Australian Schedule and Dental Glossary 12 Revised 29012020
Australian Schedule and Dental Glossary 12 Revised 29012020
Australian Schedule and Dental Glossary 12 Revised 29012020
Schedule of Dental
Services and Glossary
Twelfth Edition
The Australian Schedule of Dental Services and Glossary
Australian Dental Association
Twelfth Edition
Published by the Australian Dental Association
12–14 Chandos St, St Leonards, NSW 2065 Australia
© Australian Dental Association, 2017
Amended items
111, 222, 231, 232, 242, 745, 746, 762, 763
New items
250, 251
An Australian Glossary of Dental Terms was first published by the Australian Dental Association (ADA) in 1986.
The Fifth Edition was expanded to The Australian Schedule of Dental Services and Glossary (Schedule) in 1996.
Since its inception, it has been universally accepted as the definitive coding system of dental treatment and is recognised
by the National Centre for Classification in Health.
The ADA, in developing the Twelfth Edition, has considered submissions from within the membership, specialist
affiliated dental groups, health funds and other interested dentists and groups. The contributions of the Chief
Executive Officer and secretariat of the ADA and members of the Schedule and Third Party Committee are
gratefully acknowledged.
Current information on the GST is included on page xxii and is available on the Association’s website (www.ada.org.au).
Hugo Sachs
Federal President
Australian Dental Association
Clarification
Any disputes or clarification regarding the interpretation, use and or guidelines on item numbers must be made to
the Chief Executive Officer of the Association informing the CEO of the names and addresses of the parties involved
together with the details of the dispute. The CEO will then refer that information on to the Association’s Schedule and
Third Party Committee Chairman for evaluation and decision. The CEO will then inform both parties of the decision.
Confidentiality will be maintained.
Federal and/or State and Territory specialist groups, ADA affiliated bodies, or other individuals or organisations, must
not offer interpretation or guidelines for the use of item numbers within The Australian Schedule of Dental Services and
Glossary without the explicit written endorsement of the Federal Executive of the ADA.
Guidelines for Submissions to the ADA’s Schedule and Third Party Committee
The ADA’s Schedule and Third Party Committee welcomes submissions and comments on the Schedule.
Suggestions for new and amended item numbers should be accompanied by a suggested draft for the Schedule
– that is, item number, heading and brief description.
An organisation submitting on behalf of a particular discipline of dentistry should first consult with branches of
equivalent organisations in other States and Territories in order to arrive at a consensus. Third parties should submit
through their umbrella organisations.
Dental Materials
The Twelfth Edition of the Schedule has continued to classify dental materials into basic generic groups. Examples are
given in the following table.
Linings
Linings used beneath restorations, as interposing material, form an integral part of a restoration and are not to be
itemised separately.
Restorative Procedures
When two materials are used in the same restoration, the predominant material type should be used to itemise
that restoration.
Where a restoration includes a fissure sealant on the same tooth and on the same surface, then only one item
number shall be used to describe that restoration.
Endodontics
Item numbers describing chemo-mechanical preparation, obturation and other procedures associated with root canal
treatments should be utilised as the services they represent are completed, whether in a single visit or in multiple
appointments.
If an additional visit is necessary to irrigate and redress the root canal system, item 455 should be used. Chance filling
of an accessory canal while obturating a main canal is not to be deemed an additional canal obturation. The provisional
(temporary) closure of the access cavity between visits should not be separately itemised.
Example 2
An implant supported bridge carrying one indirect pontic supported by a veneered crown at each end incorporating
an abutment attached to the underlying osseointegrated implant (commonly known as a three-unit implant supported
bridge) would be itemised as:
2 x 661, 2 x 672, 1 x 643
Example 3
An implant supported bridge carrying eight pontics supported by a veneered crown incorporating an implant abutment
attached to four osseointegrated implants (commonly known as a fixed full arch implant supported bridge) would be
itemised as:
4 x 661, 4 x 672, 8 x 643
Example 4
A rigid bar fitted to four underlying osseointegrated implants to provide support and retention for a dental prosthesis
with three retention devices and designed for self-removal would be itemised as:
4 x 661, 1 x 664, 3 x 645, 3 x 735. The removable prosthesis would be itemised as either 665 or 667.
Example 5
A removable prosthesis carrying artificial teeth on a resin base supported by two osseointegrated implants to which it is
attached and that is designed for self-removal would be itemised as:
2 x 661, 2 x 735, 1 x 665
Example 6
A removable prosthesis carrying artificial teeth on a cast, wrought or milled metal frame supported by two
osseointegrated implants to which it is attached and that is designed for self-removal would be itemised as:
2 x 661, 2 x 735, 1 x 667
Example 7
A removable prosthesis carrying artificial teeth on a cast, wrought or milled metal frame supported by four
osseointegrated implants to which it is attached and that is not designed for self-removal would be itemised as:
4 x 661, 1 x 666
Example 8
Bonded bridges are similarly itemised as per other fixed bridges. For instance, a three-unit indirect bonded bridge that
has two retainers and a single indirect pontic is itemised as:
2 x 649, 1 x 643
Example 9
A tooth supported provisional bridge carrying two indirect pontics supported by provisional crowns at each end
(commonly known as a provisional four-unit bridge) would be itemised as:
2 x 631, 2 x 632
Example 10
An implant supported provisional bridge carrying one provisional pontic supported by a provisional crown at each end
incorporating a provisional abutment attachment to the underlying implant (commonly known as a provisional
three-unit implant supported bridge) would be itemised as:
2 x 633, 2 x 634, 1 x 632
Infrastructures (such as a core for crown including post), stress-breakers and precision or magnetic attachments should
be appropriately itemised.
Direct, Indirect
The terms “direct” and “indirect” are used to distinguish between restorations/services fabricated directly in the mouth
(direct) and those fabricated outside the mouth using models, copings or digitised images (indirect). A dental technician
may assist in the fabrication of indirect restorations.
Certain restorations use both intraoral and extraoral procedures but are to be itemised by the predominant element of
fabrication.
Example:
Some resin-based restoration materials are formed in the mouth but are removed for extraoral curing and finishing
before cementation/insertion. These are to be itemised as direct restorations.
Some restorations are milled extraorally before cementation/insertion. These are to be itemised as indirect restorations.
Some cast restorations will have the casting pattern prepared in the mouth before being completed extraorally.
These are to be itemised as indirect.
Cementation
Where the term “cementation” is used in the Schedule, it implies the various processes (cementation, bonding,
adhesion, curing, attaching) employed to achieve enduring retention of a restoration or prosthesis in the mouth.
Immediate Dentures
Immediate dentures require multiple itemisation.
Example:
A full upper immediate denture in which six teeth are replaced immediately following their extraction should be
itemised with the following items:
Partial Dentures
Partial denture items 721, 722, 727 and 728 are used to describe the base only (resin or cast metal) of the
partial denture.
Item 733 (tooth/teeth) should be used to describe the number of teeth borne by the denture base.
When retainers (clasps) (731), overlays (734), occlusal rests (732), precision or magnetic attachments (735)
or metal backings (739) are used, they should be appropriately itemised.
Item 730: A coding used only by the Department of Veterans’ Affairs to identify the actual cost of the cast alloy
framework of a partial denture. Its use is usually supported by the provision of an invoice or copy thereof.
Example:
Provision of a five-tooth mandibular acrylic partial denture where the saddles are connected by a wrought bar and
where there are two clasps and two occlusal rests would be itemised as:
Provision of a five-tooth cast metal framework maxillary denture with two occlusal rests and two retainers would be
itemised as:
Tooth Identification
If it is necessary or useful to identify a tooth, the FDI Two-digit Tooth Identification number should be employed.
Please note that tooth ID is not applicable to implants.
Example 1
Where a simple extraction of a supernumerary tooth – for example, in the anterior area adjacent to the upper right
central incisor is performed, it would be itemised as:
Example 2
Where the removal of a supernumerary requires an incision and the raising of a mucoperiosteal flap, but where removal
of bone or sectioning of the tooth is not necessary to remove the tooth – for example, if in the upper right premolar
area – is performed, it would be itemised as:
Example 3
Where the removal of a supernumerary and an adjacent impacted upper right wisdom tooth is required, and where
both teeth require both removal of bone and sectioning of the tooth after an incision and a mucoperiosteal flap is
raised and the tooth is removed in sections, it would be itemised as:
Itemisation of Accounts
The original itemisation of dental services should be provided in a form consistent with the following guidelines that,
although not mandatory, are recommended by the ADA:
(a) Provider number of the dentist providing the service.
(b) Entity to which payment is to be made.
(c) Specialist description if appropriate.
(d) Address of the place of practice.
(e) Telephone number of the place of practice.
(f) Name and address of the party responsible for the debt.
(g) Name of patient.
(h) Date on which the account was rendered.
(i) Date on which service was provided.
(j) Identification of service by the Schedule number and/or description of service sufficient to identify the
procedure.
(k) Fee charged for each item of service.
(l) Details.
(m) Balance owing.
(n) When a subsequent account is issued, it should be endorsed “duplicate copy”.
(o) GST, where appropriate, should be itemised.
(p) Where tooth ID is required, FDI notation should be utilised.
Tooth Terminology
Fissure
A naturally occurring
Enamel crevice in the enamel.
The hard, calcified substance Crown
that is the surface of a crown The crown of the tooth is
of a tooth. the part of the tooth that is
visible and is above the gum
margin or gingiva.
Gingiva
The marginal part of the gum
that surrounds the tooth where
it emerges from the deeper,
supporting tissues.
Periodontal ligament
The ligament that connects
a tooth, by its root, to the
Mucosa supporting bone.
The name given to the
lining of epithelium
inside the mouth, and its
immediate substructures.
Dentine
The calcified tissue that
forms the major part of
a tooth. In the crown
of the tooth, the dentine
Cementum is covered by enamel.
The pulp chamber of the
The calcified tissuethat is on the
tooth is enclosed by dentine.
surface of the root of a tooth and
that provides attachment for the
periodontal ligament.
Root
The root is the part of the tooth
below the gum margin and is
connected through cementum
on its surface and the fibres of
the periodontal ligament to the
Pulp supporting bone.
The organ at the centre of a
tooth containing blood vessels,
connective and neural tissue, and
cells that produce dentine.
Dental Arch
Anterior teeth
The teeth in the upper or lower arch
usually comprising the central and lateral
incisors and the canine (or cuspid) teeth.
Labial
An adjective to describe the
aspect or surface of teeth or
Premolar (bicuspid) teeth other object or structure in the
The teeth in each quadrant of the mouth that is in proximity to
dental arch usually immediately the lips – for instance, the front
behind the canine teeth. surface of the incisor teeth.
Palatal
An adjective to describe the aspect
or surface of the teeth or other
object or structure in the mouth
which is adjacent to the palate.
Right condyle
Left condyle
Ramus of mandible
Angle of mandible
Body of mandible
“Impaction”
Unerupted third molar
against second molar
(maxillary)
Casting Technique
Irrespective of the metal employed, castings used in dentistry are usually made by the wax elimination process, which
permits accurate and very complex shapes to be cast in metal and used as inlays, crowns, bridges or partial dentures.
Figure 1 Figure 2
In this example, the tooth is prepared by cutting to The wax pattern with its sprue is embedded in heat
a designed shape. A wax pattern is made to form resistant plaster. When the sprue is removed and
and contour that would replace the missing tooth the wax is melted away by heating, a hollow mould
structure. Sometimes wax patterns are made directly remains into which molten metal may be forced
in the mouth; at other times they are made on a or cast.
replica (die) of the tooth or teeth.
The wax pattern is then lifted away from the tooth
(or die) by means of a pin (sprue) melted onto its
external surface.
Figure 3 Figure 4
Excess metal is cut away and the casting is trimmed, The casting is attached to the prepared tooth with
fitted to the tooth or die, and polished. a special adhesive cement. It replaces exactly the
missing tooth structure.
Crown
Crown of natural
Crown tooth reduced to
accept the crown
Bridge
Retainer Retainer
(full crown)
Abutment tooth
Abutment tooth
Pontic (artificial
replacement tooth)
Post crown
Root filling
Prepared root
of tooth
Artificial new
crown
Implants
Abutment section
inserted after removal
of healing screw
Abutment head
section designed
to receive a crown
Outer bone plate
Oral mucosal
Cancellous bone epithelium
Endosseous implant
Retainer clasp
Figure 1
Figure showing cast alloy framework on model
of mandibular teeth made from an impression.
Denture tooth
Figure 2
Cast alloy framework with six teeth.
Veneer
Figure 1 Figure 2
Incisor tooth prepared for veneer Incisor tooth with veneer attached.
and veneer before attachment.
Explanatory Notes
This publication (excluding appendixes) is a public ruling for the purposes of the Taxation Administration Act 1953.
A public ruling is an expression of the Commissioner’s opinion about the way in which a relevant provision applies, or
would apply, to entities generally or to a class of entities in relation to a particular scheme or a class of schemes.
If you rely on this Ruling, the Commissioner must apply the law to you in the way set out in the ruling (unless the
Commissioner is satisfied that the ruling is incorrect and disadvantages you, in which case the law may be applied to
you in a way that is more favourable for you – provided that the Commissioner is not prevented from doing so by a time
limit imposed by the law). You will be protected from having to pay any underpaid tax, penalty or interest in respect of
the matters covered by this ruling if it turns out that it does not correctly state how the relevant provision applies to you.
[PLEASE NOTE THE PARAGRAPH NUMBERS FROM THE ATO RULING HAVE BEEN
ADOPTED IN THE FOLLOWING EXTRACT]
8. This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be
reproduced by any process without prior written permission from the Commonwealth. Requests and inquiries
concerning reproduction and rights should be addressed to:
Date of effect
9. This Ruling applies on or after 20 February 2016. However, this Ruling will not apply to taxpayers to the extent
that it conflicts with the terms of a settlement of a dispute agreed to before the date of issue of this Ruling (see
paragraphs 75 and 76 of Taxation Ruling TR 2006/10).
Ruling
15. This Ruling addresses the goods and services tax (GST) treatment of the supply of goods and services by
dentists. This Ruling includes Attachment A at page 22.
Supplies made by dentists under section 38–7
Supplies of services
16. Supplies of dental services and repairs of dental goods by a dentist to a patient for which a Medicare benefit is
payable under Part II of the Health Insurance Act 1973 are GST-free under subsection 38–7(1) (see paragraphs
31 to 34 of this Class Ruling).
Supplies of goods to patients (goods other than medical aids and appliances covered by section 38–45)
17. Supplies of goods to a patient in the course of supplying that patient with a GST-free service under subsection
38–7(1) are also GST-free under subsection 38–7(3) if the supply is made to the patient at the premises at which
the GST-free service is supplied (see paragraphs 68 to 69 of this Class Ruling).
Supplies of goods to patients (goods other than medical aids and appliances covered by section 38–45)
19. Supplies of goods to a patient in the course of supplying that patient with a GST-free dental service under
subsection 38–10(1) are also GST-free under subsection 38–10(3) if the supply is made to that patient at the
premises at which the GST-free service is supplied (see paragraphs 68 to 69 of this Class Ruling).
Supplies of specifically designed spare parts for medical aids and appliances
21. The supply of a specifically designed spare part for a GST-free medical aid or appliance (“customised
toothbrushes for people with disabilities”, “dentures and artificial teeth”, and “mandibular advancement
splints”) is GST-free under subsection 38–45(2).
22. Generic spare parts that are not specifically designed for a GST-free medical aid or appliance are not GST-free
(see paragraphs 82 to 85 of this Class Ruling).
24. A supply is GST-free if the dominant part of the supply is the specifically designed spare part and the labour
is merely integral, ancillary or incidental to the supply of the spare part. However, the supply is taxable1 if the
dominant part is the labour and the spare part is merely integral, ancillary or incidental to the labour.
25. If the specifically designed spare part or the labour is neither integral, ancillary nor incidental to the other,
the supply is a mixed supply that is partly GST-free (the spare part) and partly taxable (the labour).
Appendix 1 – Explanation
This Appendix is provided as information to help you to understand how the Commissioner’s view has been
reached. It does not form part of the binding public ruling.
26. Under the GST Act, some goods and services supplied by dentists are GST-free where certain requirements are
satisfied.
27. GST is payable on supplies that are taxable supplies but not on those that are GST-free. A dentist may claim
input tax credits for the GST included in the price of things acquired for making taxable or GST-free supplies
or both.
29. However, section 9–5 also provides that a supply is not taxable to the extent that it is GST-free or input taxed.
30. For the purposes of this ruling, the provisions of the GST Act dealing with input taxed supplies are not
relevant to any supplies made in the dental industry. The relevant GST-free provisions of the GST Act are
considered below.
1
In this Class Ruling, when a supply is indicated as being taxable or partly taxable, it is assumed that all the requirements for a taxable supply under
section 9-5 are met.
2
The exception in subsection 38–7(2) does not apply to the items referred to in the Schedule in Attachment A to this Class ruling. Subsection 38–7(2) provides
that a supply of a medical service is not GST-free under subsection 38–7(1) if it is a supply of a professional service rendered in prescribed circumstances within
the meaning of regulation 14 of the Health Insurance Regulations that are made under the Health Insurance Act 1973 (other than the prescribed circumstances
set out in regulations 14(2)(ea), (f) and (g)).
39. In all States and Territories, dentists are required to be registered pursuant to the relevant State or Territory
Act. Accordingly, a person who is registered pursuant to the State or Territory Act will be considered to be a
“recognised professional” in dental services pursuant to paragraph 195–1(a).
Paragraph 38–10(1)(c)
40. To satisfy this requirement, the service must generally be accepted in the profession associated with supplying
services of that kind (in this case, the dental profession) as being necessary for the appropriate treatment of the
recipient of the supply.
What is “appropriate treatment”?
41. A dentist will provide “appropriate treatment” to the patient if the dentist assesses the patient’s state of health
and determines a process for preserving, restoring or improving the physical or psychological wellbeing of
that patient. “Appropriate treatment” includes any subsequent services provided to the patient as part of that
process.
42. “Appropriate treatment” also includes medical treatment of a preventive nature - for example, a periodic oral
examination where there is no evidence of an ailment prior to attendance. However, this does not extend to
the supply of services and goods in relation to customised mouthguards. Whilst a customised mouthguard is a
device that may prevent or reduce damage sustained to the mouth and teeth in the event of an injury, it is not
considered to be “treatment” that is performed on a patient.
43. To be GST-free, the dental profession must accept that the service is necessary and acceptable treatment,
taking into account the patient’s individual circumstances.
44. Services provided in assessing a patient for insurance or litigation purposes – that is, medico-legal services – are
not “necessary for the appropriate treatment” of the patient and are not GST-free.
45. Services that are predominantly for the improvement of the appearance of the patient are also not “necessary
for the appropriate treatment” of the patient and therefore are not GST-free.
46. Services that are intended to improve the health of the patient but that also comprise a “cosmetic” component,
– for example, reconstruction of a badly damaged tooth – are “necessary for the appropriate treatment” of the
patient and are therefore GST-free.
47. A modification to a denture or other appliance undertaken for the changing condition of the patient is
appropriate treatment of that patient and is GST-free if supplied by a dentist to a patient. The “changing
condition of the patient” will include situations such as:
• an addition to the denture where the patient has had a tooth extracted; or
• a modification or adjustment to a denture owing to a change in the shape or structure of a patient’s
mouth, palate, gums or jaw.
48. Services for determining that a modification is required and any subsequent services to ensure that the denture
fits correctly are also GST-free if the elements of section 38–10 are satisfied.
Who is the “recipient of the supply”?
49. Paragraph 38–10(1)(c) requires that the supply must be generally accepted in the profession associated with
supplying services of that kind as being “necessary for the appropriate treatment of the recipient of the supply”.
50. As only an individual can receive treatment as a patient, the “recipient of the supply” must be an individual for
the supply to be GST-free under section 38–10.
Supply of dental services under arrangements with third parties
51. In some cases, dentists will have agreements with third parties under which there is a binding obligation on the
dentist to provide something to the patient for which the third party is liable to pay. In these cases, the third
party is the recipient of the supply. Depending on the particular agreement, the dentist may be making supplies
for the patient as well as the third party.3
52. In the absence of a binding obligation, there may still be a supply by the dentist to the third party where the
following factors4 are present:
3
See, for example, the case of Federal Commissioner of Taxation v Secretary to the Department of Transport (Vic) [2010] FCAFC 84; 2102 ATC 20–196.
4
See paragraph 221B of GSTR 2006/9 but note the difference in terminology. Here, “third party” is used instead of “payer”, “dentist” is used instead of
“supplier” and “patient” is used instead of “third party”.
(a) there is a pre-existing framework or agreement between the third party and the dentist that
contemplates that the parties act in a particular manner in respect of supplies by the dentist to
particular patients or a class of patients;
(b) the pre-existing framework or agreement:
(i) identifies a mechanism by which the particular patients or the class of patients are to be
identified such that the supplies made to them come within the scope of the framework or
agreement; and
(ii) specifies that the third party is under an obligation to pay the dentist if there is a relevant
supply by the dentist to a patient and also sets out a mechanism by which such payment is
authorised.
(c) the framework or agreement and the mechanism for authorising the payment are in existence
before the supply by the dentist to the patient (that is, the dentist knows in advance that the third
party is obliged to pay some or all of the consideration in the event of the supply to the patient);
(d) the dentist makes the supply to the patient in conformity with the pre-existing framework or
agreement between the parties; and
(e) the obligation of the third party to make payment pursuant to the pre-existing framework or
agreement is not an administrative arrangement to pay on behalf of the patient for a liability owed
by the patient to the dentist. Rather, once the supply becomes a supply to which the framework
or agreement applies, the framework or agreement establishes a liability owed by the third party
(not the patient) to the dentist in the event that there is a supply by the dentist to the patient.
53. Under section 38–60, where the third party is an insurer, an operator of a statutory compensation scheme or a
compulsory third party scheme (scheme operator), or an Australian government agency, the supply to the third
party by the dentist is GST-free to the extent that the underlying supply of the dental service to the patient is a
GST-free supply under sections 38–10 or 38–7.
54. Under subsection 38–60(4), the dentist and the third party can agree that the supply not be treated as GST-
free. The dentist and the third party may choose not to treat supplies as GST-free where, for example, there is
a combination of GST-free and taxable supplies and determining the amounts for each supply may be complex.
The option of not treating any of the supplies as GST-free may be administratively easier for the parties.
55. Where a third party is not an insurer, a scheme operator or an Australian government agency, the supply to the
third party is not a GST-free supply under section 38–60.
Example 2 – Supply of health services by a dentist to a third party not being an insurer, a scheme
operator or an Australian government agency
59. XYZ Company contracts with a dentist to provide dental treatment to its employees. XYZ Company is not
an insurer, a scheme operator or an Australian government agency.
60. XYZ Company is the recipient of the supply of professional services from the dentist. If the dentist is
registered for GST, the supply of the services is a taxable supply.
61. Section 38–60 does not apply in this scenario to make the supply to the third party GST-free because XYZ
Company is not an insurer, a scheme operator or an Australian government agency.
Example 3 – The third party merely pays for the supply of dental treatment on a patient’s behalf
64. Jenny is a dentist who is a “recognised professional” for GST purposes. Adam makes an appointment to see
Jenny. At the initial consultation, Adam tells Jenny that he sustained damage to his tooth whilst at work and
that she can bill his employer for the costs. Jenny confirms with Adam’s employer that she can send the bill
to them.
65. Jenny does not have a pre-existing agreement or a binding obligation with Adam’s employer to provide the
treatment to Adam.
66. Jenny is making a GST-free supply to Adam that is paid for by Adam’s employer. Jenny is not making any
supply to Adam’s employer – they are merely paying the bill on Adam’s behalf. The fact that another entity
pays for the service does not alter its GST-free status.
67. Goods and Services Tax Ruling GSTR 2006/9 (Supplies), at paragraphs 114–246, provides detailed guidance in
analysing third party arrangements for determining who the recipient of a supply is.
Dental goods – subsections 38–7(3) and 38–10(3)
68. If a dentist supplies goods as part of a GST-free service, those goods are also GST-free under subsection
38–7(3) or 38–10(3) if they are supplied to the patient in the course of supplying a dental service and the supply
is made at the premises at which the service is supplied.
69. The phrase “in the course of supplying” means that the goods are supplied at the same time as the dental
service and they are:
• individually customised or manipulated for the treatment of the illness or disability of that particular
patient; or
• essential for treating that patient during that particular consultation.
5
Subsection 9–15(2).
73. In determining whether a medical aid or appliance is widely used by people without an illness or disability,
reference should be made to how the wider community uses these goods - that is, the common purpose for
which the goods are purchased. Subsection 38–45(1) does not require the medical aid or appliance to be
used in a particular way but rather focuses on the purpose for which the wider community purchases these
products. Irregular or uncommon use of a medical aid or appliance in a way contrary to its manufactured
purpose does not prevent the good from being GST-free.
74. The items in the table in Schedule 3 to the GST Act that are of relevance to the dental industry are:
• item 29 – “customised toothbrushes for people with disabilities”
• item 30 – “dentures and artificial teeth”, and
• item 75 – “mandibular advancement splints”.
75. For GST purposes, “customised toothbrushes for people with disabilities” are considered to be toothbrushes
that have been adapted – for example, contoured, to suit the needs of a class of disabled persons.
76. “Dentures” for GST purposes are considered to be an artificial restoration of several teeth (partial denture)
or all of the teeth of either jaw (full denture). “Artificial teeth” are considered to be those that are fabricated
and replace natural teeth in form and function. The phrase “artificial teeth” includes a single tooth as well as
multiple teeth. Full crowns and bridges are artificial teeth.
77. A “mandibular advancement splint” is a small device made of plastic or similar material that is worn in the
mouth whilst sleeping (similar in appearance to a mouthguard). It is designed to help to stop some types
of snoring. The splint is designed to push the mandible (lower jaw) forward, helping to keep the tongue
clear of the pharynx (the back of the throat). The splints are also sometimes used for the treatment of
temporomandibular joint disorder (TMJ).
Consumables
78. Where, in the course of supplying one of the products listed at item 28, item 30 or item 75 in the table in
Schedule 3, a dentist consumes various things, there is only one overall supply of the listed item.
Things made and consumed in the process of constructing and supplying a listed item form part of the one
overall GST-free supply of that product, even if the components are separately itemised in the bill.
79. Examples of things consumed in the process of constructing and supplying a GST-free medical aid or appliance
include oil, lubricant, glue and generic parts like screws and wires. Consumable items are acquired with the
intention that they will be destroyed, consumed or expended. They do not retain their individual character or
nature when a new medical aid or appliance is supplied or when a repaired medical aid or appliance is returned
to its owner.
80. However, where these things are supplied separately to the medical aid or appliance, they are only GST-free
if they are specifically designed spare parts of that medical aid or appliance (see paragraphs 82 to 84 of this
Class Ruling).
Example 4 – Goods used or consumed in the process of constructing and supplying a GST-free medical
aid or appliance
81. Steve (a dentist) contracts Mike (a dental technician) to make a crown for Steve’s patient. In order to make
the crown, Mike must first create a plaster model. Mike itemises the crown and plaster model separately
on his bill to Steve. The plaster model is integral to the manufacturing process and is not used for any other
purpose. The plaster model forms part of the overall supply of the crown, all of which is GST-free. Goods
made and consumed in the process of constructing and supplying a GST-free medical aid or appliance form
part of the overall GST-free supply of that item.
Spare parts for GST-free medical aids and appliances – subsection 38–45(2)
82. Under subsection 38–45(2), a spare part for a GST-free medical aid or appliance is also GST-free if it is
specifically designed as a spare part for that GST-free medical aid or appliance and is supplied for that purpose.
83. For GST purposes, a “spare part” is a part that can be used to replace a faulty, worn or broken part of another
thing. The part needs only to be capable of replacing the faulty, worn or broken part. It does not actually have
to be used for that purpose.
84. Spare parts that are not specifically designed to replace a faulty, worn or broken part of a GST-free medical aid
or appliance are not GST-free. This means that things like generic screws that are not specifically designed for a
GST-free medical aid or appliance are not GST-free spare parts.
However, as explained in paragraphs 78 to 80 of this Class Ruling, things used and/or consumed in the
construction and overall supply of a GST-free medical aid or appliance are part of that overall GST-free supply.
Therefore, whilst a generic screw when supplied on its own is not a GST-free spare part for a denture because
it is not specifically designed for that purpose, it would be GST-free if that screw formed part of the supply of
the denture.
Example 5 – A part that cannot be used as a spare part for a GST-free medical aid or appliance
85. A chrome/cobalt casting frame is the internal framework for a denture. Dentures are covered by item 30
in the table in Schedule 3 and are GST-free. Whilst the framework is a component of a denture, it is not a
“spare part” for a denture. This is because, if the framework is broken, either it is repaired or a completely
new denture is supplied. A new framework is never actually supplied to replace a faulty, worn or broken
framework of the denture. Therefore it is not a GST-free spare part.
Repair services
86. Other than repairs of dental goods that may be GST-free under section 38–7 (see paragraphs 31 to 34 above),
there is no specific exemption in the GST Act for the supply of repairs of medical aids or appliances or their
spare parts.
Supply of spare parts with labour services
87. Where the specifically designed spare parts are supplied together with a labour component (for example,
an installation or fitting service) that is not GST-free, the GST treatment will depend on how the supply is
characterised. The table below provides a summary of how the supply may be characterised.
6
See Goods and Services Tax Ruling GSTR 2001/8 for further guidance in determining whether a part of a supply is integral, ancillary or incidental to the
dominant part of the supply.
Example 6 – GST-free supply of spare parts to which labour is integral, ancillary or incidental
89. A tooth is fitted to a denture to replace a broken or missing tooth under a “supply and fit” contract.
The supply of the tooth itself is GST-free under section 38–7 or section 38–10. The fitting of the tooth is
merely integral, ancillary or incidental to the supply of the tooth. The fitting of the tooth and the supply
of the tooth are a single composite GST-free supply of an “artificial tooth”. See Type A in the table in
paragraph 87 of this Class Ruling.
Example 7 – Taxable supply of labour to which the spare parts are integral, ancillary or incidental
90. A denture is in poor condition and is sent to be restored, which involves a significant amount of labour. The
restoration service is not GST-free under section 38–7 as no Medicare benefit is payable for the service. As
part of that restoration, a clasp is replaced. Of itself, the clasp is a GST-free spare part for a denture under
subsection 38–45(2). However, in this case, the supply of the clasp is integral, ancillary or incidental to the
supply of the restoration service, which is not GST-free. The supply of the clasp merely contributes to the
proper performance of the contract to restore the denture, this supply takes up a marginal proportion of
the total value of the service package and the customer does not seek the supply of the clasp as an aim in
itself, but merely as part of the supply of the restoration service. The supply of the restoration service and
the spare part is a single composite taxable supply. See Type B in the table in paragraph 87 of this Class
Ruling.
Example 8 – Partly taxable and partly GST-free supply of spare parts and labour as neither component is
integral, ancillary or incidental to each other
91. A tooth is added to a denture to replace a broken or missing tooth under a “supply and fit” contract.
At the same time, a small crack that is discovered in the denture base is repaired. This repair service is not
GST-free under section 38–7 as no Medicare benefit is payable for the service. An extra charge is made for
the repair of the crack. Neither the repair of the crack nor the fitted tooth is integral, incidental or ancillary
to each other. The fitted tooth part of the supply is GST-free under section 38–10 and the repair part is
taxable. The supply is partly taxable and partly GST-free. See Type C in the table in paragraph 87 of this
Class Ruling.
Apportionment
A supply that is partly taxable and partly GST-free
92. Where a dentist makes a supply that is partly taxable and partly GST-free (a mixed supply), the dentist will need
to apportion the consideration charged for the supply between the GST-free and taxable parts pursuant to
section 9–80.
93. A reasonable basis for apportionment must be used and each case must be determined on its own facts.
Records must be kept that explain the method of apportionment used. Goods and Services Tax Ruling GSTR
2001/8 gives further guidance on mixed supplies and apportionment.
94. As a means of minimising compliance costs, part of a supply may be treated as being integral, ancillary or
incidental to the other part if the consideration that would be apportioned to it (if it were part of a mixed
supply) does not exceed the lesser of:
• $3.00; or
• 20% of the consideration of the total supply.
95. This approach may be adopted to treat a supply as a composite supply (that is, either wholly GST-free or
taxable), although it might otherwise be considered as a mixed supply. However, if the consideration for a part
exceeds the lesser of $3.00 or 20% of the consideration for the total supply, it does not necessarily mean that
the part is not integral, ancillary or incidental.
Charging GST on a GST-free medical aid or appliance or a specifically designed spare part
96. In some circumstances, it may be difficult to determine those supplies that are GST-free and those that are
taxable.
97. Subsection 38–45(3) allows a supplier and recipient to agree not to treat supplies, or a particular supply,
as GST-free. For example, if a supply of a medical aid or appliance is made to another business, both businesses
can agree to treat the supply as taxable.
Diagnostic Services
Examinations
Only one of the item numbers 011–017 may be used at one visit.
014 Consultation #
A consultation to seek advice or discuss treatment options regarding a specific dental or oral condition.
This consultation includes recording an appropriate medical history and any other relevant information.
090 Cone Beam Volumetric Tomography analysis and/or interpretation – temporomandibular joints only #
The analysis and/or interpretation of a cone beam volumetric scan (refer to item 026) of the temporomandibular
joints only, including an open mouth scan if required. The procedure is often employed in diagnosis, treatment
planning and analysis for dental procedures. CBVT is also known as "CBCT".
091 Cone Beam Volumetric Tomography analysis and/or interpretation – orofacial structures #
The analysis and/or interpretation of a cone beam volumetric scan (refer to item 026) of the entire dentition and
supporting alveolar structures, also including any or all of the following: temporomandibular joints, paranasal
sinuses and airway, cranial base, cervical spine. The procedure is often employed in diagnosis, treatment planning
and analysis for dental procedures. CBVT is also known as "CBCT".
Remineralisation Agents
122 Topical remineralisation and/or cariostatic agents, home application – per arch
The prescribed use, by a patient at home, of a custom-made tray for the application of remineralisation
and/or cariostatic agents to the patient’s dentition. This procedure describes the complete course of treatment
per arch. For provision of the tray and medicaments or other remineralisation agents, see items 926 and 927.
Procedures described in this section include the insertion of sutures, normal post-operative care and suture removal.
Itemisation of a procedure described in this section includes the insertion of sutures, normal post-operative care and
suture removal.
Some procedures in this section may attract a Medicare rebate for approved dental practitioners. It is not appropriate
practice to use both ADA and Medicare item numbers to describe the same procedure.
Only one item number should be used to describe each oral surgery procedure on the same day by the same operator.
Extractions
Surgical Extractions
322 Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth
division
323 Surgical removal of a tooth or tooth fragment requiring removal of bone
324 Surgical removal of a tooth or tooth fragment requiring both removal of bone and tooth
division
322 Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division
Removal of a tooth or tooth fragment where an incision and the raising of a mucoperiosteal flap are required,
but where removal of bone or sectioning of the tooth is not necessary to remove the tooth.
324 Surgical removal of a tooth or tooth fragment requiring both removal of bone and tooth division
Removal of a tooth or tooth fragment where both removal of bone and sectioning of the tooth are required
after an incision and the raising of a mucoperiosteal flap. The tooth will be removed in sections.
344 Vestibuloplasty
The surgical deepening of the buccal or labial vestibule in the mucosa.
Dislocations
Osteotomies
General Surgical
373 Removal of tumour, cyst or scar involving muscle, bone or other deep tissue
The surgical removal of a tumour, cyst or scar involving muscle, bone or other deep tissue. Pathological review
may be necessary.
391 Frenectomy
Removal of a frenum.
412 Incomplete endodontic therapy (tooth not suitable for further treatment)
A procedure where in assessing the suitability of a tooth for endodontic treatment a decision is made that the
tooth is not suitable for restoration. Temporisation is itemised separately.
414 Pulpotomy
Amputation within the pulp chamber of part of the vital pulp of a tooth. The pulp remaining in the canal(s) is
then covered with a protective dressing or cement.
Periradicular Surgery
Procedures described in this section include normal post-operative care.
437 Surgical treatment and repair of external root resorption – per tooth
Surgical treatment of external root resorption.
438 Hemisection
Separation of a multi-rooted tooth into two parts.
445 Exploration and/or negotiation of a calcified canal – per canal, per appointment
451 Removal of root filling – per canal
452 Removal of a cemented root canal post or post crown
453 Removal or bypassing fractured endodontic instrument
455 Additional visit for irrigation and/or dressing of the root canal system – per tooth
457 Obturation of resorption defect or perforation (non-surgical)
458 Interim therapeutic root filling – per tooth
445 Exploration and/or negotiation of a calcified canal – per canal, per appointment
Chemical and physical procedures to locate and/or negotiate an abnormally calcified root canal where specific
time is devoted to this procedure.
455 Additional visit for irrigation and/or dressing of the root canal system – per tooth
Additional debridement irrigation and short-term dressing required where evidence of infection or inflammation
persists following prior opening of the root canal and removal of its contents.
Itemisation of a restorative service includes the preparation of the tooth, placement of a lining, contouring of the
adjacent and opposing teeth, placement of the restoration and normal post-operative care. Pins, cusp capping and
restoration of an incisor corner replacement are to be itemised separately.
Direct Restorations
Indirect Restorations
Crowns
Itemisation of a crown includes management of the soft and hard tissues associated with the crown during impression
taking and insertion visits.
Bridges
For examples of correct itemisation of bridges, see Notes for Guidance on pages x and xi.
665 Prosthesis with resin base attached to implants – removable – per arch
A removable prosthesis carrying artificial teeth on a resin base supported by the implants to which it is
attached. This prosthesis is designed for self-removal. Abutments attached to implants should be itemised as
661; retention components within prosthesis should be itemised as 735.
666 Prosthesis with metal frame attached to implants – fixed – per arch
A fixed prosthesis carrying artificial teeth on a cast or milled metal frame, supported by the implants to which
it is attached and not designed for self-removal. This is inclusive of the sealing of the access to the abutment
screws. Abutments attached to implants should be itemised as 661.
667 Prosthesis with metal frame attached to implants – removable – per arch
A removable prosthesis carrying artificial teeth on a cast, wrought or milled metal frame, supported by the
implants to which it is attached. This prosthesis is designed for self-removal. Abutments attached to implants
should be itemised as 661; retention components within prosthesis should be itemised as 735.
Reasonable care and adjustment following the insertion of the denture are included in the itemisations.
Denture Maintenance
Denture Repairs
An impression(s), if required, should be appropriately itemised.
777 Identification $
Marking a dental appliance with a patient’s name or other form of enduring patient identification.
Removable Appliances
Fixed Appliances
Extraoral Appliances
Attachments
Emergencies
Drug Therapy
Occlusal Therapy
A B
Abscess or cyst, drainage with incision 392 Bacteriological:
Abrasion – enamel micro-abrasion 116 examination 041
Abutment: screening 048
implant, fitting of 661 Bar for overlay denture 664
preparation (bonded) 649 Biopsy of tissue 051
provisional implant 633 Bleaching:
Acrylic crown 611 external 118
Acupuncture – dental 948 home application 119
Adding tooth to: internal 117
denture 765 provision of medicament 927
partial denture 768 tray 926
Addition to metal denture 769 Blood sample 055
Additional root canal irrigation or dressing 455 Bonding:
Adhesive restorations: orthodontic attachment 862
anterior – direct 521–526 tooth fragment, of 579
posterior – direct 531–536 Bone:
Adjunctive physical therapy (TMD) 971 cyst, removal of 371, 373
Adjustments: fractures 352–355, 359
dentures 741 Maxillary sinus augmentation –
lateral wall approach 247
orthodontic 871
Maxillary sinus augmentation –
After-hours loading 915
trans-alveolar technique 246
Alveolectomy 331
Osseous graft – block 244
Amalgam (see Metallic restorations – direct):
Osseous surgery 242
preliminary restoration for crown 627
periodontal osseous graft 243
restorations 511–515
Bridge:
Anaesthetic:
enamel bonded – retainer 649
loading for treatment 949
intra-coronal attachments – precision or
local 941
magnetic 645
Antibiotic sensitivity test 043
pontic – direct 642
Anti-snoring device 983, 984
pontic – indirect 643
Antrum, maxillary, surgery of 393
provisional (temporary/intermediate) 632
Apical seal 434
recementing 652
Apicectomy 432
removal of 656
Attachments:
repair of 658, 659
orthodontic 862
stress-breaker 644
precision or magnetic 645, 735
Bypass/removal fractured endodontic instrument 453
semi-fixed 644
C Course of treatment:
F H
Facings (see Veneers) Haematological examination 056
Fibrous tuberosities, reduction of 337 Haemorrhage, control of 399
Fillings (see Restorations or Root canal fillings) Hemisection (of tooth) 438
Fissure sealing 161 Histopathological examination 052
Flabby ridge, reduction of 338 Hygiene, oral instruction 141
Fluoride, topical (see Remineralisation agents) 121–123 Hyperplastic tissue, excision of 341
Fractures (bone) 352-355, 359
I
Frenectomy 391
Identification of denture 777
Full crown:
Immediate tooth replacement 736
acrylic – indirect 611
Implants:
metallic – indirect 618
bone augmentation 243
non-metallic – indirect 613
diagnostic template 678
veneered – indirect 615
fitting of abutment 661
Full dentures 711, 712, 719
fitting of bar 664
Functional orthopaedic appliance 823
full crown – metallic – indirect 673
Functional orthopaedic appliance
– custom fabrication 823 full crown – non-metallic – indirect 671
Functional orthopaedic appliance full crown – veneered – indirect 672
– prefabricated 824
insertion, first stage 684
insertion, single stage 688
G
maxillary sinus augmentation –
General anaesthesia –
lateral wall approach 247
loading for treatment under 949 maxillary sinus augmentation –
Gingival graft 235 trans-alveolar technique 246
prosthesis with metal frame – fixed 666
Gingivectomy 231
prosthesis with metal frame – removable 667
Glass ionomer (see Adhesive/Tooth-coloured
prosthesis with resin base – removable 665
restorations – direct)
provisional implant 689
Gold foil restorations (see Metallic restorations – direct)
provisional implant abutment 633
Graft:
provisional implant restoration 634
block 244
removal 663
gingival 235
removal and reattachment of prosthesis 669
osseous 243
screw removal and replacement 668
skin and mucosal 345
second stage surgery 691
GST page xxii
surgical guide 679
Guided tissue regeneration: Impression for denture repair 776
membrane removal 237 Incisal corner replacement 578
per tooth or implant 236
Incisal corner, restoration of 578
Incision and drainage 392
L Occlusal:
post and root cap – indirect 629 Pulpectomy and root canal filling – primary tooth 421
dentures 761–766, 769 Root resection or hemisection (of tooth) 241, 438
V
Veneers:
bonded facing direct 526, 536
bonded facing indirect 556
recementing 651
Vestibuloplasty 344
Vitality test 061
VMK (full crown – veneered) 615
W
Written report 018
Wrought bar 738
X
X-rays (see Radiographs)