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 .