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Health watchdog probes alleged rort of super scheme for dental veneers

After seeing Instagram advertisements from Dental Boutique spruiking that eligible patients could access their super for dental treatment, Sfetkas booked a consultation in May 2023.

Health watchdog probes alleged rort of super scheme for dental veneers

An Instagram post from Dental Boutique that states that eligible patients can use their superannuation to fund dental treatment.

Dental records from Sfetkas’ first presentation to the clinic state that his main concerns were “missing teeth, cavities, aesthetic concerns (colour, shape), TMJ [temporomandibular joint] and muscle discomfort”. The medical records detail the treatment options as orthodontics, teeth whitening, porcelain veneers, resin bonding and a single tooth implant.

But a form sent to the ATO, written by a Dental Boutique dentist, claimed Sfetkas was experiencing “chronic pain and [an] inability to eat satisfactorily”. A separate statement to the ATO written by the Sydney GP said Sfetkas was in “chronic pain and discomfort due to his dental condition and requires intervention”.

Sfetkas said he told neither practitioner that he was in any pain or struggling to eat. He said he was missing one tooth. He also claims no dentist at Dental Boutique looked into his mouth before completing the form for the ATO.

“I was in no pain or discomfort,” he told this masthead, adding that he had never heard of TMJ or complained about symptoms associated with TMJ dysfunction, which can cause joint tenderness and facial pain.

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“It was for aesthetic reasons. I didn’t like my teeth. They were yellow and a bit crooked.”

This masthead is aware of the practitioners’ names but has chosen not to identify them.

Responding via their lawyer, Rebekah Giles, Dental Boutique denied allegations of fraudulent activity and said that none of their practitioners had received notifications from AHPRA about its investigation.

The statement also said Access My Super, which bills itself as helping patients access their super fund for medical care, managed the application process, including preparing documents and providing financial advice. Dental Boutique said they no longer have a relationship with Access My Super.

“Dental Boutique remains committed to ongoing review of all of their procedures and protocols to ensure regulatory compliance,” the clinic said. “They have a strict policy which they abide by and have regular team meetings with all clinicians to ensure that the dentists and supporting staff are aware of the regulations, which can often be complex.”

Dental Boutique said it was unable to comment on Sfetkas’ case due to patient confidentiality, but said new patients received a complimentary consultation with a dentist or a Certificate 4-qualified nurse who collected preliminary diagnostic imaging. That information, it said, is then used by a dentist to compile an initial treatment plan.

The clinic said if patients indicated an interest in withdrawing funds from their superannuation, they were referred to a third-service provider, such as Access My Super. Dental Boutique added it provided the proposed treatment plan to those providers, which assess the patient’s eligibility.

Dental Boutique said “a very small portion” of their cases were funded through that scheme. However, on a video posted on Instagram, the practice said “a large majority of our patients utilise the payment plans or early super release options available here”.

In a separate Instagram video, a Dental Boutique practitioner states: “It could be Invisalign that you’re looking for, it could be veneers that you are looking for … we will do whatever it takes to allow us to help you by looking at payment options, payment plan and superannuation as well. Don’t worry about the major cost.”

Instagram posts from Dental Boutique detailing their payment options.

Instagram posts from Dental Boutique detailing their payment options.

There are strict rules around accessing superannuation early for medical treatment. To be approved, Australians must provide the ATO with two separate reports from a medical specialist and a medical practitioner to certify that treatment is necessary to treat a life-threatening illness or injury or to alleviate acute or chronic pain.

Sfetkas said he was unaware he had to meet these conditions.

He said Dental Boutique staff told him he was the “perfect candidate” for veneers and asked him to sign a form that authorised Access My Super, which purports to have an “100 per cent application approval success rate”, to contact him.

Sfetkas said Access My Super arranged a telehealth consultation with a GP in Sydney, who completed a report for the ATO claiming she was Sfetkas’ regular treating doctor despite having never met him before.

AHPRA is also investigating allegations the GP’s report to the tax office included a treatment plan that outlined extensive work required to fix Sfetkas’ teeth, before he had been thoroughly examined by a dental practitioner.

Matt Hopcraft, a dental public health expert at the University of Melbourne, speaking broadly on the issue, said there were real concerns patients were not being fully informed about the consequences of withdrawing their super early to fund medical treatments.

“There’s also concerns about [whether] people are being encouraged to have treatment that isn’t appropriate or perhaps clinically necessary,” Hopcraft said. “Clearly this money seems to be going for veneers and cosmetic treatments – are they complying with guidelines?”

He said the latest data from the ATO showed about 5 per cent of the $11 billion spent a year on all dental health treatments in Australia was now being funded through superannuation savings.

“The scheme is being misused and the government would be much better channelling their time and money into funding dentistry under Medicare,” he said.

“Anecdotally, a lot of the cases are veneers – they’re not life-threatening illnesses, or chronic and acute pain. There’s a mental wellbeing and self-esteem aspect, and those things are important too … but that wasn’t what the [early release of superannuation scheme] was designed for.”

Dental Boutique said a range of medical treatments could involve a cosmetic element, adding porcelain restorations, such as crowns and bridges that improve dental aesthetics, were part of a holistic treatment for conditions like TMJ disorder.

Sfetkas is now exploring legal action against Dental Boutique to recoup the $41,000 he spent on veneers and crowns, which he said left him in severe pain and with speech issues. “I was having Panadol every four hours for one month and waking up in the night with pain,” he said.

He is paying for the veneers to be redone at a specialist dental clinic. A practitioner there made a mandatory report to AHPRA due to their concerns about the access to super and Sfetkas’ previous dental treatment.

The Dental Board of Australia said dentists must comply with the board’s code of conduct, which expects them to provide honest and truthful information when preparing reports and certificates, including to the ATO. It has received 13 notifications about patients accessing superannuation for dental treatment, including five related to advertising that encourages patients to use the scheme. The Board said it expects these figures to grow.

“Providing misleading information to support a patient’s request to draw from superannuation is potentially grounds for the board to consider disciplinary action, in addition to any action that the ATO may deem necessary.”

A spokesman for the ATO said the early access scheme “appropriately and necessarily” relied on the professional judgment of medical providers.

“ATO staff are not equipped, nor required, to question a patient’s diagnosis or the required treatment strategy, or to otherwise interfere in the relationship between a patient and their medical professional in relation to their medical diagnosis or treatment,” he said.

Access My Super and the NSW-based GP did not respond to requests for comment.

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