If the past six weeks feel like a lot to keep track of, that reaction is reasonable. A brand-new Standard of Practice took effect on July 3. A corporate certificate deadline is bearing down on August 31. And the Canadian Dental Care Plan is rejecting more than half of preauthorization requests. None of these items can sit in the “I’ll get to it” pile. Here is what you need to know, and what to do about it.
The New RCDSO Standard: Ending the Dentist-Patient Relationship
The Royal College of Dental Surgeons of Ontario approved a new Standard of Practice at its June 18, 2026 Council meeting. The standard, titled “Managing Conflicts and Ending the Dentist-Patient Relationship,” became effective on July 3, 2026. This is not an advisory or a guideline. It is a Standard of Practice, which means full compliance is required for every Ontario dentist now.
The standard addresses a situation that most dentists encounter eventually: a breakdown in the therapeutic relationship that makes continuing care untenable. Under the new SOP, a dentist may end a patient relationship in specific, defined circumstances. These include persistent non-compliance with a recommended treatment plan, abusive or threatening behavior toward staff or the dentist, repeated missed appointments without notice, and financial misconduct. What the standard makes clear is that ending the relationship is a professional decision with procedural obligations attached, not simply a matter of discretion.
Notice is a key requirement. The RCDSO expects that patients receive written notice with enough advance time to find alternative care. The standard does not permit abrupt termination except in narrow circumstances involving safety. In practice, this means your notice must be clear, professional, and delivered in a way you can document. A verbal conversation is not sufficient on its own.
Continuity of care obligations remain in effect even after you have decided to end the relationship. You are expected to continue providing emergency care during the notice period, and you must take reasonable steps to help the patient transition to another provider. If you are the patient’s primary care dentist or have ongoing active treatment underway, those responsibilities weigh even more heavily in how you manage the transition.
Documentation is where many practices will be most exposed. The RCDSO expects that your records reflect the circumstances that led to the decision, the notice given, the steps taken to support continuity of care, and confirmation that the patient received the communication. A note that simply says “patient dismissed” will not satisfy this standard.
Take time this month to read the full SOP directly from the RCDSO and distribute it to your office manager and any associate dentists in your practice. If you have a patient dismissal policy in your practice manual, compare it against the new standard and update it accordingly. If you do not have a written policy, now is the time to create one.
HPC Renewal Deadline: August 31, 2026
If your Ontario dental practice operates under a Healthcare Professional Corporation, your Certificate of Authorization must be renewed by August 31, 2026. The RCDSO is clear on what happens if you miss this deadline: the certificate is automatically revoked.
The fee structure matters here. Renewals completed before July 31 cost $175. After July 31 and through August 31, the fee increases to $200. If you have not already initiated your renewal, do it this week. The mechanics of the RCDSO online renewal portal are straightforward, but the window is narrowing.
A revoked Certificate of Authorization does not mean you cannot practice dentistry. It means your professional corporation cannot legally operate as the entity through which you practice. The downstream consequences can include problems with your billing structure, your insurance arrangements, and your corporate banking. Restoration after revocation carries additional costs and administrative burden that are entirely avoidable.
Check your renewal status today. If your HPC is current, confirm it. If it is not, start the process immediately.
CDCP: Why More Than Half Your Preauthorizations Are Being Rejected
The Canadian Dental Care Plan has reached $3.4 billion in committed funding. Demand has exceeded government forecasts by a wide margin, which is a sign that the program is reaching patients who genuinely needed access to care. For Ontario dental practices, however, the administrative reality of the CDCP has become a significant challenge. Only 46% of preauthorization requests are currently being approved. That means more than half are coming back as rejections, creating cash flow pressure and requiring additional staff time to manage.
Understanding why claims are being rejected is the first step toward improving your approval rate. Common rejection patterns include procedure codes that do not align with the patient’s age band or CDCP benefit category, clinical justification narratives that are too brief or do not directly address the CDCP reviewer’s criteria, missing or insufficient radiographic documentation attached to the submission, and treatment plans that exceed what the patient’s coverage tier supports without a proper breakdown of covered versus non-covered portions.
The CDCP reviewers are assessing whether the proposed treatment is necessary, appropriate for the patient’s covered benefit category, and supported by the clinical records you have submitted. Vague notes and incomplete documentation are the most common reason legitimate claims are being denied. A note that says “patient presents with decay” is not the same as a note that identifies the specific tooth, describes the extent of the lesion, notes the radiographic findings, and explains why the proposed treatment is the appropriate clinical response.
On the documentation side, every preauthorization should go out with the relevant bitewing or periapical radiographs attached, not simply referenced. Your clinical notes should tell the story of why this treatment is needed for this patient. If the CDCP benefit guide restricts a procedure to certain clinical indications, your records should explicitly address those criteria.
When a preauthorization is rejected, review the rejection reason carefully before resubmitting. If the rejection is based on missing documentation, gather and attach it. If it is based on a coding issue, verify the correct procedure code against the CDCP fee guide. If the rejection appears to be a clinical judgment call, you have the right to appeal, and a well-structured appeal with clear clinical rationale is worth pursuing for higher-value treatments.
At a practice management level, consider assigning a dedicated team member to CDCP claims and preauthorizations, separate from your routine billing. The volume and complexity of CDCP administration is substantial enough that it benefits from focused ownership rather than being absorbed into a general billing workflow.
New Leadership at the ODA and CDA
Dr. Janet Leith became the 153rd President of the Ontario Dental Association on June 1, 2026. Dr. Kirk Preston was elected President of the Canadian Dental Association for the 2026-27 term. Both leaders take the helm at a moment when CDCP advocacy, regulatory change, and the economics of dental practice are all pressing simultaneously.
ODA and CDA leadership transitions matter to Ontario practices because both associations are active in the discussions that shape what CDCP looks like operationally, how the fee guide evolves, and how the profession responds to regulatory change at both the provincial and federal levels. Staying engaged with your professional associations is not a passive exercise right now.
What You Should Do
The immediate priorities are clear. Renew your HPC Certificate of Authorization before July 31 to avoid the higher fee and, more critically, before August 31 to avoid revocation. Read the new RCDSO SOP on ending the dentist-patient relationship and compare it against your current practice policy. Review your CDCP preauthorization rejections and identify the patterns so you can address documentation gaps at the source.
None of these items are optional, and several carry automatic consequences if ignored. The good news is that all of them are manageable with focused attention in the next few weeks.
How MAP Can Help
If navigating RCDSO compliance requirements, corporate certificate renewals, or CDCP billing challenges is stretching your team’s capacity, MAP Healthcare Consulting and Management works with Ontario dental practices on exactly these issues through our Risk and Compliance and OHIP Billing service lines.