This page includes a brief summary of the PPO dental plan benefits. A complete description of insured benefits, including limitations and exclusions, will be provided in the Certificate of Insurance.

Lifetime of Smiles program features:

  • Brush biopsies for early cancer detection
  • Testing for genetic gum disease
  • Coverage for antimicrobial agents

Type I Preventive Dental Services, including:

  • Oral evaluations
  • Routine dental cleanings
  • Fluoride treatment (children under age 19)
  • Sealants (children under age 14)
  • Space maintainers (children under age 19)
  • Bitewing x-rays
  • Intraoral complete series x-rays
  • Genetic test for susceptibility to oral diseases

Type II Basic Dental Services, including:

  • New fillings
  • Simple extractions, incision and drainage
  • Surgical extractions of erupted teeth, impacted teeth, or exposed root
  • Biopsy (including brush biopsy)
  • Endodontics (includes root canal therapy)
  • General anesthesia/IV sedation
  • Minor gum disease (non-surgical periodontics)
  • Scaling and root planing
  • Periodontal maintenance
  • Localized delivery of antimicrobial agents
  • Major gum disease (surgical periodontics)

Type III Major Dental Services, including:

  • Dentures and bridges
  • Stainless steel crowns (children under age 19)
  • Inlay, onlay, and crown restorations
  • Treatment for TMJ disorder (non-surgical)

Type IV Ortho services, including:

  • No orthodontic treatment age limitation
  In-network Out-of-network
Plan year maximum $1,500 per person $1,000 per person
Plan maximum – ortho services $1,250 lifetime (child and adult) $500 lifetime (child and adult)
Plan year deductible (applies basic and major services only) $50 individual/$150 family $50 individual/$150 family
Type I preventive services coinsurance 100% 80%
Type II basic services coinsurance 80% 60%
Type III major services coinsurance 60% 40%
Type IV ortho services coinsurance 40% 25%

Find a dentist

Using an in-network dentist offers you better benefits. The Sun Life Dental Network® has over 130,000 unique providers1 so you are sure to find a dentist near you. 

Contact information

Questions about your plan? 

Call us at 844-583-5036

To submit a claim, mail to:

Sun Life

P.O. Box 1618

Milwaukee WI 53201-1618

1 Sun Life's dental networks include its affiliate, Dental Health Alliance®, L.L.C. (DHA®), and dentists under access arrangements with other dental networks. Nationwide counts are state level totals.

This dental plan does not provide coverage for pediatric oral health services that satisfies the requirements for “minimum essential coverage” as defined by the Patient Protection and Affordable Care Act. (“PPACA”).

Group insurance policies are underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) in all states, except New York, under Policy Form Series 15-GP-01 and 16-DEN-C-01. Product offerings may not be available in all states and may vary depending on state laws and regulations.

© 2023 Sun Life Assurance Company of Canada, Wellesley Hills, MA 02481. All rights reserved. The Sun Life name and logo are registered trademarks of Sun Life Assurance Company of Canada. Visit us at www.sunlife.com/us.

SLPC 32085 06/23 (exp. 06/25)