Downeast Center For Restorative Dentistry
12 Newmarch Street Kittery, ME 03904
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $103 | 0% | $103 | Medium |
| Child Dental Cleaning | $87 | 0% | $87 | Medium |
| Fluoride - Topical Application | $42 | 0% | $42 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $302 | 0% | $302 | Medium |
| Sealant placed on the tooth surface to prevent decay | $61 | 0% | $61 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $111 | 0% | $111 | Medium |
| Periodic dental exam - established patient | $58 | 0% | $58 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $93 | 0% | $93 | Medium |
| X-Ray Dental - Complete intraoral series | $161 | 0% | $161 | Medium |
| X-Ray Dental - Four images - bitewings | $71 | 0% | $71 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $37 | 0% | $37 | Medium |
| X-Ray Dental - Two images - bitewings | $42 | 0% | $42 | 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 | $225 | 0% | $225 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $264 | 0% | $264 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $225 | 0% | $225 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $282 | 0% | $282 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $205 | 0% | $205 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $647 | 0% | $647 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $259 | 0% | $259 | Medium |
Orthodontic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Orthodontic Treatment Visit (Periodic - as part of a contract) | $76 | 0% | $76 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $139 | 0% | $139 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $228 | 0% | $228 | Medium |