One unit of time

Each additional unit of time

RECONTOURING OF TEETH FOR FUNCTIONAL REASONS

(Not associated with delivery of a single or multiple prosthesis)

One unit of time

Each additional unit of time

OCCLUSION

Occlusal Adjustment/Equilibration:

(a) May require several sessions
(b) May be used in conjunction with basic restorative treatment only when occlusal
adjustment/equilibration is not required as a result of that restoration.
(c) Not to be used in conjunction with the delivery and post-insertion care of: fixed or removable
prosthesis (50000 & 60000 code series) by the same dentist for period of three months.

One unit of time

Two units

Three units

Four units

Each additional unit over four

RESTORATION

Treatment of dental caries includes pulp protection and local anaesthesia.
Where, at the same appointment, in order to conserve tooth structure, two separate restorations are
performed on the same tooth involving a common surface, when one restoration might have been
done; this should be considered as one restoration in assessing the fee.
Finishing restorations is a separate procedure done at a separate appointment (See 16100)

CARIES, TRAUMA AND PAIN CONTROL

Caries/Trauma/Pain Control

(removal of carious lesions or existing restorations or gingivally attached tooth fragment and
placement of sedative/protective dressings, includes pulp caps when necessary, as a separate
procedure).

First tooth

Each additional tooth same quadrant

Caries/Trauma/Pain Control

(removal of carious lesions or existing restorations or gingivally attached tooth fragment and
placement of sedative/protective dressings, includes pulp caps when necessary and the use of a band
for retention and support, as a separate procedure)

First tooth

Each additional tooth same quadrant

Trauma Control, Smoothing of Fractured Surfaces Per Tooth

First tooth

Each additional tooth same quadrant

RESTORATIONS, AMALGAM

RESTORATION, AMALGAM, PRIMARY TEETH

Rertorations, Amalgam, Non-Bonded, Primary Teeth

One surface

Two surfaces

Three surfaces

Four surfaces

Five surfaces or maximum surfaces per tooth

Rertorations, Amalgam, Bonded, Primary Teeth

One surface

Two surfaces

Three surfaces

Four surfaces

Five surfaces or maximum surfaces per tooth

RESTORATIONS, AMALGAM, PERMANENT TEETH

Restorations, Amalgam, Non-Bonded, Permanent Bicuspids and Anteriors

One surface