In Canada, the delivery of dental care is left largely to private markets; public funding is limited to targeted groups of the population and substantial variation between provinces exists. In this article, the levels and sources of expenditures on dental care, the levels and distribution of service use associated with these expenditures and the oral health outcomes "produced" in Canada are considered in an international context. The international trend toward an increasing share of public funds for dental care expenditures is not observed in Canada. Instead an increasing reliance on private funds is associated with greater barriers to care, particularly among less prosperous groups. In the absence of oral health data at the national level, the impact of these trends on oral health outcomes is unknown. Several key messages are identified in the comparative analysis to inform any future oral health strategy for Canada.