Dover Dental Associates
2 Ridge Street Dover, NH 03820
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $124 | 0% | $124 | Medium |
| Child Dental Cleaning | $111 | 0% | $111 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $347 | 0% | $347 | Medium |
| Sealant placed on the tooth surface to prevent decay | $56 | 0% | $56 | Medium |
| Topical fluoride varnish application | $45 | 0% | $45 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $97 | 0% | $97 | Medium |
| Periodic dental exam - established patient | $54 | 0% | $54 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $97 | 0% | $97 | Medium |
| X-Ray Dental - Complete intraoral series | $185 | 0% | $185 | Medium |
| X-Ray Dental - Four images - bitewings | $97 | 0% | $97 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $42 | 0% | $42 | Medium |
| X-Ray Dental - Two images - bitewings | $97 | 0% | $97 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $40 | 0% | $40 | Medium |
Dental Fillings
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Silver (Amalgam) Dental Filling - One surface, primary or permanent | $208 | 0% | $208 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $292 | 0% | $292 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $326 | 0% | $326 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $215 | 0% | $215 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $292 | 0% | $292 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $197 | 0% | $197 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $361 | 0% | $361 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $272 | 0% | $272 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $184 | 0% | $184 | Medium |