Eligibility for Funding
An individual must be:
1. A resident of Ontario in possession of a valid OHIP number
2. Diagnosed as having a cleft lip and/or palate, a craniofacial anomaly or other severe dental dysfunction
3. Be registered in the program before their 18th birthday. The Ontario Cleft Lip and Palate/Craniofacial Dental Program covers up to 75% of the preapproved dental specialist treatment costs not covered by private dental insurance.
These costs may include:
- Dental infant orthopaedics
- Orthodontic treatment
- Some restorative dentistry
- Dental prosthetics
- Dental implants and oral surgery not funded by OHIP
The program will NOT
cover the cost of regular dental checkups, some procedures that are not deemed eligible and long term followup care.
Clinic Team Members
An individual’s eligibility for registration with the program is determined by the Dental Director and the assessment team at each designated centre. Rehabilitation for these conditions requires the expertise of a team of medical, dental and other specialists.
If you would like to refer a child to the Cleft Lip and Palate/Craniofacial Dental Program for an eligibility assessment, please complete the referral form below and fax it to (519) 252-5873.
Plastics clinics and dental clinics are held at JMCC and are comprised of the following team members:
- Plastic surgeon
- Paediatric dentist
- Oral-Maxillofacial Surgeon
- Speech-Language Pathologist
- Social Worker
- Administrative Assistant
- A treatment plan and fee estimate must be forwarded to, and approved by, the Dental Director of a designated centre prior to the initiation of any dental treatment.
- Use of private dental insurance and coverage provided by The First Nation and Inuit Health Branch, Ontario Works, Ontario Disability Support Program or The Children in Need of Treatment Program must always precede any funding through the Cleft Lip and Palate/Craniofacial Dental Program.
- The program will reimburse 75% of dental treatment costs remaining after private dental insurance.
- If there is no private insurance in place, the program will reimburse for the 75% of the approved estimate.
- A funding limit applies to treatment for clients registered with diagnoses other than Cleft Lip and Palate and/or Craniofacial syndromes.
- All requests for reimbursement (e.g. orthodontic bills) must be sent to The Hospital for Sick Children, the designated provincial paymaster for the program.
The following reimbursement request form must be submitted to The Hospital for Sick Children with your original dental bill:
Please click here for Reimbursement Request Cover Form
Medela Special Needs feeders (cleft lip and palate bottles) and replacement parts are available for purchase at the JMCC. Please contact us to order bottles and supplies.