Silver Lake Dental
96 Main Street Wilmington, MA 01887
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $110 | 0% | $110 | Medium |
| Child Dental Cleaning | $81 | 0% | $81 | Medium |
| Fluoride - Topical Application | $41 | 0% | $41 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $289 | 0% | $289 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Periodic dental exam - established patient | $50 | 0% | $50 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $88 | 0% | $88 | Medium |
| X-Ray Dental - Complete intraoral series | $152 | 0% | $152 | Medium |
| X-Ray Dental - Four images - bitewings | $78 | 0% | $78 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $35 | 0% | $35 | Medium |
| X-Ray Dental - Two images - bitewings | $107 | 0% | $107 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $28 | 0% | $28 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $152 | 0% | $152 | Medium |
Dental Fillings
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $252 | 0% | $252 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $311 | 0% | $311 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $179 | 0% | $179 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $252 | 0% | $252 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $179 | 0% | $179 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $622 | 0% | $622 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $153 | 0% | $153 | Medium |