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Basic Services

Percentage Payable – 80% of Applicable Fee Guide

Expenses incurred for the following items are considered eligible expenses:

  1. Diagnostic Services
    • oral examinations, once every 12 months
    • occlusal, posterior bitewing or extra-oral films, limited to 4 of each type every 12 months
    • full mouth films once every 12 months
    • single films, limited to 10 every 12 months
    • consultation required by the attending dentist
  2. Preventative Services
    • one unit of scaling and one unit of polishing, once every 12 months
    • topical fluoride treatment, once every 12 months
    • provision of space maintainers for missing primary teeth
    • provision of habit breaking appliances
  3. Restorative Services
    • amalgam, silicate, acrylic and composite restorations
  4. Endodontic Services
    • treatment of the diseases of the dental pulp (including root canal therapy)
  5. Periodontal Services
    • treatment of diseases of the gums and other supporting tissue of the teeth including:
      1. scaling not covered under preventative services and root planing up to a combined maximum of 16 units per calendar year;
      2. provisional splinting; and
      3. occlusal equilibration, up to a maximum of 8 units per calendar year.

      However, procedures for guided tissue regeneration are considered eligible only if performed in conjunction with the following periodontal surgical procedures: Flap approach or Osseous grafts – autographs or allografts, provided natural teeth are involved.

  6. Prosthodontic Services
    • relining, rebasing, and repairing an existing denture
    • repairing an existing bridge
  7. Surgical Services
    • the following items required in relation to dental surgery:
      1. diagnostic radiographs
      2. laboratory procedures
      3. general anaesthetic
        • extractions (including extractions of impacted teeth)
        • simple alveolectomy at the time of tooth extraction
        • removal of tumours, cysts, neoplasms, plus the incision and drainage of an abscess
  8. Protective athletic appliances for the teeth, limited to 1 in every 12 months.


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