Individually molded device designed primarily to be worn for the purpose of helping prevent injury to the teeth and their surrounding tissues. Sometimes called a mouth protector.
Services and supplies which are reimbursed in whole or in part under the conditions of the dental benefit plan, subject to all the terms and conditions of the agreement or insurance policy. Charges are subject to any contractual agreements, exclusions and limitations. Any charges not covered by the plan are considered non-covered charges.