Do you need your wisdom teeth removed? Find out about costs covered for tooth extraction by health insurance.
Having your wisdom teeth taken out is one of the most dreaded dental procedures for many Australians, but it’s also one of the most common.
Let’s examine wisdom teeth removal costs, the steps you can take to cover some of your expenses and more.
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Does private health insurance cover wisdom teeth removal?
Although wisdom teeth removal can be expensive, the good news is that some of the wisdom teeth removal cost are covered by private health insurance. However, the cover available will depend on whether your extraction is completed “in the chair” by a dentist as an outpatient, or if you are admitted to hospital as an in-patient and have to go under general anaesthetic to have the teeth removed by a dentist or oral surgeon.
If your procedure is done as an inpatient in a hospital, it falls to a hospital cover health insurance policy to provide the cover you need. This can include cover for hospital accommodation and theatre fees, anaesthetist and other medical fees.
However, as hospital cover policies do not cover outpatient services, extractions completed “in the chair” can fall under the auspices of extras or general treatment cover. These policies will cover some or all of the dental fees charged by your dentist or oral surgery specialist, but don’t provide any cover for hospital admissions.
What is the difference between inpatient and outpatient treatment?
Less complex wisdom tooth extractions can usually be done “in the chair” and are cheaper than more complicated cases, which require hospital admission. For a basic case, the average cost of tooth extraction can be anywhere from $150 to $200 per tooth.
If you require a local anaesthetic but the procedure can still be done in the chair, this could rise as high as $400 per tooth. Add in the cost of an initial consultation and any X-rays that are required, and if you don’t have any private health cover in place you could end up significantly out of pocket.
However, if you need to be given sedatives or general anaesthesia, the cost of surgical extraction of wisdom teeth can be up to $3,000.
Not only does the severity and complexity of the procedure affect the wisdom teeth removal cost, it also determines whether you are treated as an outpatient or an inpatient. Outpatient procedures can be done “in the chair” by your dentist or perhaps an oral surgeon, and they can be partially or even fully covered by an extras policy. Inpatient wisdom teeth removal means you will incur hospital accommodation, theatre fees and anaesthesia costs which can only be covered by a hospital policy.
What affects the cost of tooth extraction?
There are several factors that affect wisdom teeth removal costs including:
- The type of procedure. Impacted teeth generally cost more to remove than simple extractions. This is because they require surgery and cannot be completed “in the chair” by your regular dentist.
- The dentist. The pricing structure your dentist uses can also have a big influence. There are no limits on how much a dentist can charge for wisdom teeth removal, only guidelines issued by the Australian Dental Association.
- The specialist. If your case requires you to be referred to an oral surgery specialist, be prepared to pay higher fees.
- Your private health insurance. The level of hospital and/or extras cover you have can have a big impact on how much you pay for treatment. In addition, if your dentist is a specialist provider for your health fund, the fund may set the fees the dentist is allowed to charge for the procedure.
- Where you live. Costs vary from one state to the next, while it’s also cheaper to get wisdom teeth removed in major cities than it is in rural areas.
How much are you going to pay?
The costs for dental vary depending on which state you live in and the level of treatment you require. The tables below display the de-identified data provided to the Department of Health by private health funds of the average cost for dental procedures performed in 2015.
| Item number | Description | Average cost |
|---|---|---|
| 011 | Comprehensive oral examination | $59.10 |
| 012 | Periodic Oral Examination | $55.54 |
| 013 | Oral examination – limited | $49.31 |
| 014 | Consultation | $49.31 |
| 022 | Intraoral periapical or bitewing radiograph | $41.52 |
| 311 | Removal of tooth or part(s) thereof | $171.65 |
| Item number | Description | Average cost |
|---|---|---|
| 011 | Comprehensive oral examination | $68.89 |
| 012 | Periodic Oral Examination | $62.50 |
| 013 | Oral examination – limited | $57.47 |
| 014 | Consultation | $76.25 |
| 022 | Intraoral periapical or bitewing radiograph | $45.90 |
| 311 | Removal of tooth or part(s) thereof | $174.67 |
| Item number | Description | Average cost |
|---|---|---|
| 011 | Comprehensive oral examination | $58.25 |
| 012 | Periodic Oral Examination | $52.63 |
| 013 | Oral examination – limited | $46.22 |
| 014 | Consultation | $62.00 |
| 022 | Intraoral periapical or bitewing radiograph | $41.00 |
| 311 | Removal of tooth or part(s) thereof | $164.89 |
| Item number | Description | Average cost |
|---|---|---|
| 011 | Comprehensive oral examination | $56.60 |
| 012 | Periodic Oral Examination | $52.54 |
| 013 | Oral examination – limited | $49.14 |
| 014 | Consultation | $62.52 |
| 022 | Intraoral periapical or bitewing radiograph | $43.68 |
| 311 | Removal of tooth or part(s) thereof | $145.95 |
| Item number | Description | Average cost |
|---|---|---|
| 011 | Comprehensive oral examination | $61.88 |
| 012 | Periodic Oral Examination | $60.00 |
| 013 | Oral examination – limited | $49.13 |
| 014 | Consultation | $64.79 |
| 022 | Intraoral periapical or bitewing radiograph | $43.17 |
| 311 | Removal of tooth or part(s) thereof | $174.54 |
| Item number | Description | Average cost |
|---|---|---|
| 011 | Comprehensive oral examination | $58.79 |
| 012 | Periodic Oral Examination | $53.63 |
| 013 | Oral examination – limited | $47.75 |
| 014 | Consultation | $65.68 |
| 022 | Intraoral periapical or bitewing radiograph | $42.56 |
| 311 | Removal of tooth or part(s) thereof | $158.89 |
| Item number | Description | Average cost |
|---|---|---|
| 011 | Comprehensive oral examination | $59.91 |
| 012 | Periodic Oral Examination | $55.95 |
| 013 | Oral examination – limited | $49.17 |
| 014 | Consultation | $63.58 |
| 022 | Intraoral periapical or bitewing radiograph | $44.24 |
| 311 | Removal of tooth or part(s) thereof | $157.18 |
Source: http://www.privatehealth.gov.au/healthinsurance/whatiscovered/averagedental.htm
Why do people get their wisdom teeth removed?
In many people, wisdom teeth can cause a wide range of potentially serious problems if they are simply left in place. There are several reasons why you may need to have your wisdom teeth removed, including:
- Impacted wisdom tooth. This is when the tooth only partially emerges from your gums and it can lead to infection. Impacted teeth can also suffer from serious tooth decay, or can lead to the formation of cysts, which can destroy bone and damage nearby teeth.
- Tooth decay. It can be very difficult to properly clean an impacted wisdom tooth, and bacteria, food and other nasties can accumulate in the area and cause decay.
- Gum infection. If a wisdom tooth only partially emerges from the gum, this can cause food and bacteria to get stuck beneath the gum and cause infection.
- Pressure pain. As wisdom teeth emerge, they put a great deal of pressure on other teeth in your mouth as they make room for the new arrival. This can cause extreme pain and also erode other teeth.
- Orthodontic purposes. If you’ve previously received orthodontic treatment to straighten your teeth, the pressure caused by wisdom teeth can counteract that treatment and push your teeth out of place.
- Dentures. It is typically recommended that most people who require dentures have their wisdom teeth removed.
What to expect when getting wisdom teeth removed
Pain. That’s the first word that springs to most people’s minds at the mention of getting wisdom teeth removed, but often the fear of what could happen is actually much worse than the actual procedure.
With simple extractions, such as where the tooth is visible in the mouth and easy to access, it can be removed by forceps under local anaesthetic. This procedure can be done in your dentist’s chair.
However, more complex cases require admission to hospital and surgery, as well as a sedative or general anaesthesia. The surgeon will then cut open your gums, remove any teeth, bone and other debris, and in some situations you may require stitches.
Of course, the exact details of the procedure will vary depending on your wisdom teeth and how your dentist or surgeon decides to remove them. Your dentist or surgeon will give you a full rundown of what to expect before the procedure begins.
How to recover from wisdom teeth removal
Once the surgery is complete and your teeth have been removed, remember to follow your dentist’s or surgeon’s instructions to ensure the quickest possible recovery. If you’ve been “put under”, your vital signs will be monitored by nurses before you’ve recovered from the anaesthesia.
Gauze may be left in your mouth for up to half an hour after surgery, and you may need to apply ice packs periodically for the next 48 hours. Your dentist or surgeon will also be able to advise you on any pain relief medication you should take.
You’ll also be given tips and advice on how to ensure a speedy recovery, such as:
- Eating only soft food for a specified period
- Avoiding smoking, brushing your teeth or using mouthwash in the first 24 hours after surgery
- Avoiding disturbing the wound
- Completing a course of antibiotics
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