Does a root canal need preauthorization?
For most teeth, no. A standard root canal on a front tooth (an incisor or canine), a premolar (bicuspid), or a first or second molar does not need preauthorization. The Government of Canada lists root canal treatment among the plan's basic services, together with pulpectomies, which it describes as the first step of a root canal, and treatments to reduce infection and relieve pain.
No preauthorization does not mean automatic payment. The plan considers coverage only when the tooth meets its eligibility and restorability criteria, set out below, and Sun Life's 2026 Ontario benefit grid opens its list of root canal services that need no preauthorization with a note that the plan's root canal rules must be met. A claim can be checked after it is paid to confirm the rules were met.
This page reflects the CDCP Dental Benefits Guide effective April 1, 2026, the Government of Canada's coverage page as modified on August 27, 2026, and Sun Life's 2026 Ontario benefit grid, which applies to services from April 1, 2026. The rules can change, and the plan, not the clinic, decides each claim.
Which teeth does the plan consider?
The plan considers a root canal on incisors, canines, premolars, and first and second molars.
A wisdom tooth (third molar) is considered only when the first and second molars are missing and the wisdom tooth bites against a natural or artificial molar. A root canal on a wisdom tooth always needs preauthorization.
What conditions must the tooth meet?
The plan considers a root canal only when the tooth is one of the eligible teeth above and also meets the plan's restorability criteria. It will not consider one if you are at high risk of cavities, or have moderate to severe gum disease throughout your mouth, and there is evidence that the disease is widespread and has been long-standing, uncontrolled or untreated.
Every one of these restorability criteria must be met:
- No active gum (periodontal) disease.
- Enough bone support on x-rays: at least as much of the tooth held in bone as there is above the bone, and no bone loss into the area where the roots divide.
- Enough healthy tooth left for the edge of the planned restoration to sit 3 mm from the bone.
- Room for the tooth at its natural size, side to side and top to bottom, with no space lost to decay or crowding.
- No need for additional treatment such as crown lengthening, root resectioning or orthodontics.
When is preauthorization needed?
These root canal services always need preauthorization. The plan must approve them before treatment starts, or they are not covered, except rarely through post-determination in an emergency.
- A root canal on a wisdom tooth (third molar)
- Re-treatment of a tooth that has already had a root canal
- Apicoectomy and retrofilling, which the plan lists with its root canal services, on any tooth
How does preauthorization work?
Your dentist's office sends the request to Sun Life, which administers the plan and decides each request under rules set by Health Canada. For root canal services, the request includes dated x-rays of the tooth and a record of your gum measurements, both from the last 12 months, and the reasons for the treatment. You do not send it yourself, and Sun Life sends the decision to the office.
The plan does not publish a set time for a decision. If treatment starts before preauthorization is granted, the service is not covered, except through post-determination: an after-the-fact review meant to be used rarely and only in emergent situations, which may also be declined.
Not every request is approved. The decision takes your oral health history and medical conditions into account, and it settles only whether the plan will pay, not whether the treatment is right for you; that stays between you and your dentist.
A preauthorization is generally valid for up to 12 months from the date it is approved, as long as you are still eligible for the CDCP on the day of treatment. It is not a promise of payment: the claim is assessed on your eligibility and on the plan's coverage, fees and rules on the day you are treated.
If a request is declined, you can ask for one reconsideration. Your dentist's office submits it for you within 60 days of the denial, with new or additional clinical information, and the result is final. The plan also does not pay for procedures related to a service it declined. You can still choose to have treatment the plan does not cover and pay the office directly.
What limits apply?
These services are limited per tooth, counted over your lifetime:
- Re-treatment of a root canal: once per tooth, with preauthorization
- Apicoectomy: once per tooth, with preauthorization
- Retrofilling: once per tooth, with preauthorization
- Pulpectomy or pulpotomy: once per tooth, and on baby front teeth (primary incisors) only for children under 5
Is urgent care for tooth pain covered without preauthorization?
Yes, for a set of urgent services. Sun Life describes the plan as covering a range of urgent care and names these as covered without preauthorization: emergency exams, pain control for a decayed or injured tooth, pulpotomies and pulpectomies, and open and drain, which drains an infected tooth.
The plan's limits still apply. A pulpectomy or pulpotomy is covered once per tooth in your lifetime, pain control is not covered on the same day and tooth as a filling, an open and drain, a pulpectomy, a pulpotomy or a root canal, and you pay any co-payment.
An emergency exam has no frequency limit, unless it is billed together with check-up services; it then counts as a check-up exam, and the check-up limit of one in any 12 months applies.
The plan does not define an emergency; your dentist decides how urgent your needs are. Urgency does not remove a preauthorization requirement. If a service that needs one, such as a root canal on a wisdom tooth, cannot wait for a decision, the office can ask for post-determination afterwards, but it is judged on the same criteria and may be declined, and Sun Life tells dental offices to discuss with you beforehand what you might have to pay.
Is a crown after a root canal covered?
Not automatically. A crown is a separate decision: the plan considers crowns only for people aged 18 and older and only through preauthorization, and the tooth that had the root canal must have healed before the crown is requested. The crown must also meet the plan's own crown criteria.
The plan's payment for a root canal includes the temporary filling placed during treatment, and replacing it if needed; the crown is not part of it. The page on crowns, linked below, explains the crown rules.
What will you pay?
Your share depends on your adjusted family net income, which must be under $90,000 to qualify for the plan. The plan pays a percentage of its own established fee for each covered service, and the rest of that fee is your co-payment, which you pay directly to the dental office.
If your adjusted family net income is under $70,000, the plan pays 100% of its fee and your co-payment is 0%. From $70,000 to $79,999, it pays 60% and your co-payment is 40%. From $80,000 to $89,999, it pays 40% and your co-payment is 60%.
Even with a 0% co-payment, you may still pay part of the cost. Dental offices are encouraged to bill the plan's fees but may charge up to their usual fees, and you pay any difference as well as any co-payment. You also pay for any service the plan does not cover that you agree to have.
You should not be asked to pay the full cost up front: the plan pays the dental office directly and does not reimburse patients. Before you agree to treatment, the office must go over which recommended services the plan will and will not cover and what you will be charged, and the Government of Canada advises always asking about uncovered costs before treatment. What the plan pays follows its rules, fees and your co-payment level on the day of treatment, which can differ from an earlier estimate.