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Periodontics such as:

Periodontal scaling and root planing (once per quadrant in 24 months).

Periodontal surgery (once per quadrant in 36 months).

Periodontal maintenance, including cleanings, following active periodontal therapy (once each three months).

Endodontics such as:

Root canal therapy on permanent teeth (once in a lifetime for each tooth).

Retreatment root canal therapy on permanent teeth (once in a lifetime for each tooth).

Therapeutic pulpotomy on primary or permanent teeth for members under age 16.

Other endodontic surgery intended to treat or remove the dental root.

Prosthetic Maintenance such as: