A guide to private health insurance for root canals
What is a root canal?
Beneath your tooth, are all the essential vessels, tissue fibres and nerves that keep that tooth alive. When this part of your gum (known as ‘the pulp’) becomes damaged or infected, it must be removed to preserve your dying tooth.
A root canal is the dental procedure to replace your damaged pulp with a root filling. It’s known as endodontic treatment.
The root canal process involves several important stages, including:
removing the decay and infection,
filling and sealing the canals,
and restoring functionality to your tooth.
A root canal often requires several visits to your dentist or specialist endodontist. The more visits you need, the more costly your treatment.
Root canal treatment is a common dental procedure designed to save a damaged or infected tooth. Here are some common symptoms that may be signs you need a root canal.
Severe toothache, especially when chewing or biting.
Extreme and prolonged sensitivity to hot and cold temperature.
Tooth discolouration with your tooth becoming darker.
Pimple-like sores on your gums.
Tender and swollen gums.
If you’re experiencing any of the above symptoms, check with your dentist in the first instance. When a root canal is recommended, you’ll want to consider your costs. Factors that affect the cost of your root canal procedure include the complexity, and whether you also require a filling afterwards or a crown).
What you need to know about root canal procedures:
Root canal is a major dental procedure, and in Australia it can be very expensive. Because Medicare doesn’t generally cover dental care, any major dental procedures can end up costing you thousands, if you’re not insured.
However, private health insurance can cover root canal from around $6 a week.
How much does a root canal typically cost?
In Australia, root canal can cost several thousand dollars without private health insurance. The average cost of a root canal without a crown in Australia ranges from $2,000 to $3,400, according to the 2017 national dental fee survey.
Root canal costs with a crown can be even higher. This total fee generally comprises the following expenses:
Assessment by an endodontist: $100 - $200
Root canal therapy: $1,700 - $2,700
Filling of the tooth after root canal therapy: $200 - $550
These costs can be less if your root canal is performed by your general dentist rather than an endodontist. An endodontist is a specialist practitioner, and charges around 20%-30% more than a general dentist. It's also worth pointing out that additional treatment can cost up to 30% more than your initial root canal treatment.
Follow up consultations are common, as several appointments might be required so bear this in mind when you’re budgeting for your root canal treatments. Two main factors affecting the cost of your root canal treatment:
The location of your infected tooth: When the diseased tooth is located in the front of your mouth, it’s generally cheaper to treat because front teeth have a single root. However, if your infected tooth is a molar, your root canal will cost a lot more. Molars often have three or more roots. The more roots in the affected tooth, the harder your dentist’s job is to correct your problem, taking longer, and costing you more.
Complexity of the procedure: If your damaged tooth roots have a simple straight layout, your procedure may be easier, and therefore cheaper. Bear in mind that the longer your problem’s been around, the harder and more costly it’s likely be to treat it.
Does private health insurance cover root canal treatment?
Private health insurance can cover the cost of a root canal. Root canal is included under 'major dental' in extras cover. While some cheaper policies claim to include root canal procedures, many of these offer only low annual benefit limits (around $400-$500), leaving you largely out of pocket.
To minimise your out of pocket costs, a more comprehensive extras policy is ideal. When shopping for a policy, look at your annual limits and the amount you can expect to get back after a claim. Some policies that cover root canal therapy start at only $6 a week.
Maintenance from a dental professional is crucial to protect those pearly whites, but unfortunately, dental services are rarely covered by Medicare. However, with an extras health insurance policy that has good dental benefits, you can maintain your oral health without breaking the bank.
What are the benefits of root canal treatment?
No one likes having a major dental procedure but getting a root canal might be necessary to prevent a worsening of your oral health. Some of the benefits of having a root canal treatment can include:
Tooth loss prevention: Getting rid of your damaged or infected pulp (which is a section of your gum tissue) preserves your dying tooth without needing to have it removed and/or replaced. Costly as a root canal can be, dentures cost far more.
Preservation of your surrounding teeth and jawbone: Removing your pulp infection prevents the damage spreading to the bone around your tooth, and to the rest of your teeth.
Preventing the degeneration of your jawbone: Missing teeth can impact the health of your jawbone. Root canals prevent these complications.
Frequently asked questions:
What are the waiting periods for a root canal with private health insurance?
When it comes to your health insurance, dental procedures and consultations fall under your extras cover. There are two categories for dental cover:
General Dental: Includes preventative services, such as your regular teeth cleaning and any fillings. Some funds also cover simple tooth extractions and X-ray costs under ‘general’. Most, however, only cover your oral exams, any mouth guards, and teeth cleaning. A 2 month waiting period usually applies to general dental services.
Major Dental: Major dental cover is for more complex (and more costly) treatments. This includes endodontic procedures like root canal treatment. It also includes orthodontic treatments. Major dental usually covers crowns as well. This can benefit you, as root canals often require a crown to be fitted afterward. A 12 month waiting period usually applies to major dental services.
If you have a private health insurance policy, it’s important to check what dental extras are included in your cover. Some policies will cover primary dental care such as dental check-ups, but exclude major dental procedures like root canals and crowns.
You may wish to upgrade to a higher level of cover if root canals aren’t covered by your existing policy, and you suspect you’ll need to undergo this procedure. Discuss what’s right for your dental health with your dentist.
Root canal treatment can be one of the best ways to address severe tooth decay, alleviate pain and discomfort, and avoid tooth loss. It’s important that you check the fine print of your extras cover to understand exactly what you’re covered for. If in doubt, call your health insurance provider.
* Compare Club compares selected products from a panel of trusted insurers. We do not compare all products in the market. This guide is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions.