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.--JMINI STRAXIVE POLICIES (Conttued) <br />C. OPTIONAL TREATMENT <br />In <br />rendering dental care, the dentist and the patient frequently consider possible <br />optional treatment plans. <br />In those instances where the member er selects a optional treatment plan a opp ose <br />to that dental treatment plan which is customarily provided, the cost or such optional <br />treatment will be based upon the Provider usual and customary fee. A� credit for the <br />fee o p y the procedure customarily provided vill be allowed towards the fee fo r sueb <br />optional treatment. For example: <br />1. Partial Dentures <br />a. If a standard cast chrome partial l denture will restore function, the Provider <br />will allow a treatment credit toward the cost of a more complicated <br />recision appliance which the member and Provider may choose to use. <br />. A removable cast artial for patients under the age of 1 is considered <br />p optional � <br />treatment. treatment credit ill be allowed for ace <br />a p <br />maintainer. <br />2. Fixed Bridges <br />a, A fixed bridge in any posterior quadrant, v en the abutment teeth are <br />denta.11X sound and would be crowned only for the purpose of supporting a <br />i <br />pontic, is considered optional treatment. treatment credit will be allowed <br />for -a partial denture. <br />. Replacement of missing anterior teeth with a fixed bridge is considered the <br />• <br />treatment of choice, provided dental conditions perrmt. <br />c. A fixed bridge for patients under the age of 16 is considered optional <br />treatment. A treatment credit will be alloyed for a space maintainer. <br />3# Fillings and Crowns <br />. If a tooth can be adequately restored using amalgam or composite <br />restorations, any other type of restoration, such as a crown, is considered <br />optional treatment. A treatment credit will be allowed for filling. <br />. A. porcelain, porcelain fused to metal, or plastic processed to metal crown <br />for patients under the age of 1 is considered optional treatment. <br />p t . <br />treatment credit will e allowed for any acrylic or stainless steel crown, <br />CA 4/91 <br />