Your fee guide is set once a year, by your province. Your gloves, gowns, bibs and barrier film are textiles, paper and plastics — and those are at 50%.
In force since 8 September · what hit a dental practice
Canada’s counter-tariffs on US goods reach a dental practice through the consumables cupboard, not the equipment bay:
- Clothing, textiles and protective garments — 50% — gloves, gowns, drapes, scrubs, laundry stock
- Plastic tableware, kitchenware, sacks and bags — 50% — barrier film, handpiece sleeves, cups, waste bags
- Paper and pulp products, including tissues and cardboard — 50% — bibs, tray covers, pouches, cartons
- Toilet paper and facial tissue — 25%; carpets and textile floor coverings — 25%
- Glass containers — 50%; beauty and personal care — 50% — the whitening and home-care shelf at the desk
Nothing on Canada’s list is described as a medical or dental good, and that is precisely why a dental supply account is caught: the schedule is written by material, not by use. Seven hundred-plus US products, $27.6 billion of imports, at rates of 15%, 25% and 50%, in force since 8 September. Goods already in transit on that date were not caught. This is being charged on the orders you place this week, not something arriving later in the year.
A dental fee guide is published provincially, once a year. A glove invoice is not. That is the whole shape of the problem: the revenue on a hygiene recall is fixed by a document somebody else writes on an annual cycle, and a large share of it is billed through insurance plans that will not absorb a supply increase in the middle of their own plan year. Talks between Ottawa and Washington have broken down, so plan on this lasting rather than lifting.
The American measure matters less directly, and it is worth saying why. US Section 338 has been in force since 22 August at 50% on roughly $28 billion of Canadian exports, CUSMA does not exempt captured goods, and it names 554 specific tariff subheadings rather than categories — advisers keep saying screen by code, not category, because a product one line away from a listed code is untouched. A practice sells appointments, so almost none of that reaches its revenue. It reaches the parcels. The US $800 de minimis exemption ended on 29 August 2025, so every parcel entering the United States now clears formally and carries a merchandise processing fee of about US$7.85 on a manual entry, plus duty; one documented case had a $37 item land at $60.17. HS codes have been required on all cross-border shipments since 1 September. If you send cases to a lab across the border, that is a shipment.
What we do about it: the New Markets Review works out exactly where your consumables, supply accounts and lab work are exposed, builds you a private AI knowledge base on your own supplier and procedure data, and scopes what to build next. It also covers who else in the world would buy what your practice has built. See what you receive →
What this actually does to a dental practice
- The fee guide moves once a year, and you do not write it. Provincial guides are set annually. Consumable prices moved on 8 September and will move again. Nothing in that cycle closes the gap for you.
- Insurance plans pay the schedule, not your costs. Where most of the billing runs through plans, a mid-year supply increase has nowhere to go. It lands on the practice, in full, until the next guide.
- The consumables list is long and nobody has costed it. Gloves, gowns, bibs, drapes, barrier film, sleeves, cups, pouches. Per patient each is pennies. Across a full appointment book it is the difference between a good year and a flat one.
Three things to do this week
- Cost your five highest-volume procedure codes at this week’s consumable prices. Hygiene recall, radiographs, a single-surface restoration, an extraction, a denture adjustment. Most practices have never done this and are surprised by which codes are thin.
- Ask your dental supplier for country of origin and the tariff line — the code, not the category — on your top twenty consumables. Clinically equivalent alternatives at lower landed cost frequently exist and are almost never offered unprompted.
- Write down every case you send out and where the lab is. If any of it crosses a border, that is a customs entry rather than a courier run, and it has been priced as a courier run for a year.
What it looks like in practice
Worked example · a four-chair general practice in Kamloops
Two dentists, two hygienists and three at the front desk across four operatories, about 5,200 patient visits a year. Roughly 70% of billing runs through insurance plans at the provincial fee guide; the rest is paid by the patient. Crown, bridge and denture work goes to two labs, one in Vancouver and one across the border in Washington State. The only retail is toothbrushes and a whitening line at the desk. The chairs were bought in 2019 and the imaging unit in 2021.
The barrier kit is the biggest mover and it is on no procedure cost sheet. Protective garments and textiles are at 50%, which is gloves, gowns, drapes and laundry stock. Plastic sacks and bags are at 50%, which is barrier film, sleeves and waste bags. Paper products are at 50% and facial tissue at 25%, which is bibs and tray covers. Every one of those is consumed per patient rather than per month, so the increase scales with the appointment book, not with the size of the storeroom.
The crown crosses the border twice, and nobody treats the lab courier as an importer. Sending a case south is a shipment. The $800 de minimis exemption ended on 29 August 2025, so each parcel now clears formally, carries a merchandise processing fee of about US$7.85 on a manual entry plus any duty, and needs an HS code, required on all cross-border shipments since 1 September. A documented case saw a $37 item land at $60.17. The finished unit then comes back. None of that cost reaches the procedure it belongs to.
One thing we could not settle, and one we would set aside. Whether a specific lab appliance or its alloy is captured depends on its actual classification, and both schedules name codes rather than categories, so we would not guess — that is a question for the lab and a licensed customs broker, in writing. What we would set aside is the capital list: the chairs and the imaging unit are bought once a decade and were bought years ago, so deferring the next one is a real decision but not what is costing this practice money in the current fee-guide year.
Then the other half. A clinic cannot export a filling, and we are not going to pretend otherwise — the patient has to be in the chair. What can leave the country is what the practice has already built and written down: the recall and short-notice system that keeps four chairs full, the hygiene protocol, the treatment-plan presentation, the staff training. Software and services cross a border with no freight, no duty and no customs paperwork at all, CETA opens EU public procurement worth about $3.3 trillion a year, and Australia and New Zealand share the clinical vocabulary so nothing needs translating. That is a two-year build, not a fix for this quarter’s glove invoice, and it should be planned as one.
What we would build:
- A per-procedure consumable model tying each fee-guide code to the actual barrier kit and materials used, so the codes that have gone thin are visible by name well before the next guide is published.
- A reorder screen showing origin, tariff line and two clinically equivalent alternatives before the order is confirmed, because textiles and plastics at 50% are where substitution pays best.
- A lab ledger recording where each case went, what the border added to it, and what the same case would cost at a domestic lab.
- A recall and short-notice list that fills cancellations automatically, because a filled chair is the only revenue lever the fee guide does not set.
The fee guide is published once a year and you do not write it. Everything above sits on the side of the ledger you do.
What you receive
Six things, built for your practice, starting within 48 hours of checkout.
The core is a written review: deep research across your consumables, supply accounts, lab work and sector, with a human checking every finding against the actual schedules and discarding what is wrong. You also get a private AI knowledge base trained on your website, supplier price lists, lab invoices and procedure mix — yours to keep, and able to answer “what does a hygiene recall actually cost us now?” with a source you can check. Running through both is a scoped plan of what we would build, with real hour estimates.
Alongside those: a slide deck for the partners, a one-page infographic, and video and audio overviews.
See a complete worked example → — every artifact, unredacted.
What we would build for your practice
- A per-code cost model tying every fee-guide code to its real consumable and chair-time cost, and flagging the codes that no longer cover themselves.
- A supply and reorder dashboard showing origin and equivalent non-US products before the order is placed rather than after the invoice arrives.
- A lab and case tracker holding turnaround, remake rate and true landed cost per lab, including what a border crossing adds.
- A recall and hygiene retention engine that finds the patients who are overdue and fills tomorrow’s gaps without anyone working a phone list by hand.
And beyond tariffs: the booking, charting or patient-portal system you have been putting off. See our case studies.
And the other half — who else would buy this?
You cannot put a restoration in a box, so a dental practice is not an exporter in the ordinary sense and we will not pretend otherwise. What does cross a border is everything built around the chair — the recall and scheduling system you had written for yourselves and could licence to fifty practices like you, the hygiene and sterilization protocols another country’s clinics would pay for, the training material, and the treatment-plan tooling — because software and services move with no freight, no duty and no customs paperwork at all.
CETA opens EU public procurement worth about $3.3 trillion a year, health systems included.Japan
An ageing population, and software that arrives with no freight and no customs paperwork.Australia & NZ
Same language and much the same clinical vocabulary, so protocols and training need no translation.Getting found
How a practice in another country finds your software in the first place.
Two things worth knowing
There is money for this
Ottawa has $7.5 billion behind tariff-hit businesses, including non-repayable contributions up to $3 million and working capital loans from $250,000. InfiniteUp does not run these programs and takes nothing from them. The full list →
Every parcel south is a formal entry now
The US $800 de minimis exemption ended on 29 August 2025. A parcel to a lab or a supplier now clears formally with a merchandise processing fee of about US$7.85 on a manual entry, plus duty, and needs an HS code. Small shipments are where this hides.
Questions we get asked
Is dental supply exempt because it is clinical?
No. Nothing on Canada’s list is described by clinical use at all — the schedule is written by material, which is why gloves and gowns sit under protective garments at 50% and bibs and tray covers under paper products. Whether a specific item is captured depends on its classification, which your supplier or a licensed customs broker can confirm. A remission process is open for inputs that genuinely cannot be sourced outside the United States. How remission works →
We buy everything from a Canadian dental supplier. Are we affected?
Almost certainly, through that supplier. Canadian dental distributors source heavily from US manufacturers and pass counter-tariff costs down the chain, so it arrives as a revised price list rather than a customs bill. Ask for the entry date on any blanket increase, because goods already in transit on 8 September were not caught.
We send lab work to the United States. What changed?
The parcel rules. The $800 de minimis exemption ended on 29 August 2025, so every shipment now clears formally, carries a merchandise processing fee of about US$7.85 on a manual entry plus any duty, and requires an HS code. Whether the appliance itself is captured by the 50% Section 338 measure depends on its specific tariff subheading — there are 554 of them, so screen by code and confirm with a broker rather than assuming from the category.
Do I have to hire you for software afterwards?
No. The plan is written to be useful whether or not you ever work with us.
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Related
- Medical and wellness clinics
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- Salons and barbershops
- Professional services
- The full rules, in plain English
- Where else in the world would buy this?
The worked example above is an illustration, not a client, and every tariff fact in it is real. Operational and strategic guidance from a software studio, not legal, customs, dental, or tax advice. Confirm classification and duty liability with a licensed customs broker. Last reviewed 19 September 2026.