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Dental Care For People Living With HIV
There are currently three different ways you can access dental care depending on your circumstances. See the relevant section below for how to access the most appropriate scheme.
- The 2.3 Program and Community Dental Services for people on a pension card or Centrelink benefit
- Medicare rebated dental treatment Enhanced Primary Care (EPC) for people with chronic and complex conditions (including HIV) - whether working or on a pension. This program is now open again after previously being closed in March 08
- Private Dental Treatment.
The 2.3 Program (for people with HIV on a Centrelink benefit)
If you have a current Health Care Card, Pensioner Concession Card, or Commonwealth Seniors Card (A State Seniors Card is not sufficient) you can access free basic dental treatment and specialist dental care.
There are two ways you can access dental care depending on where you live:
1. Outside of Sydney, general non-HIV specialist, dental treatment is available to concession card holders and/or a pensioners, from Community Oral Health Clinics in your local area. This will cover most dental care including preventative work, restorations, extractions and minor surgery. For your nearest oral health service, call 1300 651 625, or look in the telephone book under 'Area Health Service'.
Have your pension concession card or current health card, and your Medicare card available before ringing, as you will be asked for the card numbers and expiry dates.
In the Northern Rivers area (Grafton to Tweed Heads) information about non-urgent care through private dentists for people with HIV is available from the 2.3 Program Dental Manager, Mary Peterson, (02) 6620 2617. To be eligible for this program you must have HIV, be a concession card holder and/or a pensioner, and have been resident in Northern Rivers for at least six months.
Applications are available from; Clinic 145 (Tweed Heads) (07) 5506 6850, SHAIDS (Lismore) (02) 6620 2980, Grafton Base Hospital (02) 6640 2229, and ACON in Lismore (02) 6622 1555 email@example.com. The form needs to be signed by either your GP/HIV doctor, the Enhanced Primary Care (EPC) coordinator (02) 6620 2980 Beverly.Scott-Visser@ncahs.health.nsw.gov.au, or the Client Services Officer at ACON (02) 6622 1555 firstname.lastname@example.org.
If you are not yet registered with the 2.3 programme but are experiencing acute (urgent) dental pain, the North Coast Area Health Service provides emergency dental treatment. Contact any of the numbers listed above for advice and support.
In the Illawarra area dental care is accessed through the Area Health Service by calling 1300 369 651 (Mon-Fri 8.30am to 3pm) to complete a questionnaire. You will be assessed for priority and placed on a waiting list. If your condition becomes more urgent, call again to be reprioritised. If the local clinic cannot fit you in urgently, you can be issued with a voucher to take to a local dentist.
Patients are advised to register on the waiting list for a check-up, as they will be seen eventually.
In the Hunter area, the Hunter/New England Oral Health Intake Assessment Line 1300 720 023 provides appointments for people who have a Health Care Card. The first appointment is for assessment only.
People who have oral pain get a priority assessment appointment within two to three days, (the maximum waiting time is two weeks).
If you have on-going oral problems you can get a general oral health assessment by ringing to make an appointment and asking to be seen as a ‘Category D’ (chronic conditions) patient. You must be seen within 12 months.
If you have difficulty accessing care in your area, contact the Care and Support Worker at your local ACON office:
Tel: Hunter (Newcastle) on (02) 4962 7700 or 1800 063 060
Tel: Illawarra (Wollongong) on (02) 4226 1163 or 1800 063 060
Tel: Northern Rivers (Lismore) on (02) 6622 1555 or 1800 633 637
Tel: Mid North Coast (Port Macquarie) on (02) 6584 0943 or 1800 063 060
2. In Sydney the ‘2.3 Program’ is available to concession card holders and/or a pensioners.
The '2.3 Program' is available through Sydney Dental Hospital and St. Vincent’s Dental Department. When contacting dental services, state that you want an assessment under the '2.3 Program' and let staff know if you have facial swelling, injury or pain, so that they can prioritise appropriately. For emergencies outside of working hours, contact the Accident and Emergency Department of your local hospital.
Sydney South West Oral Health Service (SSW-OHS)
This is part of Sydney Dental Hospital and covers South West Sydney. It has a centralised Oral Health Information and Intake Service: there are two telephone numbers: 1300 559 393 or (02) 9293 3333 (Fax 02 9293 3488)
There is also an email information service (SSW-OHS is not able to provide information on or advice about the costs of treatment by private dental practitioners).
St. Vincent’s Hospital Dental Department (Victoria Street, Darlinghurst)
The Dental Department works closely with the hospital’s HIV Medicine Unit, community and hospital-based HIV/GPs, and specialists to provide general dental treatment and management of most oral problems arising from HIV infection. It provides assessment, cleaning, fillings, extractions, but not specialist or reconstructive dentistry (root-canal and crowns). If you need specialist care you will be referred to the Sydney Dental Hospital.
For appointments call: (02) 8382 3129. If you are in pain or experiencing swelling, you should generally expect to be seen the same day. Be sure to state that you want an assessment under the ‘2.3 Program’ (the specialist HIV program).
3. Other Non-Metropolitan Areas
In other non-metropolitan areas, talk with the HIV/AIDS Service Coordinator in your area. Your Area Health Service, which is listed in the telephone book, will provide this information. If they don’t know how to access services for people with HIV – ask them to find out or contact the ACON HIV Health Maintenance Team.
Enhanced Primary Care (EPC) for people with 'chronic and complex' conditions (including HIV)
Who is eligible for the EPC Dental Care scheme?
Anyone, working or on a pension, with a chroic medical condition (HIV included) and complex care needs (have recieved care from a GP and two other health care providers - e.g. psychologist, chiropodist, dietician, etc, etc) and whose oral health is impacting on their general health, can access this scheme. GPs will assess eligibility and for most people will be able to prepare a 'GP Management Plan' and 'Team Care Arrangements'.
The EPC scheme covers up to $4,250 of dental work including; assessments, extractions, fillings, restorative work (bridges, crowns and implants), dentures, orthodontic services and preventative services.
Will there be any cost?
Some private dentists are bulk billing on this scheme, but many will set their own fees and charge you the difference between that and the Medicare rebate. (Any out-of-pocket expenses count towards the Extended Medicare Safety Net (EMSN), which is $519.50 for concession card holders and $1,039 for others and families [April 2008]).
How do I access the EPC Dental Care scheme?
Make an appointment to see your GP as soon as possible (You might need a longer appointment than usual to enable the GP to prepare a 'GP Management Plan' and 'Team Care Arrangements' - check with your doc/clinic). Ask your doctor if you are eligible (most people with HIV are). Your doctor will give a referral to a private dentist. Ask if they know one that bulk bills - or you can suggest a dentist if you know one.
Your doctor will send paper-work to Medicare. You cannot start dental work until the 'Care Plan' is completed and Medicare has processed your information. Call Medicare on 132 011 to check if everything has been processed. Make an appointment with the dentist you have been referred to, and take your Care Plan and GP referral letter to your first appointment.
If your dentist does not bulk bill, ask them for a quote that includes; X-rays, history taking, examination, treatment and/or cleaning. If you have to pay up-front take the receipts to Medicare to claim the rebate.
The EPC scheme will probably be closed again in the near future, but patients have previously been able to complete a whole course of planned treatment beyond a closing date if they had already started their first treatment. So it is probably important to see your GP as soon as possible and start dental treatment quickly.
For more information speak to your GP, contact Medicare on 132 011 www.medicareaustralia.gov.au , or call the Care and Support Workers at ACON.
If you are ineligible for the publicly funded systems or can afford private dental treatment, regular dentists can provide most dental needs for people with HIV. If they have specific concerns they can consult or refer you to specialist HIV dental services in Sydney or Northern Rivers (see above).
There is no legal requirement to disclose your HIV status to a dentist. However, it’s helpful for a dentist to know if you have HIV so they can pay extra attention to a range of conditions and treat them early, before they become problematic. If you don’t already have a dentist you trust and feel comfortable with, you could talk with your doctor, other people with HIV, or ACON’s HIV Health Maintenance Team.
Before you choose a dentist, you can ask to visit the surgery, get a feel for the atmosphere and talk with them about their experience of treating people with HIV.
If the cost of dental treatment is a problem, you may be able to access Medicare services under the '2.3 Program' or the EPC Scheme if it is still running (see above).
There is no legal requirement to disclose your HIV status to a dentist. However, it’s helpful for a dentist to know if you have HIV so they can pay extra attention to a range of conditions and treat them early, before they become problematic.
Contact: ACON’s HIV Health Promotion Team
Tel: (02) 9206 2102
Free Call: 1800 063 060