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DEFINITIONS As used in this evidence of coverage, the terms listed below will have the meanings set forth below. When defined terms are used in this evidence of coverage, they will appear with initial capitalization. The plural use of a term defined in the singular will share the same meaning. Amalgam means a silver filling material usually used on posterior teeth. Anterior means teeth located in the front of the mouth — upper and lower six (6) teeth with three in each Quadrant of the mouth; twelve (12) teeth in total. Asymptomatic means without symptoms, the absence of any indication of disease, surrounding pathology or impaired function. Bicuspid means teeth located immediately in front of the molar teeth — upper and lower with two in each Quadrant of the mouth; eight (8) teeth in total. Bridge or Bridgework means a fixed replacement for one or more missing teeth that is permanently attached to the teeth adjacent to the empty space(s). Cast Restoration means an inlay, onlay, or crown. Co -Payment or Co -Pay means a fixed dollar amount or a fixed percentage of the Maximum Allowed Charge of the Covered Services performed by Your Selected General Dentist, for which We are not responsible, as shown in the Schedule of Benefits. You must pay Your Co -Payment at the time of delivery of supplies or services. Cosmetic means services performed solely for appearance. Treatment of decay, disease or injury to the teeth or supporting tissues of the teeth is not evident. Cosmetic means any procedure which is directed at improving the patient's appearance and does not meaningfully promote the proper function or prevent or treat illness or disease. Covered Service means a dental service used to treat Your or Your dependent's dental condition which is: • prescribed or performed by a Dentist while such person is covered for dental benefits; • Dentally Necessary to treat the condition; and • described in the Schedule of Benefits, or • Dental Benefits sections of this evidence of coverage. Crown means a restoration place over a tooth to strengthen and/or replace missing tooth structure. A crown can be made of different materials, for example, noble, high noble, and base metals, or porcelain or porcelain and metal. Dental Hygienist means a person trained to: • remove calcareous deposits and stains from the surfaces of teeth; and • provide information on the prevention of oral disease. The term does not include: • You; • Your Spouse; or • any member of Your immediate family including Your and/or Your Spouse's parents; children (natural, step or adopted); siblings; grandparents; or grandchildren. Dentally Necessary means that a dental service or treatment is performed in accordance with generally accepted dental standards and is: • necessary to treat decay, disease or injury of the teeth; or • essential for the care of the teeth and supporting tissues of the teeth. GCERT2011-DHMO-EOC 25C-33 19