Submitting an estimate
If you require major restorative work (e.g. crowns, bridges and dentures) or orthodontic treatments (e.g. braces and aligners), ask your dental provider to submit an estimate before booking an appointment for treatment.
You can also collect treatment information from your dentist and submit an estimate manually via My Member Account.
Tooth Tip! Your dentist should always explain costs before treatment. If a procedure costs more than $300, request an estimate to make sure your treatment plan aligns with your dental benefits. Keep in mind that it may take five to 10 business days to process your pre-determination.
Decoding your dental bill
Whether your treatment is fully covered by your plan or you had to pay out of pocket, always request a printed detail of the dental services that you are being charged for.
After submission and processing of a dental claim, an explanation of benefits will be issued which shows:
- the service date,
- the type(s) of service(s) provided (including units of time, if applicable),
- the procedure code of each service rendered,
- the cost(s) of the service(s) charged by your dentist,
- the co-insurance (e.g., it may show 100% covered by benefits or 80 to 50% member payment required), and
- how much was covered by your benefits.
Creating a smooth visit
Make sure you ask your dental office to submit your claim on your behalf to help save time and ensure claims are processed with ease.
Learn more about how your dental provider can help create a smooth visit:
About Dr. Paul Bhatti
Dr. Paul Bhatti is a licensed oral and maxillofacial surgeon a fellow of the Royal College of Dentists of Canada and a Diplomate of the American Board for Oral and Maxillofacial Surgery. He joined OTIP in 2024 as Chief Dental Officer to lead OTIP’s innovative dental strategy for group benefit plan members.
The information in this document is provided by OSSTF Benefits for general information only. OSSTF Benefits endeavours to have all information current and accurate. We make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, or suitability of the information included. All information is subject to change without notice.
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