Is Wisdom Tooth Removal Covered by OHIP?

For many patients, wisdom tooth removal is necessary for oral health. It’s not surprising, then, that one common question we hear is whether OHIP covers the cost of these kinds of oral surgeries.

While OHIP may cover certain oral surgeries performed in a hospital, it generally does not pay for wisdom tooth removal in a dental clinic. This guide explains OHIP’s role in dental surgery, the costs you can expect, and the payment options available to you.

Why You Might Need Your Wisdom Teeth Removed

Wisdom teeth, or third molars, are the last teeth to come in. For many people, there isn’t enough room in their jaw for these teeth to grow in properly. This can lead to a variety of oral health issues that make removal a practical choice.

Signs Your Wisdom Teeth Are a Problem

You may need your wisdom teeth removed if you experience some of the following symptoms:

• Pain or stiffness in your jaw near the back of your mouth
• Irritation or pain from a tooth rubbing against your cheek or tongue
• An infected flap of gum tissue over the tooth, known as pericoronitis
• Crowding of your other teeth
• Damage or decay in the neighbouring molar

The Risk of Impacted Wisdom Teeth

An impacted tooth is one that’s stuck under the gum or has only partially broken through. Impacted wisdom teeth can grow at an angle, sometimes even horizontally. This can cause significant pain, damage to adjacent teeth, and may lead to cysts that can harm the jawbone.

The Role of OHIP in Dental Surgery

Understanding what OHIP covers is key to planning for your procedure. While OHIP pays for many medical needs, it only covers specific dental work.

When OHIP May Cover Your Procedure

OHIP does not typically cover routine dental care that happens in a dental office. However, it may cover some oral surgeries if they are performed in a hospital. 

For wisdom tooth removal to be considered for OHIP coverage, the procedure must be medically necessary, meaning it requires a hospital setting due to the complexity of the extraction.

What OHIP Does Not Cover

Most wisdom tooth removals happen at a dental clinic, and these procedures are not covered by OHIP. You should expect that OHIP will not pay for the extraction itself, the sedation, or any related fees from your dentist.

Even if the procedure is done in a hospital, OHIP may only cover the hospital’s costs (like the stay), but not the dental surgeon’s fee.

The Cost of Wisdom Tooth Removal in Ontario

Since OHIP coverage is rare, it’s important to budget for the cost of wisdom tooth removal. The price can change based on several factors, including how complex the procedure is.

Factors That Affect the Price

The total cost of your extraction depends on a few things:

• Number of Teeth: The price will increase with each tooth you need removed.
• Impaction: A simple extraction of a fully erupted tooth costs less than removing an impacted tooth.
• Sedation: The type of sedation you choose, from oral to IV sedation, will affect the final bill.
• Diagnostics: Costs for X-rays or other imaging are usually separate.

Average Cost Per Tooth & For All 4

In Ontario, a simple wisdom tooth extraction can cost between $200 and $400 per tooth. For a more complex or surgical extraction, the cost can be $450 to over $750 per tooth. 

If you need all four wisdom teeth removed, the total cost could range from $1,500 to over $2,000.

Planning for Wisdom Tooth Removal

The cost of wisdom tooth removal can be a concern. Fortunately, you have several options to help manage the expense beyond OHIP.

Your Private Dental Insurance Plan

Most private dental insurance plans cover a significant portion of wisdom tooth removal costs. At Markham Dental, we accept all major insurance companies and offer direct billing to make the process simple for you. It’s a good idea to review your policy to understand your coverage limits before your procedure.

Payment Plans & Other Options

We believe you shouldn’t have to sacrifice your oral health because of money. That’s why our clinic offers financing solutions. This allows you to spread the cost over time, making the treatment more accessible.

The Canadian Dental Care Plan (CDCP)

For those who qualify, the Canadian Dental Care Plan (CDCP) can help cover dental costs. This federal program is designed for Canadian residents who have a household income under a certain threshold and do not have private dental insurance. The CDCP can help reduce out-of-pocket costs for procedures like wisdom tooth extractions.

The Extraction Process at a Dentist in Markham, ON

When you’re ready to address your wisdom teeth, the process is straightforward. A trusted dental team can guide you through each step to help you feel comfortable.

Your Initial Consultation & X-Rays

The first step is a consultation with your dentist. We will examine your mouth and take X-rays to see the position of your wisdom teeth. From there, we can determine if removal is the right course of action.

Types of Extraction Procedures

Depending on your needs, the procedure will be a simple or surgical extraction. A simple extraction is for a tooth that is visible above the gumline. A surgical extraction is needed for impacted teeth and involves making a small incision in the gum tissue to access the tooth.

Flexible Hours for Your Busy Schedule

We know that your time is valuable. That’s why we offer convenient evening and Saturday appointments to fit your busy schedule. With our online booking calendar, you can schedule your consultation at a time that works for you, without disrupting your work week.

While OHIP coverage for wisdom tooth removal is limited, you have many other options for managing the cost and procedure. From private insurance and the CDCP to flexible financing, taking care of your oral health can fit within your budget.

At Markham Dental, our team is here to help you navigate the process with convenient appointment times that work for you.If you’re experiencing issues with your wisdom teeth, book a consultation with us today using our online calendar. We can discuss your treatment options and find a solution that fits your life.