When does the CDCP pay for a crown?
The Government of Canada lists crowns among the plan's major restorative services, which rebuild teeth that a filling can no longer restore. The plan considers three kinds of single-unit crown, meaning one crown on one tooth: cast metal, porcelain or ceramic fused to metal, and porcelain or ceramic. Ready-made stainless steel or plastic (polycarbonate) crowns are a separate benefit with different rules; this page is about the three types above.
These conditions apply to each of these crowns, on top of the limits explained below. You must be 18 or older. The plan must approve the crown through preauthorization before treatment begins. The tooth must meet both the plan's tooth eligibility criteria and its restorability criteria, explained below. And before your dentist can request the crown, treatment for any active decay or gum disease has to be finished.
These conditions are not the whole test. Sun Life has said that the published criteria are not a complete list and that it applies the plan's internal processes and clinical criteria as well, so a tooth that seems to meet every rule on this page can still be declined.
Your dentist assesses the tooth, but the plan makes the decision: Sun Life reviews each request against rules set by Health Canada. Preauthorization only decides whether the plan will cover the crown under its clinical criteria, and even an approval is not a promise of payment, as explained below. It does not decide whether a crown is the right treatment for you; that stays between you and your dentist.
The Government of Canada notes that the plan's criteria are stricter than those of private insurance plans, and each decision takes your oral health history and medical conditions into account.
This page reflects the CDCP Dental Benefits Guide in effect from April 1, 2026, the Government of Canada's list of covered services as updated on August 27, 2026, and the 2026 Ontario benefit grid, which applies to services from April 1, 2026.
Which teeth can get a crown under the CDCP?
Your tooth has to pass two tests. The first is about which tooth it is. Incisors, canines, premolars (bicuspids) and first and second molars are eligible. A wisdom tooth (third molar) is eligible only when the first and second molars are missing and the wisdom tooth bites against a natural or artificial molar.
The second test is whether the tooth can be restored with a crown. Your dentist checks this using x-rays and gum measurements, which go with the request. All of the following must be true:
- There is no active gum disease around the tooth.
- The tooth has enough bone support on x-rays: a crown-to-root ratio of 1:1 or less, and no bone loss where the roots divide (furcation involvement).
- Enough healthy tooth is left for the edge of the crown to sit 3 mm from the top of the bone, with a 1.5 mm collar of tooth (a ferrule) for the crown to wrap around.
- The space for the crown is the same size as the natural tooth, with none of it lost to decay or crowding.
- The tooth is so heavily filled or broken down that it can no longer hold a regular filling. The plan calls this an extensively restored tooth, defined in the next section.
- The tooth does not need any additional treatment, such as crown lengthening, root re-sectioning or orthodontics.
What counts as an extensively restored tooth?
The plan's test for how much of the tooth is filled or missing depends on the type of tooth:
- Front teeth, with or without a root canal: the filling or missing tooth runs across the whole biting edge, from one side to the other, and down to both points where the tooth touches its neighbours.
- Premolars and molars that have had a root canal: the filling or missing tooth covers 3 or more connected surfaces and takes in either both marginal ridges (the edges of the biting surface next to the neighbouring teeth) or a whole cusp, as shown on x-rays.
- Premolars and molars without a root canal: the filling or missing tooth covers 5 connected surfaces.
When will the plan not consider a crown?
Even on an eligible tooth, the plan will not consider a crown in these situations:
- To improve how a tooth looks.
- For stress fractures or chipping on a tooth that has only a small filling or no filling.
- Only to treat sensitivity from a cracked tooth or from erosion, abrasion or wear (attrition). The plan may consider a crown on such a tooth when sensitivity is not the only reason.
- For someone at high risk of cavities, or with moderate to severe gum disease throughout the mouth, when there is evidence of widespread decay or gum disease that has gone on a long time, is uncontrolled or is untreated.
Which crown-related treatments does the CDCP never cover?
Some treatments are on the plan's list of exclusions. The plan does not cover them at any time, and an exclusion cannot be reconsidered:
- Crowns on dental implants, and every other implant-related procedure.
- Bridges.
- Veneers and three-quarter crowns.
- Inlays and onlays, whether composite, precious metal or ceramic.
- Crown lengthening.
- Cosmetic treatment such as teeth whitening.
How many crowns will the CDCP cover?
The plan covers at most 4 crowns per person in any 120 months (10 years), and no more than 1 crown per eligible tooth in any 96 months (8 years). These are rolling periods, each counted from the date of the earlier service.
Related services have their own limits. Repairing a crown and re-cementing a crown are each limited to once in any 36 months per tooth. A core, the build-up that supports a crown, is considered only for members aged 18 and older, only together with an approved crown preauthorization, and only if the existing filling on the tooth is more than 24 months old. Cores and posts share one limit of 4 in any 120 months per person, on permanent teeth only.
Can you get a crown after a root canal?
A root canal does not make a crown automatic. The treated tooth must have healed before your dentist requests the crown, and the crown still needs its own preauthorization and has to meet the same tooth and restorability criteria as any other crown.
Within those criteria, the extensively restored test for a premolar or molar that has had a root canal is different from the test for one without; the section on extensively restored teeth above sets out each.
The plan's payment for the root canal includes the temporary filling; the crown is a separate service. The root canal itself has its own rules, which our root canal page explains.
How does preauthorization for a crown work?
Your dental office sends the request to Sun Life; you do not send it yourself. For a crown, the request includes a claim or treatment form, a treatment plan covering all your completed and pending treatment, dated x-rays from the last 12 months showing the tooth's root and your back teeth (periapical and bitewing x-rays), gum measurements from the last 12 months, and any relevant clinical notes.
If the request does not show that the criteria are met, the plan can ask for more information or deny it. Requests are processed in the order they arrive, and the plan does not publish a set time for a decision. The decision is sent to your dental office.
For the plan to cover the crown, treatment must not start until it is approved. A crown started before approval is not covered, except through post-determination: a request made after treatment, which the plan reserves for rare emergent situations, judges on the same criteria and may decline.
Most approvals stay valid for up to 12 months from the approval date, as long as you are still eligible for the CDCP on the date of service. An approval is not a promise of payment: the claim is assessed on your eligibility, your co-payment level, and the plan's rules and fees on the date of service.
What if the plan says no?
If the request is denied, you can ask for one reconsideration within 60 days of the denial. Your dental office submits it for you with new or additional clinical information, a different reviewer at Sun Life looks at it, and that decision is final. Exclusions, such as crowns on implants, cannot be reconsidered.
When the plan declines a crown, it also does not cover services related to it, such as the core that would have supported it. You can still choose to go ahead with treatment the plan does not cover and pay the dental office directly.
What will you pay for a crown?
If the plan approves your crown, your co-payment depends on your adjusted family net income, which must be under $90,000 for you to be eligible for the CDCP at all. Your co-payment is the share of the plan's established fee (the fee the plan sets for each service) that the plan does not pay and that you pay to the dental office. The levels are:
- Under $70,000: the plan pays 100% of its established fee and your co-payment is 0%, though other charges may still apply.
- $70,000 to $79,999: the plan pays 60% and your co-payment is 40%.
- $80,000 to $89,999: the plan pays 40% and your co-payment is 60%.
Can you be charged more than the co-payment?
Yes, at any co-payment level. CDCP fees can differ from what a dental office charges, and an office is allowed to bill you the difference, up to its usual fees. You also pay for any service you agree to that the plan does not cover.
Before you agree to treatment, the office must discuss with you which services the plan will and will not cover and what you will be charged. The Government of Canada also advises you to ask about any costs the plan will not cover.
The plan pays the dental office directly and does not reimburse patients, so you should not be asked to pay the full cost up front.