With the end of the year fast approaching, the Australian Dental Association NSW (ADA NSW) is urging patients with private health insurance (PHI) to book their dental appointments now, before most dental benefits expire on 31 December 2025.

During the June 2025 quarter, private health insurers paid $1.695 billion in general treatment (ancillary) benefits, a 4.6% decrease from the previous quarter (source: APRA). Dental care made up the largest portion of this spend at $950.93 million. Despite this demand, the average benefit paid per dental service fell to $68, a 3.6% decline from March 2025.

ADA NSW warns this shows many patients still aren’t maximising the preventive care they’re entitled to each year.

“It’s a busy time of year but it’s also when dental check-ups matter most,” said ADA NSW President Dr Mark Morrin. “Patients who have private health insurance have already paid for their benefits. If they don't use them before December 31, they simply disappear.”

Preventive dental care is not only more affordable than emergency treatment, but it can also help identify broader health conditions early, including gum disease and oral infections.

Most PHI funds operate under a “use it or lose it” system, where dental extras do not roll over to the new year.

“Many people forget they have unused benefits available, or delay treatment until issues worsen,” Dr Morrin said. “We strongly encourage patients to check their policy and book any necessary treatment now, while appointments are still available.”

ADA NSW also reminds families that eligible children can use the Child Dental Benefits Schedule (CDBS) before year-end. The CDBS provides up to $1132 in Medicare-funded dental treatment over two calendar years for children aged 0–17, yet only around one in three eligible children currently access it. Families can check CDBS eligibility and remaining balance via their Medicare online account at www.my.gov.au.

“Tooth decay remains the most common chronic disease among Australian kids. Around one in four children aged five to 10 has untreated decay, which can lead to serious health problems later. If you have private health insurance, make sure you book your check up in the next few weeks,” Dr Morrin added.