are several dental procedures that you may have heard referred to as "dental
cleanings". Some of these
procedures are done to prevent periodontal disease (gum disease/pyorrhea) from
occurring (preventive) while others
are done to either stop or reverse the effects of the periodontal disease
Please remember that those procedures considered to be therapeutic
have an additional copayment according to your Schedule of Benefits.
Prophylaxis - Adult/Child
is a routine cleaning of the teeth for a patient whose gums are in normal
condition with no periodontal disease present.
A prophylaxis is a preventive treatment.
It includes the removal of plaque and calculus ("tartar") from the
crown of the tooth, above the gum line. The
teeth are also polished. This
dental cleaning is covered at no additional cost except for any applicable
office visit copayments. Your
dentist may determine that you need to have this procedure performed more
frequently than every six months. In
this case, your plan may have a specific copayment.
Please refer to your Schedule of Benefits for plan specifics.
ADA CODE D4355
Full Mouth Debridement to Enable Comprehensive Periodontal Evaluation
is the removal of plaque and calculus ("tartar") from above the gumline (supragingival)
and below the gumline (subgingival) which would keep the dentist from
performing a comprehensive oral evaluation.
This is an initial procedure and does not eliminate the need for other
periodontal treatment or cleanings.
This procedure has an additional copayment according to your Schedule
Periodontal Scaling and Root Planing - Four or more teeth
(Therapeutic) Per Quadrant
procedure (sometimes referred to as a "deep cleaning") removes plaque and
calculus ("tartar") from both the crown and the root of the tooth.
Scaling and root planing is very time consuming and often requires
local anesthetic (numbing). This
is a therapeutic treatment usually associated with moderate to severe
periodontal disease and has an additional copayment according to your Schedule
Periodontal Maintenance (Therapeutic)
maintenance therapy is an ongoing process following treatment for periodontal
disease. It helps to prevent the progress of further disease and helps keep
the gums healthy. It consists of a series of appointments in which the teeth
are re-examined, any plaque and tartar are removed from the crown and roots,
and the teeth are polished. The
number of follow-up appointments and the time between them vary from patient
to patient. This procedure has
an additional copayment according to your Schedule of Benefits.