All new patients in our clinic will require an exam and if necessary, the dentist will designate x-rays to be taken as part of the standard of care practices. Dental x-rays (radiographs) may be prescribed every 3-5 years or as needed to provide accurate and best treatment care outcomes.
D1110 | Adult Prophylaxis (12 teeth or less, $10.00 discount) | $30.00 |
D4346 | Adult Prophylaxis Class II (Generalized moderate to severe gingivitis) | $35.00 |
D1120 | Child Prophylaxis (up to 12 years) | $20.00 |
D1208 | Fluoride Treatment | $7.00 |
D1206 | Fluoride Varnish | $7.00 |
D1351 | Pit and Fissure Sealant (per tooth) | $6.00 |
D4355 | Full Mouth Debridement with Prophylaxis | $35.00 |
D4341 | Scaling and Root Planing ($10 per quadrant) | $40.00 |
D4910 | Periodontal Maintenance | $35.00 |
D0150 | Comprehensive Oral Exam | $15.00 |
D0120 | Periodic Oral Exam | $10.00 |
D0210 | Complete Radiograph Survey (Child or Adult) | $30.00 |
D0330 | Panoramic Radiograph (Child or Adult) | $30.00 |
D0220 | Periapical- Single, first film | $6.00 |
D0230 | Periapical- Each additional film | $6.00 |
D0272 | Bite-wings- 2 films | $12.00 |
D0274 | Bite-wings- 4 films | $17.00 |
D0277 | Vertical Bite-wing Survey (7 films) | $20.00 |
Film Duplicating- Each survey | $15.00 |
We accept Cash, Check, Visa, Mastercard, Discover, American Express, and JCB for dental services.
The IU Northwest Dental Education Clinic does NOT provide restorative services like fillings or extractions except during special community events throughout the year.
