The cost of visiting a dentist in Alberta in 2018 could be 8.5 per cent lower than it was in 2016.

The Alberta Dental Association and College unveiled a revised fee guide Wednesday, recommending new fees for 60 different procedures. On average the fees are 8.5 per cent lower than 2016 fees.

It's the college's second attempt this year at a fee guide. The first, which recommended an average reduction of three per cent, was blasted by Health Minister Sarah Hoffman after it was released in August.

Saying the fee reduction didn't go far enough, Hoffman sent the college back to the drawing board.

Hoffman heralded the updated fees at a news conference Wednesday.

"It's been a step that's been long awaited," she said.

The new fee guide is effective Jan. 1.

A year in the making

Mintoo Basahti, president of the Alberta's dental college, acknowledges dentistry has grown expensive in the province. (John Shypitka/CBC) For 20 years, Alberta dentists operated without a fee guide, meaning they had free range on what they could charge. A 2016 review found Alberta's dental fees to be the highest in the country.

The provincial government announced in December 2016 that a new dental fee guide, similar to what other provinces had in place, would be created to curtail costs.

The college, which worked with the government on the revisions, recognizes "that the current economic environment is challenging" and acknowledges "the fact that dentistry has become expensive in Alberta," said president Mintoo Basahti.

According to the new guide, the cost of an oral exam for a new patient will be $72 in Alberta, down from $75 recommended in the August fee guide. In British Columbia, the fee is $43.

A new fee guide recommends dental fees drop on average by 8.5 per cent in 2018. (Government of Alberta) The guide is just that: a guide. Dental fees in Alberta are not regulated and dentists are free to establish their own rates.

Hoffman said the guide offers patients a way to compare.

"After 20 years without a guide, it will take some time for dentists to adjust," she said.

Edmonton periodontist Douglas Pettigrew said coming up with a fee guide acceptable to both dentists and the government has been a challenge.

'Where do you cut back?'

"The government's study suggests that it is more expensive to run a practice in Edmonton and in Alberta, in general," Pettigrew said, citing an average overhead cost of 70 per cent.

"We run mini hospitals without government support," he said.

"You make a very good living, but you don't get rich doing dentistry," said Pettigrew, who has been in the profession for nearly 50 years.

The downward pressure on fees could mean some dentists will work longer, see more patients and potentially have to renegotiate staff salaries — or even lay off some employees, Pettigrew said.

"The challenge is where do you cut back?" he asked.

Pettigrew expects there will be patients asking whether dentists are following the guide. He predicts some dentists will adhere to it while others will not.

"Patients should alway speak to their dentist about the fees and they have the right to shop around and check with other dentists and compare fees and they should do that," Pettigrew said.

"If you really like the dentist you're working with and he's doing really good work, maybe it's worth paying a bit more."