PREVENTIVE & DIAGNOSTIC SERVICES
Sealants are used to fill in narrow grooves in the biting surface of a tooth that cannot be adequately cleaned by brushing. In some cases, the tooth structure has fine grooves or pits which accumulate plaque, not because the person doesn't brush, but because they're too narrow to allow even one bristle into them. These grooves will develop cavities over time, and you don't want that. So the dentist, the hygienist, or assistant will brush on a coating that seals the grooves and pits, making it possible to brush off all the plaque and keep your teeth healthy. Sealants are generally placed on permanent molars.
This is a focused beam of X-Ray particles through bone which produces an image on special film, showing the structure through which it passed. This gives the familiar black and white images that doctors and dentists use to diagnose problems. X-rays are a necessary part of the diagnostic process, and not to use them could lead to undiagnosed disease. Without an X-ray of the whole tooth, and supporting bone and gum tissues, there is no real way to detect infection or pathology that requires attention.
In our office we use digital radiography which allows us to take X-rays using 50-70% less radiation versus conventional X-rays. Coupled with computer monitoring, digital x-ray technology allows us to enhance the images for better diagnosis of any dental concerns. (See FAQ page for more detailed information on x-rays, including the different types we may obtain.)
TYPES OF "CLEANINGS"
Depending on the health of your mouth and the amount of plaque, tartar and stain on your teeth, you will require one of several types of cleanings. It is important to understand the difference between the types of cleanings and that not every person requires the same type of treatment. (If you need to understand the difference between plaque and tartar, please see the FAQ page for more information).
Routine Prophylaxis - This is the most common type of cleaning and what nearly every insurance company covers either most or all of the cost twice per year. Some insurance companies pay for the service twice per year, either one every six months OR twice per year. There is a difference between those two requirements. This type of cleaning is performed to remove plaque, calculus (tartar) and stains from the tooth structures in a healthy mouth. It is intended to help maintain healthy teeth and gums. Prophylaxis means the prevention of disease. The dental code for this procedure is D1110.
Full Mouth Debridement - This procedure is required when there is excessive plaque, tartar and/or stain and is performed so that the Dentist may perform a comprehensive evaluation and diagnosis. Generally this is necessary when it has been a long time since your last dental cleaning. After a Full Mouth Debridement, you may need a Routine Prophylaxis or you may need Scaling and Root Planing, as discussed below. Some insurances cover this procedure while others do not. It is not preventive in nature. The dental code for this procedure is D4355.
Periodontal Scaling and Root Planing - This procedure is required when active Periodontal Disease is present (for a definition of periodontal disease, see FAQ) and is a therapeutic treatment, not a preventive treatment. It involves cleaning the teeth AND the root surfaces to remove plaque, tartar and/or stain. The procedure, by nature, is more difficult and time consuming than a Prophylaxis. Generally, one side of the mouth is done on one visit and the other side on another visit. Scaling and Root Planing is generally performed WITH anesthetic to numb the side that is being cleaned, for your comfort. Most insurances consider this as a BASIC service, so there is usually a deductible and a copay percentage involved. The dental code for this procedure is D4341 or D4342, depending on how many teeth are involved in each quadrant of your mouth. There are are four quadrants, UR, LR, UL and LL, so this procedure is usually charged 4 times in one mouth, unless the periodontal disease is localized to just an area or two.
Periodontal Maintenance - This procedure is instituted following periodontal therapy (scaling and root planing) and continues at varying intervals, determined by the clinical evaluation of the dentist, for the life of the dentition (natural teeth) or any implant replacements. It includes the removal of the bacterial plaque and calculus from above and below the gumline, site specific scaling and root planing where indicated, and polishing the teeth. If new or recurring periodontal disease appears, additional diagnoistic and treatment procedures must be considered. This, once again, is not a preventive service and is covered differently by different insurances. The dental code for this procedure is D4910.
If you have moderate to severe Periodontal Disease, we will likely refer you to a Periodontist (a specialist in Periodontal Therapy) for treatment.
TOPICAL FLUORIDE TREATMENT
This treatment involves prescription-strength fluoride product designed solely for use in the dental office delivered to the dentition under direct supervision of a dental professional. This application is generally performed on children, through age 17. Adults who have a moderate to high risk of cavities may receive a fluoride treatment, if indicated.
Fluoride Varnish - A thick gel is "painted" on the teeth with a small brush - it "hardens" almost immediately, coating the teeth. It is the same color as teeth and is not noticeable visually, but the patient can feel it on his/her teeth (it feels "fuzzy"). With this treatment, the patient can eat or drink immediately following application, but is asked to avoid hard/crunchy foods (chips, hard carrots, apples, etc) and hot beverages for a period of at least 4-6 hours. When these instructions are followed, the varnish will remain on the teeth until the next brushing/flossing. The dental code for this treatment is D1206.
Fluoride is most beneficial following a thorough cleaning, as fluoride cannot penetrate plaque.