Does SHA Cover Dental? What's Included and What's Not
You have a toothache. Does SHA cover the dentist?
The short answer: sort of. The longer answer involves knowing exactly what's covered and what's not.
Here's the complete picture of dental coverage under SHA.
Table of Contents
- Does SHA Cover Dental Care?
- How SHA Dental Coverage Works
- SHA Dental Coverage Limits
- What Counts as a Dental Emergency?
- Common Dental Treatments and SHA Coverage
- Getting the Most from SHA Dental
- SHA vs Private Dental Insurance
- Private Dental Insurance Options
- Common Questions
- Taking Care of Your Teeth
- The Bottom Line
- Next Steps
Does SHA Cover Dental Care?
Yes, but it's small. SHA has an oral health package with fixed prices per treatment and a cap of KES 2,000 per household per year.
The figures below come from the gazetted SHA tariff schedule (Legal Notice 56 of 2025, as amended in May 2026).
What's Covered
| Service | SHA pays |
|---|---|
| Screening and consultation | KES 300 |
| Tooth extraction | KES 650 |
| Management of dental infections (caries, gum disease) | KES 700 |
| Dry socket treatment | KES 750 |
| Basic filling (ART with glass ionomer) | KES 1,000 |
| Suturing under local anaesthesia | KES 1,000 |
| Scaling and polishing (cleaning) | KES 1,200 |
| Herpetic wound cleaning | KES 600 |
Household limit: KES 2,000 per year, shared by everyone on the cover. One cleaning plus one filling uses most of it.
What's NOT Covered
These aren't in SHA's oral health package:
- Root canals
- Crowns and bridges
- Dentures
- Braces (orthodontics)
- Implants
- Cosmetic work like whitening and veneers
If you need one of these, you pay yourself or use private cover.
How SHA Dental Coverage Works
The catch: not every dentist offers it
The tariff schedule says dental is offered "where capacity is available, and the dental unit is willing to offer the service at the given tariff". It also says the package rolls out "subject to availability of resources".
In plain English: SHA has set the prices, but a clinic doesn't have to take SHA for dental. Many private clinics charge more than these tariffs, so they don't.
Accessing dental services
Step 1: Find a facility with a dental unit that takes SHA for dental Call first. Ask specifically about dental under SHA, not just "do you take SHA".
Step 2: Get screened The consultation is KES 300 under the package.
Step 3: Treatment If the treatment is on the list above, SHA pays the tariff. If the clinic charges more, you pay the difference.
SHA Dental Coverage Limits
| Rule | What it means |
|---|---|
| KES 2,000 per household per year | The whole family shares one small pot |
| Fixed tariff per treatment | SHA pays the listed amount, not the clinic's price |
| Willing facilities only | The clinic must agree to the tariff |
Dental emergencies
Severe trauma, like a broken jaw from an accident, falls under SHA's accident and emergency cover, which pays for resuscitation and stabilisation. A routine toothache is not an emergency. It goes through the dental package.
What Counts as a Dental Emergency?
| Emergency | Not Emergency |
|---|---|
| Severe swelling with fever | Mild toothache |
| Knocked-out tooth (trauma) | Cracked filling |
| Broken jaw | Chipped tooth (no pain) |
| Uncontrolled bleeding | Routine extraction |
For true emergencies, go to the nearest hospital.
Common Dental Treatments and SHA Coverage
Extractions
Covered? Yes. SHA pays KES 650 per extraction.
Fillings
Covered? A basic filling (atraumatic restorative treatment with glass ionomer) is KES 1,000. Other filling types aren't listed, so expect to pay the difference or the full cost.
Root Canals
Covered? No. Root canals aren't in SHA's oral health package.
Cleaning
Covered? Yes. Scaling and polishing is KES 1,200. That's more than half the household's yearly KES 2,000.
Dental X-rays
Covered? Not listed in the oral health package. Ask the facility before you assume.
Getting the Most from SHA Dental
Tip 1: Call ahead
Ask: "Do you offer dental under SHA at the SHA tariff?" That one question saves a wasted trip.
Tip 2: Spend the KES 2,000 on what matters
It's per household. A child's extraction and a filling can use the year's limit. Decide as a family.
Tip 3: Public hospitals first
County hospitals with dental units are more likely to work at SHA tariffs than private clinics.
Tip 4: Budget for what's not covered
Root canals, crowns, dentures and braces are on you.
Tip 5: Consider dental top-up
If dental matters to you, private insurance with a dental benefit fills the gap.
SHA vs Private Dental Insurance
| Factor | SHA | Private insurance |
|---|---|---|
| Screening | KES 300 | Usually covered |
| Cleaning | KES 1,200 | Usually covered |
| Extractions and basic fillings | Yes, at tariff | Yes |
| Root canals | No | Often covered |
| Crowns | No | Often covered |
| Braces | No | Some plans |
| Annual limit | KES 2,000 per household | Set by your plan |
Private Dental Insurance Options
Most Kenyan insurers offer dental as part of, or an add-on to, outpatient cover. Limits and what's included vary by insurer and plan, so compare the actual benefit schedule, not the headline.
See how SHA and private cover fit together in best private insurance to top up SHA, get a price on the health insurance calculator, or read what SHA pays across every benefit.
Common Questions
"Can I see any dentist with SHA?"
No. Only facilities that offer dental at the SHA tariff. Many private clinics don't, so call ahead.
"Does SHA cover children's dental?"
Same package and the same KES 2,000 household limit. Braces are not covered.
"What about wisdom tooth removal?"
A simple extraction is KES 650 under the dental package. An impacted wisdom tooth that needs surgery is a different matter: ask whether the hospital bills it under SHA's surgical package.
"Can I claim for dental work I paid for privately?"
Generally no. SHA pays the facility directly at the tariff. It doesn't refund you for private dental bills.
"Is dental checkup covered?"
Yes, at a small tariff. Screening and consultation is KES 300, and it counts toward the KES 2,000 household limit.
Taking Care of Your Teeth
Since SHA dental is limited, prevention saves money:
Daily Care
- Brush twice daily
- Floss once daily
- Use fluoride toothpaste
- Avoid excessive sugar
Regular Checkups
SHA pays KES 300 for a screening and KES 1,200 for a cleaning, within the household limit:
- Visit dentist every 6–12 months
- Catch problems early (cheaper to fix)
- Professional cleaning 1–2 times per year
Cost-Saving Tips
- University dental schools — Quality care at lower costs
- Dental camps — Free screenings and basic treatments
- Early treatment — A filling costs less than a root canal
- Shop around — Prices vary between dentists
The Bottom Line
SHA dental coverage is basic:
What you can count on:
- Screening (KES 300) and cleaning (KES 1,200)
- Extractions (KES 650)
- Basic fillings (KES 1,000)
- All within KES 2,000 per household per year
What you'll need to pay for:
- Anything above the KES 2,000 household limit
- Root canals
- Crowns and bridges
- Orthodontics
- Implants
- Cosmetic work
If dental care is a priority, consider private insurance with dedicated dental benefits alongside SHA.
Next Steps
- Call nearby facilities and ask if they offer dental at the SHA tariff
- Budget for dental care not covered by SHA
- Consider dental add-on through private insurance
- Read: Best Private Insurance to Top Up SHA
- Explore: Complete SHA Benefits Guide
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