How much does the dentist cost for your children & family?
28 Jan 2016
Kids’ dental health
It’s a persistent dental myth that you don’t need to keep on top of your children’s oral health because their baby teeth are going to fall out anyway. But a kids’ dental check-up, examination, and scale and clean before school starts is vital for ongoing oral health and the identification of anything that may balloon into a problem later on.
Need some advice on how to best look after teeth? We’ve got you covered.
Playing sport? They might need a mouthguard
Another issue to consider when it comes to your children’s oral health is mouthguards. Ask your dentist if you need to update your children’s custom-fitted mouthguards. If they play football (AFL, rugby league, rugby union), hockey (field or ice), basketball or netball, or any contact sport (karate, taekwondo, judo), a properly-fitting mouthguard can minimise injury from damaged and dislodged teeth, broken jaws, and cut lips.
Children are constantly growing and you may need to remake their custom-fitted mouthguard every year or so for the optimum fit, comfort, and protection. For more information on mouthguards, including first aid advice for treating a tooth injury, go to the Australian Dental Association (ADA) website.
Also, for those of us with sporty kids, remember that sugary sport drinks can be pretty bad for their teeth, too!
What are dental costs like these days?
The cost of dentistry remains a significant stumbling block for many Australians. This is caused, in part, by a lack of clarity with pricing. Unlike medical services covered by Medicare, which have prescribed fees, there are no standard fees for services provided by dentists or other dental professionals.
Two options to explore are:
Family Tax Benefits for dental
If you are eligible under Family Tax Benefit Part A, you could be entitled to receive $1,000 in assistance towards each child’s dental treatment every two years as part of the Australian Government’s Child Dental Benefits Scheme. This program has already provided assistance to over one million children. The majority of these services have been bulk billed. To find out more, go to –humanservices.gov.au/customer/services/medicare/child-dental-benefits-schedule
Private Health Insurance
If you have private health insurance with ancillary (or ‘extras’) cover, chances are you can get a certain amount of free or low-cost preventative dental care annually – a great way to avoid high costs later on. But it won’t help if you don’t use it! A recent National Survey of Adult Oral Health found that almost 30% of people with private dental cover hadn’t visited their dentist in the last year. To get the most out of your health insurance dollar, take advantage of any dental healthcare provided. Ask what free or reduced-cost preventative dental care you can get. If the answer is nothing, consider moving your ancillary cover to a company that funds it.
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Dental codes and prices for dental procedures
All dental procedures are assigned a common dental code covering the five key areas of dentistry:
- Diagnostic
- Preventative
- Oral surgery
- Restorative
- Crowns
It’s helpful to consult the Australian Dental Association (ADA) table, below, to familiarise yourself with what the different dental codes mean. Then you can cross-match the coded treatments with the ADA table that sets out the prices and charges for those services across all states and territories. This also shows the national average cost of treatment.
The most recent table of dental codes and prices was compiled by the Department of Health using claims data from private health insurance in 2015. While it may not be 100% accurate in all cases, it gives a good benchmark for comparison against any dental quotes you may receive.
It also adds to your knowledge bank when talking to your health insurer about how much they will rebate for a particular service. Dental claims make up a big chunk of the health insurance extras industry, so make sure you’re adequately covered for any kids’ dental costs you might incur.
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ADA code descriptions
| ADA Code | Description | Category |
|---|---|---|
| 011 | Comprehensive oral examination | Diagnostic |
| 012 | Periodic oral examination | |
| 013 | Oral examination – limited | |
| 014 | Consultation | |
| 022 | Intraoral periapical or bitewing radiograph – per exposure | |
| 071 | Diagnostic model – per model | |
| 111 | Removal of plaque and/or stain. | Preventative |
| 114 | Removal of calculus – first visit | |
| 121 | Topical application of remineralising and/or cariostatic agents, one treatment | |
| 161 | Fissure sealing – per tooth | |
| 311 | Removal of a tooth or part(s) thereof | Oral Surgery |
| 521 | Adhesive restoration – one surface – anterior tooth – direct | Restorative |
| 522 | Adhesive restoration – two surfaces – anterior tooth – direct | |
| 523 | Adhesive restoration – three surfaces – anterior tooth – direct | |
| 531 | Adhesive restoration – one surface – posterior tooth – direct | |
| 532 | Adhesive restoration – two surfaces – posterior tooth – direct | |
| 533 | Adhesive restoration – three surfaces – posterior tooth – direct | |
| 534 | Adhesive restoration – four surfaces – posterior tooth – direct | |
| 575 | Pin retention – per pin | |
| 577 | Cusp capping – per cusp | |
| 615 | Full crown – veneered – indirect | Crowns |
Average dental charges for privately insured services during 2015
| ADA Code | NSW/ACT | NT | QLD | SA | TAS | VIC | WA | National Average |
|---|---|---|---|---|---|---|---|---|
| 011 | $59.10 | $68.89 | $58.25 | $56.60 | $61.88 | $58.79 | $59.91 | $58.97 |
| 012 | $55.54 | $62.50 | $52.63 | $52.54 | $60.00 | $53.63 | $55.95 | $54.40 |
| 013 | $49.31 | $57.47 | $46.22 | $49.14 | $49.13 | $47.75 | $49.17 | $48.41 |
| 014 | $65.60 | $76.25 | $62.00 | $62.52 | $64.79 | $65.68 | $63.58 | $64.39 |
| 022 | $41.52 | $45.90 | $41.00 | $43.68 | $43.17 | $42.56 | $44.24 | $42.25 |
| 071 | $63.42 | $58.92 | $56.91 | $60.68 | $64.70 | $60.64 | $62.53 | $61.33 |
| 111 | $59.35 | $73.67 | $56.86 | $60.06 | $56.81 | $55.88 | $63.53 | $58.32 |
| 114 | $107.30 | $127.11 | $104.82 | $107.67 | $107.83 | $107.48 | $108.49 | $107.13 |
| 121 | $34.81 | $31.50 | $31.12 | $32.28 | $32.22 | $33.52 | $33.86 | $33.46 |
| 161 | $53.54 | $63.45 | $52.87 | $45.46 | $47.89 | $52.26 | $57.24 | $52.82 |
| 311 | $171.65 | $174.67 | $164.89 | $145.95 | $174.54 | $158.89 | $157.18 | $163.45 |
| 521 | $141.24 | $148.42 | $134.01 | $126.43 | $151.22 | $135.95 | $131.60 | $136.30 |
| 522 | $173.91 | $179.91 | $161.92 | $152.70 | $181.62 | $163.24 | $159.22 | $165.30 |
| 523 | $199.97 | $213.70 | $189.75 | $176.58 | $206.09 | $186.88 | $185.17 | $191.19 |
| 531 | $148.10 | $159.45 | $143.86 | $134.95 | $157.76 | $143.19 | $145.13 | $144.93 |
| 532 | $191.13 | $198.33 | $179.60 | $171.75 | $195.00 | $180.53 | $184.76 | $183.99 |
| 533 | $219.92 | $238.05 | $211.72 | $208.31 | $223.38 | $210.36 | $218.10 | $215.02 |
| 534 | $244.31 | $291.62 | $240.29 | $226.79 | $252.74 | $231.77 | $241.46 | $239.04 |
| 575 | $33.75 | $34.02 | $32.13 | $30.76 | $34.18 | $33.56 | $34.27 | $33.03 |
| 577 | $34.62 | $35.95 | $34.64 | $30.98 | $34.55 | $32.40 | $40.24 | $34.20 |
| 615 | $1,463.79 | $1,497.80 | $1498.51 | $1,475.25 | $1,540.98 | $1,503.65 | $1,428.35 | $1,471.69 |
The above table was informed by data provided by private health insurers to the Department of Health which was part of the claiming process.
Be informed about your oral health – get a dental check-up!
It goes without saying that the more information you have, the more prepared you are to make the best decision you can.
If you are looking for a new dentist, phone ahead and get prices for a dental check-up and clean. How do these compare with the average in the table above? Are X-rays and fluoride treatment included? Even if you’re happy with your current dentist, ask the same questions beforehand. Check the prices against the Department of Health chart above to see where they lie in the range – you may find it’s a fair price, but you need to know that for sure.
If you need extensive work done, shop around. Don’t be afraid to get a second opinion. Or a third. Or even a fourth!
Next up, call your health insurer and ask exactly what they will pay for the dental code numbers your dentist has told you will need doing. They may cover the entire dental cost less the excess, or just a portion of the cost (in which case you will be expected to pay the gap out of your own pocket).
A little basic knowledge can help to keep your family’s dental health in tip top condition for the best possible price.
AD
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