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Cost for Services


Dental Hygiene Therapy (Cleaning)


Adult Hygiene Therapy (Class 0, I, and II)


Adult Hygiene Therapy (Class IIP)


Adult Hygiene Therapy (Class III and IV)


Child Hygiene Therapy





Full Mouth Series X-rays


Panoramic X-ray


Vertical Bitewing X-rays (4-7)


Bitewing X-ray (4)


Bitewing X-ray (2)


X-ray single film


Each additional x-ray


FMX or Pano duplicate film (non-SFSC x-ray)


Bitewing duplicate film (non-SFSC x-ray)


Digital X-rays

Same as traditional


Other Procedures


Sealants per tooth


Local Anesthesia (non-operative/non-surgical)


Night Guards and Bleaching Trays


Fissurotomy (when needed prior to sealant)

$7 per tooth

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