• Examination, 1 per benefit year
• Bitewings, not more than 4 films per benefit year
• Polishing, 1 unit per benefit year
• Scaling, 2 units per benefit year
• Fluoride, under 15 years of age, 1 treatment per benefit year
• Additional or elected treatments or services may not included

• 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 24 months
• Pit and fissure sealants
  under 16 years of age, 1 replacement per tooth, per lifetime, on permanent molars

• Denture adjustments and repairs
• Denture relining, rebasing and tissue conditioning, 1 treatment in any period of 36 months
• Recementation of fixed prosthesis

• Wisdom teeth, limited to 2 teeth per patient, per benefit year
• Periapical x-rays
• General anaesthesia, eligible when done in conjunction with Oral Surgery
• Panoramic, 1 in any period of 36 months

• Root canal therapy
• Additional scaling and/or root planing, maximum 2 units per benefit year

• Crowns
• Bridges
• Dentures

Replacement of an existing crown, bridge or dentures is an eligible expense if the replacement is required to replace an existing crown, bridge or denture which was installed less than 5 years before the replacement.