The short answer
Pediatric specialists bill from the Ontario specialist fee guide, not the general practitioner guide — so the same procedure code carries a higher suggested fee. Your insurance may reimburse against the lower guide, leaving a gap. Ask about the cost and request a pre-determination before treatment so you know where you stand.
Two Fee Guides, Not One
Every year the Ontario Dental Association publishes suggested fee guides. There isn't just one — there's a guide for general practitioners and a separate guide for certified specialists. Both use the same procedure codes, so a given treatment is billed under the same code either way. The suggested fee attached to that code is simply higher in the specialist guide.
This catches families off guard, because nothing about the appointment looks different on the receipt. Same code, different number. It isn't a surcharge our office invented, and it isn't negotiable practice by practice — it's the structure of how specialty dentistry is billed across the province.
What You're Paying For
Becoming a certified pediatric specialist means dental school followed by a multi-year hospital residency dedicated entirely to treating children. Dr. Julie Maniate completed hers at Toronto's Hospital for Sick Children and Yale–New Haven Hospital, and holds Diplomate status with the American Board of Pediatric Dentistry — the specialty's highest voluntary credential.
In practice that training buys three things: behaviour management for children who can't or won't cooperate, clinical judgment for the situations general dentistry sees rarely, and the ability to keep a frightened child calm rather than sedated. For a routine check-up on a cooperative eight-year-old, that's more expertise than the moment requires. For a two-year-old with early decay, a child with autism, or a teenager who has been avoiding care for years, it changes the outcome.
How Insurance Handles the Difference
This is where families actually get stung, so it's worth understanding before you book.
Many dental plans reimburse against the general practitioner fee guide regardless of who performed the treatment. If the specialist fee is higher than what your plan pays, the difference is yours. Other plans cover specialist fees at the specialist rate. Some cover specialist care only with a referral on file.
You do not have to guess. Ask us for a pre-determination: we submit the proposed treatment to your insurer in advance and they respond in writing with exactly what they will pay. It takes a couple of weeks and removes the entire question. For anything beyond a routine visit, it's worth the wait.
If your child is covered under the Canadian Dental Care Plan, the CDCP reimburses from its own fee schedule, which may sit below the specialist fee. Ask us to go over any gap in dollars before treatment starts. More on insurance and CDCP →
When the Specialist Is Worth It
Be honest with yourself about which situation you're in. Specialist care earns the difference when:
- Your child is under three and needs treatment, not just a look
- There's significant anxiety, a previous bad experience, or a child who won't open their mouth
- Your child has special healthcare needs — medical, developmental or behavioural
- There's dental trauma — a knocked-out or badly broken tooth
- Decay is extensive in a young child, or sedation or hospital dentistry is being discussed
For a healthy, cooperative child coming in for exams and cleanings, our general dentists are an excellent and less expensive fit. We will tell you which one you need. About our pediatric specialty care →
Ask About Cost Before You Start
Whichever dentist your child sees, ask us to walk you through the cost before treatment begins — the procedure codes, our fee, what we expect insurance to cover, and what's likely left for you. We bill your insurer directly wherever your plan allows, so you pay only your portion at the visit.
Questions about a specific estimate are welcome and never awkward. Call (613) 491-3300.