[2022] Healthy Smiles Ontario: Everything You Need to Know

Posted by Dr. Joanne Baldos and Dr. Adam Szymczak on May 28, 2022 8:30:33 PM

If you are looking for free dental care in Ontario for your child, the Healthy Smiles Ontario Program may be what you need. Eligible children and youth can receive regular dental services at no cost. This program is funded by participating dentists and the Ministry of Health and Long-Term Care.

 

Healthy Smiles Ontario (HSO) offers three pathways to address a range of oral health needs throughout the eligible population:

  • The Preventive Services Only Stream (delivered through Public Health Unit clinics);
  • The Core Services Stream; and
  • The Emergency and Essential Services Stream.

Healthy Smiles Ontario Eligibility Criteria and Eligibility Assessment Location

Healthy Smiles Ontario Program

Let's first discuss the Core Services Stream as it is the most common and most likely the one you are looking for:

HEALTHY SMILES ONTARIO

(Core Services Stream)

 

What is Healthy Smiles Ontario Program (Core Services Stream), and who is eligible for coverage?

Healthy Smiles Ontario is a government-subsidized dental program that provides free preventive, routine, and emergency dental services for eligible children and youth. To be eligible, children and youth must:

  • be 17 years of age or younger
  • live in Ontario
  • live in a low-income household:
    • 1 child household; household income must be $24,930 or lower
    • 2 children household; household income must be $26,817 or lower
    • 3 children household; household income must be $28,703 or lower

If a family receives: Ontario Works, Temporary Care Assistance, Assistance for Children with Severe Disabilities, or the Ontario Disability Support Program, they are automatically enrolled in Healthy Smiles Ontario.

 

A child with dental insurance can apply and be eligible for HSO if the above criteria are satisfied.

 

What services are covered by Healthy Smiles Ontario ( Core Services Stream)?

A full range (preventive and routine) of dental services are covered at no cost for all eligible children and youth. These services include:

  • Dental exams and Checkups
  • Cleanings
  • Fluoride treatment
  • Sealants
  • X-rays
  • Mouthguards
  • Fillings for cavities: silver and tooth-colored fillings
  • Pins
  • Root canals, posts
  • Root canal surgery
  • Prefabricated crowns
  • Indirect crowns: only for permanent teeth
  • Extractions
  • Gum surgery
  • Complete dentures
  • Partial dentures for the replacement of permanent anterior teeth only 
  • Fixed bridges for the replacement of permanent anterior teeth only 
  • Laboratory fees
  • Sedation

What services are NOT covered under Healthy Smiles Ontario?

Braces and dental implants are not covered by Healthy Smiles Ontario. In addition, cosmetic treatments such as veneers and teeth whitening are not covered.

 

How much does Healthy Smiles Ontario cost?

Healthy smiles Ontario is a free program for eligible children and youth. There are no monthly premiums, copayments, or deductibles.

 

How to apply for Healthy Smiles Ontario ( Core Services Stream)?

There are 3 ways to obtain an application and apply:

A) Pick up an application from your local public health unit or a Service Ontario location. 

B) Download and print the Healthy Smiles Ontario application: HERE.

( you will need Adobe Acrobat Reader version 10.0 or higher)

Completed paperwork should be mailed to:

Healthy Smiles Ontario

33 King Street West

PO Box 645

Oshawa, ON

L1H 8X1

 

How to apply online for Healthy Smiles Ontario ( Core Services Stream)?

C) Complete the “online application form”.

 

To complete the application online, you will need the latest version of one of these web browsers: Google Chrome, Mozilla Firefox, Safari, or Microsoft Edge.

Before you begin the online application, you need:

  • your child(ren)’s date(s) of birth
  • a valid Ontario address
  • your Social Insurance Number (SIN) or Temporary Taxation Number (TTN)
  • to have filed your taxes in the previous year
  • If you have a spouse or common-law partner, they must be with you to complete the online application. Each of you needs to have an email.

Once the application is approved, you will receive a dental card in the mail like this:

Healthy Smiles Ontario card

The dental card must be presented to a dental provider at each visit to receive dental care under the Program.

 

If there is a problem with your application, you will be contacted by phone and/or mail.

 

How to renew Healthy Smiles Card Ontario?

Each HSO dental card is issued for a full benefit year (August 1—July 31) or up to the date of the client’s 18th birthday (the earlier of the two dates), as indicated by the expiry date on the front of the card. Enrolment is automatically reassessed on an annual basis.

 

Are there any restrictions on how often I can visit the dentist through Healthy Smiles Ontario?

In theory, there are no restrictions on how often you can visit the dentist through Healthy Smiles Ontario; however, practically speaking, it is essential to keep in mind that there are significant limitations to how often procedures can be performed.

 

How do I make an appointment with a dentist through Healthy Smiles Ontario?

To make an appointment with a dentist through Healthy Smiles Ontario, you must first receive a Healthy Smiles Ontario card; then, you can contact your local dental office or Public Health Unit.

 

If you have a dentist, contact their office to determine if they participate in Healthy Smiles Ontario. If you don’t have a dentist, call different dental offices and find out if they accept HSO. If you need help finding a participating dentist, please contact your local public health (see below under "Healthy Smiles Ontario phone numbers"). The other option is to have dental treatment performed by a dentist working in a Public Health Unit.

 

The dental care provider will need to see your child's Healthy Smile Ontario Card to confirm eligibility at every visit. Once eligibility is approved, your child can receive dental services at no cost!

 

Do all dentists accept Healthy Smiles Ontario?

Unfortunately, most dentists do not accept Healthy Smiles Ontario. However, many dentists do participate in the program. Call different dental offices and ask before visiting a dental clinic.

 

Unfortunately, this government program is challenging for dental clinics to administer due to the many exceptions and restrictions in the Healthy Smiles Ontario fee guide. Hence most dental offices opt-out of participating in HSO.

 

Healthy Smiles Ontario phone numbers:

Your Local Public Health units are a valuable source of information regarding program eligibility as well as a source of application pick-up/ drop-off:

 

Toronto Public Health units:

There are 15 public health units in Toronto; call 311 (24 hours a day, seven days a week) for the closest unit to you.

Ottawa Public Health Unit:

Phone Number : 613-580-6744, 1-866-426-8885, TTY: 613-580-9656

 

Peel Public Health Unit:

Phone Number: Mississauaga and Brampton: 905-799-7700

Phone Number: Caledon: 905-584-2216

 

Hamilton Public Health Unit:

Phone Number: 905-546-2489

 

Middlesex-London Health Unit

Phone Number : (519) 663-5317 ext. 2231

 

Niagara Region Public Health Unit

Phone Number: Kitchener and Cambridge:

905-688-8248, 1-800-263-7248 ext. 7399

 

Waterloo Public Health Unit

Phone Number: 519-575-4400, ext. 13304

 

Wellington-Dufferin-Guelph Public Health

Phone Number: 1-800-265-7293 ext. 2661

 

 

HEALTHY SMILES ONTARIO

(THE EMERGENCY AND ESSENTIAL SERVICES STREAM )

Healthy Smiles Ontario: The Emergency and Essential Services Stream

 

Who is eligible for the Emergency Services Stream under Healthy Smiles Ontario?

Healthy Smiles Ontario includes the Emergency and Essential Services Stream (EESS) to address emergency and/or essential dental needs. Children and youth from low-income families are eligible for the EESS if they meet the following criteria:

  • 17 years of age or younger; and
  • a resident of Ontario; and
  • have a clinical need that qualifies as emergency dental care; and
  • be able to show financial hardship

What qualifies as emergency/essential dental care under EESS?

Emergency dental services are available for eligible children and youth who experience sudden and unexpected dental problems. These services include: 

  • toothaches and pain,
  • abscesses and infection,
  • trauma (such as broken or knocked-out tooth),
  • lost filling,
  • deep cavity ( can be easily seen)

 What is considered financial hardship under EESS?

The child/youth or family’s income is equivalent to a level at which they would be in

receipt of the Ontario Child Benefit:

OR

The child/youth or family would suffer “financial hardship” if providing the necessary

dental care would result in any one of the following:

  • Inability to pay rent/mortgage;
  • Inability to pay for household bills;
  • Inability to buy groceries for the family; or
  • The child/youth or family will be required to seek help from a food bank to provide food. 

How to apply for EESS under Healthy Smiles Ontario?

Contact a dental clinic near you to determine if they participate in Healthy Smiles Ontario to apply for emergency care.

 

Contact your local public health unit for help if you don't have a dentist or can not find one that participates in the program.

 

To apply for EESS, a child and/or youth must meet the clinical and financial hardship criteria discussed above.

 

Your dentist or Public Health Unit will assess the child/youth for clinical eligibility and assist with completing the EESS application form, which includes attesting to financial hardship.

 

You will be asked some questions about how you or your family would be affected if you had to pay for dental treatment. For example, would you be able to pay household bills if you had to pay for dental treatment?

 

Children receiving emergency and/or essential care are covered for 12 months from their enrollment date. They must re-apply at the end of 12 months to determine if they’re still eligible.

 

HEALTHY SMILES ONTARIO

(The Preventive Services Only Stream)

(delivered through Public Health Unit clinics only)

Healthy Smiles Ontario: The Preventive Services Only Stream

How to Apply?

You can not apply for this stream. Children are identified as being clinically eligible for the Preventive Services Only Stream (PSO) through Public Health Unit screening activities. Public Health units will notify parents/guardians that their child qualifies and will assist with enrolling into the PSO stream. 

 

What is covered?

Only professionally applied topical fluoride, pit, and fissure sealants, scaling, and temporary stabilization therapy are covered under the PSO stream.

 

Healthy Smiles Ontario fee guide

To view the Healthy Smiles Ontario fee guide, visit: HERE.

The Healthy Smiles Ontario Schedule of Dental Services and Fees for Dentist Providers is not intended nor should it be relied upon to determine the scope of practice of dentists in Ontario.

 

 

We hope this blog post has helped answer all of your questions about Healthy Smiles Ontario! If you have any further questions, please ask  below and we will be happy to answer.

 

Healthy Smiles Ontario is only one of 8 government-funded dental care programs in Ontario:

OHIP Dental Coverage and Free Dental Care Ontario in 2022.

 

In the best interest of your health and well-being,

Dr. Joanne Baldos and Dr. Adam Szymczak

 

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