• 1 recall examination per benefit year.
• Initial or complete examination, once every 36 months.
• Complete series of x-rays and periapical
  Maximum 16 films including bitewings in any period of 36 months. Not eligible for dependants under 12 and periapical.
• Bitewings
  Maximum 4 films per benefit year.
• Panoramic
  1 in any period of 36 months.
• Scaling
  2 units per benefit year.
• Polishing
  1 unit per benefit year.
• Oral hygiene instruction
  1 treatment per lifetime.
• Fluoride
  Under 19 years of age, 2 treatments per benefit year.
• Pit and fissure sealants
  Under 19 years of age, 1 per molar in any period of 36 months.
• Anaesthesia
  Eligible when done in conjunction with a covered dental procedure.

• Space maintainers and maintenance
  Under 15 years of age.
• Amalgam and tooth coloured fillings
  1 per tooth in any period of 24 months.
• Stainless steel and plastic full coverage restorations
  Under 15 years of age, 1 per tooth in any period of 36 months.
• Denture adjustments and repairs.
• Relining, rebasing and tissue conditioning
  One treatment in any period of 36 months.

• Extractions
  Maximum 2 wisdom teeth per benefit year.

• Root canal therapy

• Occlusal equilibration
  Maximum 4 units per benefit year.
• Periodontal appliances
  Maximum 1 appliance per arch in any period of 24 months.
• Periodontal appliance repairs, maintenance and adjustments
  Maximum 4 adjustments per benefit year.

Excludes additional scaling.