Why the Child Dental Benefits Schedule matters

A national oral health study found untreated tooth decay in a quarter of all Australian children aged 10 and under.

The study

The University of Adelaide National Child Oral Health Survey 2012–2014 was the first population-based study of its kind in Australia for 25 years, drawing on data from 24,000 children aged 5 to 14 across the country.

It was a collaboration between the Australian Research Centre for Population Oral Health, based in the University of Adelaide's School of Dentistry, and state and territory dental services. The university's principal researcher, Associate Professor Loc Do, described it as one of the biggest and most comprehensive studies of its kind in the world.

What it found

• Over 40% of children aged 5 to 10 had decay in their primary (baby) teeth
• One quarter of children in that age group had never received treatment for their tooth decay
• On average, children aged 5 to 10 had 1.5 primary teeth with decay
• More than one third of children aged 9 to 14 had decay in their permanent teeth
• One in seven in that age group had not previously been treated for it
• Against a National Oral Health Plan target of every Australian child seeing a dentist, one in nine children never had

The untreated figures are the significant ones. Decay being present is a hygiene and diet problem — see protecting your child from dental disease and how does sugar affect your dental health? — but decay going untreated is an access problem, which is what the CDBS exists to address.

Why untreated decay matters rather than simply waiting for the tooth to fall out: should your child see a specialist paediatric dentist? sets out the three reasons, including the one most parents have not heard — a baby molar lost early takes the space for the adult tooth with it.

What the CDBS is

Under the Australian Government's Child Dental Benefits Schedule (CDBS), which took effect on 1 January 2014, more than 3 million children are eligible for dental care funded by Medicare.

It provides families with a capped amount of basic dental treatment over two consecutive calendar years for each eligible child.

Services Australia sets that cap at up to $1,158 for each eligible child over two calendar years. That is the amount published by Services Australia on its “What's covered” page, last updated 1 January 2026.

The cap moves, and the rule for when it moves is unusual

The cap amount is indexed yearly on 1 January — Services Australia. Two consequences follow, and the second one catches people out.

First, the figure in this article is not permanent, and older figures are not necessarily errors. The cap was $1,095 in an earlier period. Services Australia's own worked example describes a family whose child had a $1,095 limit across 2024 and 2025, with $840 claimed by 31 December 2024 and the remaining $255 used in 2025. If you come across an article or a fact sheet quoting $1,095, it is describing that earlier period rather than contradicting the current number.

Second, an increase in the cap only applies to a child or teenager who received their first eligible service in that calendar year — Services Australia. A child already part-way through a two-year period is not automatically topped up to the new figure when it rises on 1 January.

Because the figure changes, confirm the current amount and your child's remaining balance with Services Australia before treatment rather than relying on any published figure, including this one. The Australian Dental Association's consumer site, teeth.org.au, points families to myGov to check whether a child is eligible.

Who is eligible

Services Australia sets three conditions, and all three have to apply. Your child must be:

• 0 to 17 years old for at least one day that calendar year
• eligible for Medicare
• getting an eligible payment at least once that calendar year — or have a parent, carer or guardian getting one

You do not need to apply or register. Services Australia is explicit about this: if your child is eligible, they will send you a letter. Families who are waiting for a form to fill in are waiting for something that does not exist.

The adult receiving the payment can be the child's parent, carer or guardian, or an approved care organisation.

There is also a provision for older teenagers that is easy to miss. If you are 17 or younger for at least one day of the calendar year and your partner receives an eligible payment, you may be able to get the CDBS in your own right — Services Australia.

The qualifying payments

The CDBS is means tested. To be eligible, the child or their parent or guardian must be eligible for Medicare and receiving either Family Tax Benefit Part A or one of the following:

• Youth Allowance
• ABSTUDY
• Disability Support Pension
• Parenting Payment
• Special Benefit
• Carer Payment
• Double Orphan Pension
• Veteran's Children Education Scheme, if the child is 16 or over
• Military Rehabilitation and Compensation Act Education and Training Scheme, if the child is 16 or over

Eligibility rules are set by government and change. The list above is a guide to the categories, not a determination — Services Australia decides eligibility, and it is worth checking even if you assume you do not qualify. The scheme is substantially under-claimed. The Australian Dental Association's consumer survey of 25,000 people listed not accessing government-funded free dental entitlements among the factors behind tooth decay in Australian children, alongside sugary drinks and starting dental visits too late.

How the two calendar years actually work

This is the part that costs families money, because the window is not two years measured from your child's first appointment. Services Australia sets it out like this.

The two-year period starts at the beginning of the calendar year in which your child both becomes eligible and gets their first dental service. Not the date of the appointment — the start of that calendar year.

From there:

• You can use the full amount in the first calendar year. If you do, there is nothing left for the second.
• If you do not use the full amount in the first year, you can use the balance in the second year — but only if your child is still eligible that year. Eligibility is assessed for each calendar year, so a change in the household's payments can end it.
• Anything unused at the end of the two calendar years cannot be carried forward. You wait for a new two-year period to start.
• Remaining funds are also lost once your child is no longer eligible, whatever the balance says.

The practical consequence is worth thinking about before the first appointment rather than after. An appointment in January and one in December of the same year draw on the same two-year window, and a child who starts treatment late in a calendar year has effectively spent one of their two years. Where there is substantial work to do and the balance will not cover all of it, the sequencing across the calendar-year boundary is a legitimate thing to raise — understanding your treatment explains how plans are set out and costed.

What is covered

Services Australia lists the covered services as:

• check-ups — your child's first visit to the dentist
• X-rays — how safe are dental x-rays?
• cleaning — dental cleans and hygienists and kids teeth cleaning tips
• fissure sealing — the role of fissure sealants in children's teeth, which is among the best-value items on this list
• fillings — why do I need a filling? and tooth fillings
• root canals — root canal
• extractions

Two qualifications belong to the scheme itself rather than to any particular practice.

There are item and time restrictions on some basic dental services. Services Australia's instruction to families is to check with your dentist whether any item or time restrictions apply before starting the service. In practice that can mean a particular item is only claimable once within a set period, even where there is money left on the balance.

CDBS services do not count towards the threshold of either the Medicare Safety Net or the Extended Medicare Safety Net. Benefits claimed here do not move a family closer to either.

What is not covered

Services Australia excludes three categories outright:

• orthodontic dental work — children's braces and Invisalign and orthodontics
• cosmetic dental work — cosmetic dentistry
• any dental services in a hospital — which includes work done under general anaesthesia, described in how Smile Solutions helps manage your child's dental anxiety

The hospital exclusion is the one most likely to affect a family with a very young child who has extensive decay, because that is the situation in which treatment under general anaesthesia is sometimes proposed. It is worth asking early where any proposed treatment would take place, since the answer determines whether the CDBS applies at all.

Where you can use it

Children can use the CDBS at government dental clinics and at private dental clinics — teeth.org.au, Australian Dental Association. The benefit is not restricted to the public system.

All of the covered services are available at Smile Solutions, where registered specialists, general dentists and dental hygienists practise together under one roof — see children's dentistry and the paediatric dentists.

One practical point that catches families out: a benefit being available does not mean a particular practice bulk bills to it, or that a given treatment plan falls entirely within the cap. Ask before treatment starts whether there will be a gap, and how much. The price guide lists published fees, understanding your treatment explains how plans are presented, and payment plans covers the options where a gap remains.

Payment plan options are available. Where a plan is advertised as interest free, that describes the plan term only — a deposit may be required, an establishment fee and ongoing account fees may apply, and charges can apply if the balance is not cleared within the agreed period. The applicable terms depend on the provider and the amount financed, and are set out in writing before you commit — ask what the deposit and the establishment fee are, in dollars, and what the total will be by the end. Payment Plans.

How to claim

At Smile Solutions you can submit your claim electronically immediately after treatment — the simplest route. Contact us if you want to confirm the arrangements before booking.

Otherwise you can:

• Call Medicare on 132 011
• Download the Medicare claim form and post it to the Department of Human Services, GPO Box 9822 in your capital city
• Lodge it in person at your local Medicare Service Centre

Further information is available on the Australian Government Department of Health website and from Services Australia, which also publishes the scheme's material in a number of community languages and can arrange an interpreter for Medicare enquiries at no charge.

Victoria also provides free public dental care for children in eligible families, through community dental services and the Royal Dental Hospital of Melbourne — worth knowing about if the CDBS balance is exhausted or eligibility does not apply.

Common questions

My child turns 18 this year. Have we already lost it?

Probably not, and this is the single most valuable detail in the eligibility rules. Services Australia's age condition is that the child is "0 to 17 years old for at least one day that calendar year."

Read that literally, because it is meant literally. A child who turns 18 in March was 17 for at least one day of that calendar year, so the age condition is satisfied for the whole of that year — not up to the birthday. Provided the other two conditions still apply (eligible for Medicare, and an eligible payment received by the child or by a parent, carer or guardian at least once that calendar year), the entitlement runs to 31 December.

What that is worth in practice: a final year that families routinely write off. If there is outstanding work and a balance, the months after an eighteenth birthday are usable months. Get the balance confirmed and get the appointment booked well before December, because the year ends whether or not the work is finished.

Services Australia decides eligibility, not this page and not the practice — confirm it with them before you plan around it.

We never got a letter. Does that mean we are not eligible?

Not necessarily, and it is worth checking rather than assuming.

Services Australia's position is that "you don't need to apply or register for CDBS. If your child is eligible we'll send you a letter." The letter follows eligibility; it does not create it. But eligibility is assessed for each calendar year, and it turns on whether an eligible payment was received at least once in that year — so a household whose circumstances changed partway through a year can become eligible without that being obvious from the letterbox.

Address details, a change in who receives a payment, and a change in care arrangements can all put a family in the position of being eligible and not knowing it.

The scheme is substantially under-claimed, and the Australian Dental Association's own consumer research lists not accessing government-funded free dental entitlements among the factors behind decay in Australian children. The cost of checking is a few minutes; the cost of assuming is the whole benefit. Check through Services Australia, or through your Medicare online account via myGov — the route the ADA's consumer site points families to.

How do I find out how much is actually left?

Ask Services Australia, not your dentist's front desk — though the practice can usually check on the day too.

Services Australia publishes guidance specifically on how to check your Child Dental Benefits Schedule balance, and the ADA's consumer site directs families to myGov for eligibility. Those are the authoritative sources; a practice's system is reading the same record but is not the one that decides it.

Do it before the treatment plan is agreed, not after. Two things make the balance less predictable than it looks:

• the cap is indexed on 1 January, and an increase "only applies if your child or teenager receives their first eligible service in that calendar year" — so a child already mid-way through a two-year period does not automatically get topped up
• claims made elsewhere count. A check-up at a school dental service or another practice has already drawn on the same balance.

If you are planning treatment that will exceed the balance, say so at the start. Knowing the number changes the order in which work is sensibly done.

The dentist says an item is restricted, but we still have money left. How can both be true?

Because the cap is not the only limit. Services Australia states that "there are some restrictions for basic dental services" and instructs families to "check with your dentist if there are any item or time restrictions before starting your service."

In other words, the schedule limits which items can be claimed and how often, separately from how many dollars remain. A service that has already been claimed within the relevant period may not be claimable again even with a healthy balance sitting there.

This is not a practice declining to claim; it is the scheme's own rule. But it is the practice that can tell you which restriction applies to which item, and Services Australia explicitly puts that conversation before the appointment rather than after it.

Two questions worth asking at the planning stage: which of the proposed items are claimable now, and for any that are not, when do they become claimable again? That second answer sometimes makes waiting a few weeks the cheaper plan.

Should we spend it all in the first year, or spread it across the two?

There is no single right answer, and the honest framing is that you are choosing between two different risks.

Spreading it exposes you to the eligibility rule. Services Australia is clear that a balance can be used in the second year "only if your child is still eligible that year", and that "you also won't be able to use any remaining funds once your child is no longer eligible." If the household's qualifying payment stops, the unspent balance does not wait for you. Nor does it carry forward: "If you don't use the full amount within the 2 calendar years, you can't use the remaining funds. You'll have to wait for a new 2 year cover period to start."

Using it early exposes you to the opposite risk — a problem appearing in the second year with nothing left to meet it.

The factors that should decide it, in order:

1. How secure is the qualifying payment? If it may end, treat the balance as use-it-or-lose-it.
2. Is there known work outstanding? Decay that is already diagnosed will not wait politely for a new cover period.
3. When in the calendar year did you start? Remember the period runs from the beginning of the calendar year of the first service, not from the appointment date — so a first visit in November means that year is nearly gone already.

Raise it with the practice when the plan is written. Sequencing treatment across a calendar-year boundary is an ordinary, legitimate thing to ask about, and it is much easier to do before the first item is claimed than after.

Related reading

• When should a child first visit the dentist?
• Dental crowns for children — silver or white?
• Everything you need to know about chalky teeth
• Oral health care for children with special needs
• Can you reverse tooth decay?
• Preventing dental decay
• Should I pull out my child's loose tooth?

Practical details

Written by Dr Kia Pajouhesh, managing director of Smile Solutions. The full team is listed by name.

Smile Solutions, Level 1, 220 Collins Street, Manchester Unity Building, Melbourne VIC 3000 — getting here. Phone 13 13 96, contact us, or theteam@smilesolutions.com.au. Monday–Friday 8.00am–6.00pm, Saturday 8.30am–1.30pm, Sunday by appointment.

Every clinician's registration can be verified free on the AHPRA public register at ahpra.gov.au.

Published 28 August 2018. Survey findings are attributed to the University of Adelaide's National Child Oral Health Survey 2012–2014 and are as at that study. Cap amounts, eligibility conditions, covered items and the two-year rules described above are attributed to Services Australia as published at the time of writing. They are set by the Australian Government and change over time — this page is not a statement of your entitlement. Confirm current details and your child's balance with Services Australia.

General information only — it is not a diagnosis, a treatment plan or financial advice, and it does not replace advice from your treating practitioner. Suitability and outcomes vary between children, and all treatment carries risks that should be discussed with your clinician. Payment plan terms are set by the credit provider and change; confirm current terms directly before you commit.

Smile Solutions trades under ABN 28 193 514 103.