Root canal cost with private health insurance

Root canals can save a tooth that’s badly infected or damaged. Teeth can become infected or damaged by:^1,2

• Decay
• Gum disease
• Cracked fillings
• Wear and tear
• Repeated dental work.

You’ll need to have a local anaesthetic to ensure there is no pain during the procedure.¹ After the session is complete, you may have some discomfort, swelling and pain. Your dentist may prescribe pain medicine to help with your recovery.

Symptoms of a root canal infection include:^1,2

• Severe tooth pain that’s unresponsive to pain medication
• Severe toothache when biting
• Swollen, tender gums
• Pus around a tooth
• Sensitivity to hot or cold temperatures that continues after the hot or cold item has been removed
• Loose tooth
• Tooth that gets darker in colour
• Swelling in your face or neck.

Many of these symptoms can be associated with other dental issues but should be checked out regardless of their cause. Deep tooth decay can sometimes be painless, not cause discomfort, and may only be discovered through an x-ray. Keeping up good oral health practices, such as brushing twice daily, flossing and regular dental check-ups, can help you maintain your dental health, avoid these root canal problems or catch the issue early.

Your health insurance policy can provide health cover for root canal treatment, provided you have extra covers with the correct inclusion. There are four distinct groups for dental benefits: general, major, orthodontics and endodontics. Root canal therapy will fall under either endodontics or major dental, depending on the health fund you sign up with. Health funds can decide how to group different dental procedures in their policies, so you should check the policy documents to understand what inclusions cover what procedures. Depending on what your treatment requires, you may need a procedure (e.g. crowns, fillings) that’s covered under a different inclusion to your root canal therapy.

It’s also important to understand your limits beforehand so you’re not caught out when you need to make a claim. More comprehensive policies usually have higher annual and sub-limits, meaning lower out-of-pocket expenses when you need to make a claim. Cheaper policies may offer cover for root canal treatment but have a lower limit, meaning more out-of-pocket expenses.

Medicare does not cover most dental care and dental treatment. If you require root canal treatment and don’t have private health insurance, you’ll likely need to pay the entire cost yourself. There are a few potential exceptions:⁴

• Child Dental Benefits Schedule (CDBS): For eligible children, the CDBS could potentially cover root canal costs. This is for children of families already receiving other benefits from the Australian Government. You can find out your child’s eligibility through the Services Australia website.
• Public dental services: The states and territories provide public dental services for adults and children, and eligibility rules vary depending on location. You’ll need a Health Care Card or Centrelink Pensioner Concession Card to be eligible. Waiting times for public dentists can be as long as a year.⁴

Whenever you purchase health insurance, you need to be aware of potential waiting periods. This is especially true if you’re upgrading your policy’s coverage or if this is your first policy. Waiting periods are the time between purchasing your policy and when you can make a claim. The standard waiting period for major dental and endodontic treatment is 12 months, though some health funds may offer shorter waiting periods for some services.

When it comes to root canals and more serious dental issues, you’ll likely need treatment sooner rather than later. Therefore, preparing ahead is better than waiting until you have dental problems.