Dental treatment — information for dentists and health agencies
We help people on a benefit or low income pay for dental treatment. How we help them, depends on the treatment.
We have different help for dental treatment:
- One-off assistance for immediate and essential treatment, usually non-recoverable.
- One-off recoverable assistance for dentures.
- Ongoing assistance for specific ongoing dental costs in limited situations related to a health condition or disability.
Immediate and essential dental treatment
If your patient qualifies, we can help them with up to $1,000 in a 52-week period for immediate and essential dental treatment. They can make multiple applications. This money doesn’t need to be paid back.
'Immediate and essential dental treatment' means your patient has an oral health issue that:
- has deteriorated or would begin to deteriorate if left untreated, and
- is having, or is likely to have, a detrimental effect on their oral health and/or wider physical health.
Who can qualify for dental treatment
What treatments are included?
- Consultations (including x-rays) which result in immediate and essential treatment.
- Extractions (not for orthodontic purposes).
- Fillings (tooth restorations).
- Root canal treatment (excluding molars, unless exceptional circumstances exist).
- Treating infections, including antibiotics and any temporary measures needed to enable permanent treatment.
What treatments are not included?
- Regular dental check-ups.
- Cosmetic treatments.
- Clean, scale and polish. However, the cost of teeth cleaning can be included if it’s required to treat a gum infection.
- Cast restorations.
- Orthodontic treatment.
- Molar root canal treatment, unless there are exceptional circumstances that mean a molar root canal is essential, e.g. because they’ve had previous radiation therapy in the area.
- Dentures. Patients may be eligible for a recoverable assistance payment or an advance payment of benefit for dentures.
- Treatments that are co-paid by ACC.
Recoverable assistance payment
Payments over $1,000
We still may be able to help your patient pay for immediate and essential dental treatment if:
- it's over $1,000, or
- it'll bring their total payments within a 52-week period to over $1,000.
They may need to pay some of this back.
Exceptional circumstances
We may be able to offer your patient extra assistance if they have exceptional circumstances. This is over and above the $1,000 limit in a 52-week period.
Your patient won't need to pay this back if we approve it.
These may include situations where your patient has:
- any special or unusual reasons for their oral health issue (e.g. an underlying health condition that has contributed to the issue)
- a health condition that could be severely impacted by their oral health issue (e.g. rheumatic heart disease).
If either of these apply to your patient, please let us know in the ‘comment’ field of the Dental Treatment Information form.
How to apply
Your patient needs to apply for this assistance themselves. However, they also need to provide us with certain information from you.
For immediate and essential dental treatment, you need to fill in a Dental Treatment Information form.
Give the completed form to your patient. They need it to apply for assistance.
Physical copies of the form are available at all Work and Income service centres. You can also order copies through your local MSD Health and Disability Coordinator.
Using your own form
Using your own form instead of the Dental Treatment Information form is not recommended. Your patient may be declined assistance if information is missing or incomplete.
How to apply for dental treatment: Information for clients
Payment
You need to a be registered as a supplier with us, so we can make payments to you.
Registered as a supplier with us
If we accept your patient's application, they can make the payment using their Work and Income Payment Card.
If you don't have an Eftpos machine, please tell your patient when you give them the form. We can pay you by bank transfer.
PDF information guides
You can download and print these guides, which cover information about accessing help with dental treatment from us.
Dentures
We may be able to help your patient with the costs of dentures. They need to apply and qualify for either an:
- advance payment of benefit (people on a benefit)
- recoverable assistance payment (people not on a benefit).
Recoverable assistance payment
In most cases you need to give them a quote or proof of costs.
You need to be registered as a supplier to get payments from us.
Ongoing dental treatment
We may be able to help your patient with an ongoing dental cost as part of a Disability Allowance. This is a regular payment for people on a benefit or low income. It's income and asset tested.
Disability Allowance - information for clients
The dental treatment must be associated with an ongoing health condition or disability, that's expected to last 6 months or more.
Costs directly associated with the health condition or disability must be:
- ongoing (not “one-offs”)
- of therapeutic benefit (not for preventative purposes)
- supported by the medical or nursing practitioner who signs the Disability Allowance medical certificate.
Disability Allowance medical certificate
The types of conditions or disabilities that may qualify for this funding include:
- A primary oral health condition or disability (such as oropharyngeal cancer or osteonecrosis of the jaw), or
- A primary health condition or disability that increases the risk of, and could be worsened by, oral health issues (such as periodontitis).
Examples
Periodontitis and Cardiovascular Disease
Periodontal disease is associated with a higher risk of Cardiovascular diseases like high blood pressure, stroke, and heart attacks. Treating periodontitis can improve endothelial function and potentially reduce cardiovascular risk.
Periodontitis and Diabetes Mellitus
People with diabetes are more likely to get periodontitis, and periodontitis can make it harder to control blood sugar levels. Periodontal treatment is likely to improve glycaemic control.
Periodontitis and Rheumatoid Arthritis
There is a strong link between periodontitis and rheumatoid arthritis.
Treating periodontitis may improve rheumatoid arthritis symptoms.
Other conditions
If you have another example of an oral condition that you think may qualify for Disability Allowance funding, you can write a support letter for your patient.
Please outline what the relationship between the oral condition and their primary health condition or disability is.
We’ll consider this at the time of their application.
How to apply
Your patient needs to apply for this assistance themselves. The full criteria and how to apply are on our Disability Allowance page.
As part of the application, a medical or nurse practitioner needs to fill in a Disability Allowance medical certificate
Contact us
If you have any questions or if there's something you'd like to discuss, your Regional Health and Disability Team's details are available on your regional Work and Income Health Pathway.