Root canal cost with private health insurance

Root canals may be necessary to save a tooth that’s badly infected or damaged. Teeth can become infected or damaged through decay, poor oral hygiene, injury, gum disease, cracks in teeth, repeated dental work, teeth grinding and general wear and tear.² Symptoms of root canal infection include toothache or sensitivity, swollen gums,  swelling around the face, pus, or a tooth becoming darker in colour.  A root canal can relieve pain, treat infection and prevent natural tooth loss.

With local anaesthetic, the root canal procedure is painless.¹ After the session is complete, you may have some discomfort, swelling and pain and the treated tooth may be sensitive for a day or two. Your dentist may prescribe pain medicine to help with your recovery, or you can use over-the-counter medications, such as ibuprofen.

Symptoms of a root canal infection can include toothache, swollen gums, pus around the tooth, temperature sensitivity, loose teeth, a tooth darkening in colour, and swelling around the face or neck.² Other dental issues can also cause these symptoms, so you’ll need to visit your dentist to get a diagnosis. Sometimes, deep tooth decay won’t cause any pain and can 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  or catch issues early.

Yes, your health insurance policy can provide health cover for root canal treatment, provided you have extras cover with the correct inclusions. 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, dental implants) 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 generally cover the cost of a root canal. If you require root canal treatment and don’t have private health insurance, you’ll likely need to pay all dental fees yourself. There are some public dental services available for adults and children; however, these vary by state or territory.

There are a few potential exceptions:³

• 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.³

Yes, there’s usually a 12-month waiting period for endodontic work, such as root canal treatments. This is especially true if you’re upgrading your policy’s coverage or if this is your first policy. Waiting periods for extras cover are set by individual health funds, meaning you may be able to find a policy that offers shorter waiting periods for some dental 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.