The 'Forgotten' Health Care: Why A Trip To The Dentist Costs So Much
When Sydney mum Erin Riley was told her root canal would cost $1,500, there was a simple decision to make: no.
Not because she wasn’t in pain, but she simply couldn’t afford it. The pain was tolerable, and so she put off treatment for another, more economically viable day.
Until she couldn't put it off any longer.
Riley woke up one morning with a toothache, and that evening was admitted to the emergency department.
“The pain was blinding,” she told 10 daily. “Honestly, it was worse than labour.”
Riley’s infection had spread and become life-threatening. She went under a general anaesthetic to have the tooth removed and spent three days in hospital hooked up to an intravenous drip.
"It went from 'Oh, I have a tooth pain but it'll probably go away and I'll deal with it when we can afford it' to a serious infection very quickly," Riley said.
She estimates that what was once an out-of-pocket $1500 expense ended up costing the taxpayer thousands upon thousands of dollars through the public health system.
Riley's story isn’t unique. According to the most recent oral health care report by Australian Institute of Health and Welfare (AIHW), there were about 132,700 hospitalisations in 2016-17 where the patient had general anaesthesia for a dental procedure.
Millions of Australians put off trips to the dentist due to cost. Research from the AIHW published in 2013 found almost 32 percent of Australians avoided or delayed a dentist visit due to cost, and more than 18 percent said they’d have difficulty paying a $150 dental bill.
Dentistry is “the forgotten element” of healthcare, Independent federal MP and former Australian Medical Association president Kerryn Phelps told 10 daily.
“It’s almost like the teeth are excised from the whole health discussion.”
Despite oral health being integral to medical health -- research links poor oral health to heart disease, malnutrition, and even dementia -- it has never been subsidised by the government. And the dental industry has long been reluctant to change.
It dates back to when Medicare -- then called Medibank -- was introduced under the Whitlam Labor government in 1975, according to Dr. Heiko Spallek, head of the University of Sydney’s Dentistry school.
“The government wanted to get dentistry on board, but they had so much fight from the medical doctors they just didn’t bother to include it,” Spallek said.
“Dentistry as a profession has always lobbied against being included, because they wanted to have the freedom of determining their own fees. It’s similar arguments doctors made before we had Medicare.”
Patchwork regulation around pricing means the cost of a simple scale and clean can range from $91 to $157, according to the Australian Dental Association's annual survey.
A Choice mystery shop from 2017 found the range was even greater, costing Australians anywhere from $150 to $300.
Eligible children aged two to 17 can access up to $1000 of dental work over two years under the Child Dental Benefits Schedule, but adults unable to pay for dental care in the private sector have to navigate the underfunded and limited public dental health system.
“The government is aware of the barriers to accessing affordable dental services and supports a range of targeted programs for adults and children,” Health Minister Greg Hunt told 10 daily.
Wait times for patients in the public dental system can be anywhere from one to three years for non-urgent treatments, said Spallek. Unlike other counties, public patients are only able to access services from public dentists.
“Public patients don’t have a choice, and that makes a huge difference,” Spallek said. “It’s a dichotomy you won’t find in other countries.”
Even if Australians can afford private health insurance, patients are still left out of pocket -- sometimes significantly -- when it comes to dental.
“We need to be looking at private health insurance and why it falls so far behind,” Phelps said.
“People tell stories about having root canal therapy, $900 per session, and they get $100 back. The private health insurance rebates are a joke when it comes to dentistry.”
Grandmother Sayde Chiha, told 10 daily the cost of porcelain veneers quoted at $1000 per tooth -- after private health insurance.
She had 12 teeth in need of replacing due to years of neglecting her dental care.
"I paid a lot for my kids and my daughter had braces - cost a lot. I never fix my teeth," she said.
Rather than forking out $12 000, she flew to Lebanon and had the dental work done for $2000.
"No way I can afford it here," she said.
Phelps said Aussies are also flying to countries like Indonesia or Thailand to have dental work done, finding the cost of flights, accommodation and treatment to be cheaper all up than staying at home.
“When it gets to that situation, it’s pretty ridiculous,” Phelps said.
Hunt promised to address dental care in the upcoming federal budget, and Shadow Health Minister Catherine King is expected to speak more on the topic closer to the federal election in May.
But it’s becoming high past time for the government -- whatever it looks like come May -- to bring dental care into the public health service, said Phelps.
“The public health implications of a nation without appropriate dental care make this an urgent matter.”
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