• 1 recall examination per benefit year.
• Complete series of x-rays
  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
  6 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.
• Space maintainers and maintenance
  Under 15 years of age, 1 per space per benefit year.
• Anaesthesia
  Eligible when done in conjunction with a covered dental procedure.

• 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.

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

• Root canal therapy.

• Inlays, onlays
• Crowns
• Veneers, other than for cosmetic purposes
• Bridges
• Dentures

Replacement of an existing inlay, onlay, crown, veneer, and bridge is an eligible expense if the replacement is required to replace an existing inlay, onlay, crown, veneer, and bridge which was installed 5 years before the replacement.