This document discusses periodontal diseases and treatment protocols. It provides statistics on tooth retention in older adults in the US from 1950 to 2030. It also discusses integrating periodontal care into general dental practices, including educational and clinical considerations as well as dental team involvement. Treatment protocols are outlined that classify periodontal diseases and describe the periodontal treatment process.
This document discusses the use of general anesthesia to facilitate dental treatment. It finds that 91.5% of house surgeons did not perform any treatment under sedation. Those who did use sedation obtained their training through postgraduate studies, with only 30.2% receiving undergraduate training. Oral and maxillofacial surgeons were found to provide most sedation services compared to other specialists. Guidelines for sedation are needed to standardize patient assessment, practitioner training, emergency management and more.
Assessment of clinical outcomes of roth and mbt bracket prescription using th...Selvaraj Arunachalam
The document assessed clinical outcomes of orthodontic cases treated with Roth and MBT bracket prescriptions using the American Board of Orthodontics Objective Grading System (ABO-OGS). Forty patients treated with either Roth or MBT brackets were evaluated based on post-treatment dental casts and panoramic radiographs using the ABO-OGS scoring criteria. The MBT bracket group had significantly lower scores for buccolingual inclination and occlusal contact. The total ABO-OGS score was also lower for MBT by 2.65 points, though the clinical significance was small. Both bracket prescriptions produced similar clinical outcomes with quality depending more on clinician skill than prescription.
This document discusses suction and retractors used in oral and maxillofacial surgery. It describes the objective of suction as removing fluids, blood, debris, and air from the surgical site to maintain a clear field of view. It outlines different types of suction instruments including tips, tubing, and devices. It also discusses various surgical retractors, their importance for providing exposure and separation of tissues during surgery, materials used, and types including self-retaining retractors. The document serves as a reference for suction and retraction tools in oral and maxillofacial surgery.
This document discusses a study that assessed the knowledge of dental professionals (graduate and post-graduate) regarding the use of bone grafts in dentistry. A survey of 100 dental professionals found that many general dentists do not perform bone grafting and refer such procedures to specialists, as the techniques are sensitive. The study also found that around half of clinicians prefer synthetic bone substitutes like hydroxyapatite ceramic material to avoid surgery for bone grafts, based on patient preference. The document provides background information on different types of bone grafts and their properties and classifications.
This document discusses mixed dentition space analysis, which is used to predict space requirements for unerupted permanent teeth during the mixed dentition period from ages 6 to 12 years. Accurate prediction is important for orthodontic diagnosis and treatment planning. The document outlines three main methods for mixed dentition space analysis: 1) using measurements of erupted permanent teeth on dental casts to predict sizes of unerupted teeth, 2) measuring unerupted teeth directly on radiographs, and 3) combining the first two methods. It provides details on several commonly used techniques within each category to facilitate space prediction and assessment of crowding or spacing in the dental arches.
A Cross Sectional Study of Musculoskeletal Problems Among Dentists in Pondich...QUESTJOURNAL
Purpose: This questionnaire based study was aimed at identifying common occupational hazards affecting dentists in Pondicherry which may help to make dentists aware and to take adequate precautions in their practice to prolong the service imparted to patients as well as improve the overall well being of the dental professionals The prevalence of work related musculoskeletal problems among dentists in Pondicherry was evaluated with this study. Methods: A pretested and validated questionnaire was used to collect details from practising dentists in Pondicherry .272 dentists responded to the questionnaire. Results: The data obtained was statistically analysed with SPSS Version 20 for calculating proportion and mean.84.9% (n=272) of respondents had some kind of musculoskeletal problem affecting different parts of the body.52.2% had low back pain and 50% had neck pain. Conclusion: The dental professionals are regularly exposed to various health hazards in their day to day practice. Chronic musculoskeletal disease is one of the common ailments affecting majority of dentists It is important for the dentists to be aware of the work related factors affecting their health and take adequate precautions or modifications in their working environment
This document provides an overview of evidence-based periodontology. It defines evidence-based periodontology as the application of evidence-based healthcare to the field of periodontology. The document discusses the development of evidence-based periodontology and its key components, advantages over traditional periodontology, and terminology used in evidence-based approaches. It also addresses searching for evidence, levels of evidence, systematic reviews, meta-analyses, and evidence-based decision making in periodontal therapy.
Cutaneous sinus-tract-of-dental-origin-in-an-8yearold-child-a-case-reportCecilia Young 楊幽幽
Cutaneous Sinus Tract of Dental Origin in an 8-Year-Old Child: A Case Report
Cecilia Young*, TH Tai
General Dental Practitioner, Dental Consultant and Columnist, Physician Pharmacist People Health Magazine, Hong Kong
This document discusses the use of general anesthesia to facilitate dental treatment. It finds that 91.5% of house surgeons did not perform any treatment under sedation. Those who did use sedation obtained their training through postgraduate studies, with only 30.2% receiving undergraduate training. Oral and maxillofacial surgeons were found to provide most sedation services compared to other specialists. Guidelines for sedation are needed to standardize patient assessment, practitioner training, emergency management and more.
Assessment of clinical outcomes of roth and mbt bracket prescription using th...Selvaraj Arunachalam
The document assessed clinical outcomes of orthodontic cases treated with Roth and MBT bracket prescriptions using the American Board of Orthodontics Objective Grading System (ABO-OGS). Forty patients treated with either Roth or MBT brackets were evaluated based on post-treatment dental casts and panoramic radiographs using the ABO-OGS scoring criteria. The MBT bracket group had significantly lower scores for buccolingual inclination and occlusal contact. The total ABO-OGS score was also lower for MBT by 2.65 points, though the clinical significance was small. Both bracket prescriptions produced similar clinical outcomes with quality depending more on clinician skill than prescription.
This document discusses suction and retractors used in oral and maxillofacial surgery. It describes the objective of suction as removing fluids, blood, debris, and air from the surgical site to maintain a clear field of view. It outlines different types of suction instruments including tips, tubing, and devices. It also discusses various surgical retractors, their importance for providing exposure and separation of tissues during surgery, materials used, and types including self-retaining retractors. The document serves as a reference for suction and retraction tools in oral and maxillofacial surgery.
This document discusses a study that assessed the knowledge of dental professionals (graduate and post-graduate) regarding the use of bone grafts in dentistry. A survey of 100 dental professionals found that many general dentists do not perform bone grafting and refer such procedures to specialists, as the techniques are sensitive. The study also found that around half of clinicians prefer synthetic bone substitutes like hydroxyapatite ceramic material to avoid surgery for bone grafts, based on patient preference. The document provides background information on different types of bone grafts and their properties and classifications.
This document discusses mixed dentition space analysis, which is used to predict space requirements for unerupted permanent teeth during the mixed dentition period from ages 6 to 12 years. Accurate prediction is important for orthodontic diagnosis and treatment planning. The document outlines three main methods for mixed dentition space analysis: 1) using measurements of erupted permanent teeth on dental casts to predict sizes of unerupted teeth, 2) measuring unerupted teeth directly on radiographs, and 3) combining the first two methods. It provides details on several commonly used techniques within each category to facilitate space prediction and assessment of crowding or spacing in the dental arches.
A Cross Sectional Study of Musculoskeletal Problems Among Dentists in Pondich...QUESTJOURNAL
Purpose: This questionnaire based study was aimed at identifying common occupational hazards affecting dentists in Pondicherry which may help to make dentists aware and to take adequate precautions in their practice to prolong the service imparted to patients as well as improve the overall well being of the dental professionals The prevalence of work related musculoskeletal problems among dentists in Pondicherry was evaluated with this study. Methods: A pretested and validated questionnaire was used to collect details from practising dentists in Pondicherry .272 dentists responded to the questionnaire. Results: The data obtained was statistically analysed with SPSS Version 20 for calculating proportion and mean.84.9% (n=272) of respondents had some kind of musculoskeletal problem affecting different parts of the body.52.2% had low back pain and 50% had neck pain. Conclusion: The dental professionals are regularly exposed to various health hazards in their day to day practice. Chronic musculoskeletal disease is one of the common ailments affecting majority of dentists It is important for the dentists to be aware of the work related factors affecting their health and take adequate precautions or modifications in their working environment
This document provides an overview of evidence-based periodontology. It defines evidence-based periodontology as the application of evidence-based healthcare to the field of periodontology. The document discusses the development of evidence-based periodontology and its key components, advantages over traditional periodontology, and terminology used in evidence-based approaches. It also addresses searching for evidence, levels of evidence, systematic reviews, meta-analyses, and evidence-based decision making in periodontal therapy.
Cutaneous sinus-tract-of-dental-origin-in-an-8yearold-child-a-case-reportCecilia Young 楊幽幽
Cutaneous Sinus Tract of Dental Origin in an 8-Year-Old Child: A Case Report
Cecilia Young*, TH Tai
General Dental Practitioner, Dental Consultant and Columnist, Physician Pharmacist People Health Magazine, Hong Kong
Essentials of clinical periodontology and periodonticsDr.Jaffar Raza BDS
This document provides information about a DVD on clinical periodontology and periodontics. It lists the system requirements to play the DVD, including needing Windows XP or above and Power DVD or Windows Media Player software. It notes that the accompanying DVD is only playable on a computer, not a standalone DVD player. It instructs users to wait for the DVD to automatically run or to manually open the DVD file if it does not auto-run. The document also provides information about the author and publisher of the accompanying book and DVD.
Endodontic treatment and tooth extraction with dental implant placement are two main treatment options for a diseased tooth. There are numerous factors to consider when deciding between the options, including prognosis, risks and benefits, costs, and the patient's medical history and preferences. While implant survival rates are high in the short term, endodontic treatment has shown positive survival rates in both the short and long term. Additionally, endodontic treatment preserves the natural tooth and soft tissue, which is important for aesthetics. The optimal treatment must consider all relevant factors and the patient's best interests.
Perception of Dental Visits among Jazan University Students, Saudi Arabiainventionjournals
Background:regular dental check-ups is fundamental in preventing and detecting dental diseases.Majority of Saudi patients do not have the trend to visit dentist frequently and they go only for emergency treatment and mostly pain is the driving factor. Aim: to evaluate the knowledge, beliefs and attitude of Jazan university students towards dental visits. Materials and Methodology:This descriptive cross-sectional; questionnaire based survey was carried out to evaluate the perception of Jazan university Saudi students towards dental visits. 352 students participated, age range of 20-24 years old. Results: The study revealed pain is the driving factor for most of the dental visits. 47.9%, their 1 stvisits complain was pain, 58% the driving factor for last visit is also pain. Although 29.1% occasionally visit dentist; 43% of them their last visit to dentist was 6 month ago. 47.6% were irregular visitors to dentist because they are afraid from dental needle and pain. 75% of the participants described their feeling at1st visit to dentist to be anxious and afraid. Although 88% of the participants knew that regular dental check-ups is important but this knowledge was not practiced.Only4.3% of the participants are driven to dental visit by dentist advice. Conclusion: there are lack of knowledge, wrong beliefs and negligence of dental visits in our study participants. Dental professional and mass media are not playing their role to change the knowledge and beliefs of the population.Recommendation: dental professionals’ media should be utilized spread knowledge of proper dental care.
This document provides information on the Russel's Periodontal Index and the CPITN (Community Periodontal Index of Treatment Needs). It discusses the development and purpose of each index, as well as how they are used to assess periodontal disease status and treatment needs in populations. The Russel's Index uses simple probing to evaluate gingivitis and periodontal disease severity on a scale of 0-8. The CPITN focuses on determining treatment needs by examining bleeding, calculus, and pocket depth in six sextants using index teeth. Both indices are designed for epidemiological surveys to monitor oral health and plan treatment programs.
The document summarizes a study that assessed parents' knowledge of factors influencing oral hygiene practices in pediatric patients. A questionnaire was administered to parents to obtain data on their oral health habits, beliefs, knowledge of primary dentition and tooth shedding. Most parents changed toothbrushes every 6 months but only some visited dentists annually. While most agreed treatment is important, some declined due to cost or time constraints. The study concluded parental education plays a major role in children's oral health, and awareness among parents needs improving to better care for children's teeth.
Evidenced Based Dentistry Spring 2006 Group 4 Kevin Hancock Jess ... Eviden...MedicineAndFamily
This document discusses Invisalign orthodontic treatment compared to traditional braces. It provides information on what Invisalign is, its advantages like aesthetics and comfort, and disadvantages like limited control over tooth movement. Two studies on Invisalign outcomes are summarized, finding limited evidence due to small sample sizes and high dropout rates. A third study directly compared Invisalign and braces treatment, finding Invisalign scored lower on post-treatment evaluation and had shorter treatment times but less ideal occlusions. In conclusion, Invisalign may not achieve as satisfactory results as braces for all patients.
Awareness of Orthodontic Treatment in School Children of Karnataka State – A ...IOSR Journals
Abstract : Aims: To assess the awareness of Orthodontic treatment among school children in Karnataka. Settings and Design: School settings and Descriptive cross-sectional survey. Methods and Material: A cross-sectional epidemiological survey was conducted in all the 30 districts of Karnataka. School children in the age group of 10-16 years were the target population. Population proportionate technique was employed for the sample size estimation. A total sample of 9505 was randomly selected from 102 schools all over Karnataka. A pre-structured questionnaire was used to record the awareness of children towards orthodontic treatment. Statistical analysis used: One way Anova, Scheffe’s post hoc-test. Results: Our study showed an average awareness of orthodontic treatment in Karnataka school children. Conclusions: The awareness was influenced by the literacy rate as districts with higher literacy showed higher awareness of children towards orthodontic treatment and districts with lower literacy rate showed lesser awareness of children towards orthodontic treatment.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Oral Health–Related Quality of Life in Children and Adolescents of Indian pop...Dr. Anuj S Parihar
Background: Kids and teenagers are more prone to oral diseases. Poor oral health has a significant impact on oral well-being–associated quality of life. Thus, we performed an investigation to examine the outcome of oral health status on
the quality of life of children and adolescents in Indian population, by using the Oral Health Impact Profile-14 (OHIP-14).
Materials and Methods: A total of 100 children, ranging between 1 and 19 years of age who attended Indian hospitals from November 2016 to October 2019, were included in the study. The DMFT Index (Decayed, Missing, and Filled Teeth) and OHIP-14 were used as data collection tools. Association of the total OHIP-14 score and seven subscales associated with it was evaluated using Spearman’s correlations.
Results: The results showed statistically noteworthy association between the toothbrushing regularity, number of dental appointments, history of oral trauma, smoking, and subdomains of OHIP-14 (P < 0.05)
Conclusion: Dental and oral health of an individual has a great impact on their quality of life.
Emergency management of dental trauma knowledge of hong kong primary and seco...Cecilia Young 楊幽幽
ORIGINAL ARTICLE
Emergency management of dental trauma: knowledge of Hong Kong primary and secondary school teachers
Cecilia Young 楊幽幽
KY Wong 黃堅祐
LK Cheung 張念光
Objectives To investigate the level of knowledge about emergency management of dental trauma among Hong Kong primary and secondary school teachers.
This study evaluated the socio-demographic determinants of dental service utilization among 741 secondary school students in Nigeria. The results showed that only 27.9% of students had visited a dentist before, mainly when experiencing pain. There was a statistically significant association between student type (boarding vs day) and class (junior vs senior secondary) with utilization. However, logistic regression found no socio-demographic factors predictive of utilization. In conclusion, while knowledge of dentists was high, actual utilization of dental services remained poor with no socio-demographic predictors of that utilization.
This document discusses how to apply evidence-based dentistry to patients. It notes that evidence-based practice aims to inform clinical decisions, not impose them, by considering factors specific to individual patients. When applying research findings, clinicians must consider if statistical significance translates to clinical significance for patients, if study populations match their patient, and if treatment settings can be replicated. The patient's preferences, resources, and social factors must also influence treatment decisions.
Contents lists available at science directnurse education tRAJU852744
This study aimed to determine how nursing students transfer theoretical knowledge to clinical practice and the difficulties they experience. The researchers conducted focus group interviews with 30 nursing students. The students reported that their theoretical knowledge was extensive but they struggled to apply it clinically. They lacked clinical skills and were afraid to touch patients from a fear of making mistakes. The students also reported not receiving adequate guidance from instructors in clinical settings. Some instructors were too distant or strict, making students hesitant to ask questions. Communication problems were also experienced with some nurses and clinical instructors who did not cooperate with students.
Decay risk exists for all patients to varying degrees in occlusal pits and fissures, interproximal surfaces and facial surfaces. Orthodontic treatment increases the risk of decay for a variety of reasons. Oral hygiene is more difficult; wires are in place for two to three years or longer with little opportunity to obtain bitewing radiographs; excess resin around brackets acts as a plaque trap; patients sometimes believe that because they are being seen regularly at the orthodontic office, they don’t need to visit their regular dentist until treatment is completed.
Reprinted with permission of the Ontario Dental Association and Ontario Dentist, 2012.
Prevalence,riskfactors and treatment needs of traumatic dental injuries to an...Dr. Anuj S Parihar
The document summarizes a study that assessed the prevalence of traumatic dental injuries (TDIs) to permanent anterior teeth among 6-15 year old schoolchildren in Bhopal, India. The study found an overall TDI prevalence of 8.6%. Boys had a higher prevalence than girls at a ratio of 2.22:1. Falls at home were the most common cause, and overjet greater than 5.5 mm and inadequate lip coverage were significant risk factors. Most fractured cases occurred with Class I malocclusion. While TDIs were common, many injuries went untreated.
Establishing and maintaining a successful dental practice requires careful planning in several areas:
1) Factors like location, building selection, equipment purchases, and office design must be considered to attract patients and ensure efficient work flow.
2) Effective personnel, patient, and financial management is also important, including maintaining organized records and accounting systems.
3) Dental professionals must provide quality care while protecting their own health, complying with legal and ethical standards, and preventing job hazards.
4G technology provides high-speed wireless internet access and multimedia services to users. It allows downloading of full-length movies within 5 minutes and streaming of high-definition content. 4G uses packet switching for voice and video calls, using network resources only when transmitting data. While 4G provides higher speeds and bandwidth than 3G, implementing the new technology poses challenges such as high costs and the need for more advanced hardware.
Presentasi Sidang Tesis di STT Apollos di jakarta.Roy Kumowal
Tesis ini membahas budaya jujuran dalam pernikahan adat Dayak Bulusu di Desa Sesua, Kalimantan Utara. Tesis ini meninjau pemberian jujuran secara teologis dengan melihat pandangan Alkitab dan gereja, serta tujuan asli budaya tersebut bukan untuk prestise sosial. Metode penelitian yang digunakan adalah kualitatif deskriptif dengan wawancara dan dokumentasi sebagai sumber datanya.
This document discusses how the online puzzle game Foldit uses crowdsourcing to design new antiretroviral drugs. Foldit presents protein structures and players manipulate them to fold the proteins correctly. In 2011, Foldit players designed a protein structure involved in HIV that scientists had been unable to determine in over 10 years, showing how crowdsourcing can solve scientific problems. The document outlines other examples of crowdsourcing and discusses its implications, including paradigm shifts in open science and combining gaming, science and computation to advance discoveries.
Essentials of clinical periodontology and periodonticsDr.Jaffar Raza BDS
This document provides information about a DVD on clinical periodontology and periodontics. It lists the system requirements to play the DVD, including needing Windows XP or above and Power DVD or Windows Media Player software. It notes that the accompanying DVD is only playable on a computer, not a standalone DVD player. It instructs users to wait for the DVD to automatically run or to manually open the DVD file if it does not auto-run. The document also provides information about the author and publisher of the accompanying book and DVD.
Endodontic treatment and tooth extraction with dental implant placement are two main treatment options for a diseased tooth. There are numerous factors to consider when deciding between the options, including prognosis, risks and benefits, costs, and the patient's medical history and preferences. While implant survival rates are high in the short term, endodontic treatment has shown positive survival rates in both the short and long term. Additionally, endodontic treatment preserves the natural tooth and soft tissue, which is important for aesthetics. The optimal treatment must consider all relevant factors and the patient's best interests.
Perception of Dental Visits among Jazan University Students, Saudi Arabiainventionjournals
Background:regular dental check-ups is fundamental in preventing and detecting dental diseases.Majority of Saudi patients do not have the trend to visit dentist frequently and they go only for emergency treatment and mostly pain is the driving factor. Aim: to evaluate the knowledge, beliefs and attitude of Jazan university students towards dental visits. Materials and Methodology:This descriptive cross-sectional; questionnaire based survey was carried out to evaluate the perception of Jazan university Saudi students towards dental visits. 352 students participated, age range of 20-24 years old. Results: The study revealed pain is the driving factor for most of the dental visits. 47.9%, their 1 stvisits complain was pain, 58% the driving factor for last visit is also pain. Although 29.1% occasionally visit dentist; 43% of them their last visit to dentist was 6 month ago. 47.6% were irregular visitors to dentist because they are afraid from dental needle and pain. 75% of the participants described their feeling at1st visit to dentist to be anxious and afraid. Although 88% of the participants knew that regular dental check-ups is important but this knowledge was not practiced.Only4.3% of the participants are driven to dental visit by dentist advice. Conclusion: there are lack of knowledge, wrong beliefs and negligence of dental visits in our study participants. Dental professional and mass media are not playing their role to change the knowledge and beliefs of the population.Recommendation: dental professionals’ media should be utilized spread knowledge of proper dental care.
This document provides information on the Russel's Periodontal Index and the CPITN (Community Periodontal Index of Treatment Needs). It discusses the development and purpose of each index, as well as how they are used to assess periodontal disease status and treatment needs in populations. The Russel's Index uses simple probing to evaluate gingivitis and periodontal disease severity on a scale of 0-8. The CPITN focuses on determining treatment needs by examining bleeding, calculus, and pocket depth in six sextants using index teeth. Both indices are designed for epidemiological surveys to monitor oral health and plan treatment programs.
The document summarizes a study that assessed parents' knowledge of factors influencing oral hygiene practices in pediatric patients. A questionnaire was administered to parents to obtain data on their oral health habits, beliefs, knowledge of primary dentition and tooth shedding. Most parents changed toothbrushes every 6 months but only some visited dentists annually. While most agreed treatment is important, some declined due to cost or time constraints. The study concluded parental education plays a major role in children's oral health, and awareness among parents needs improving to better care for children's teeth.
Evidenced Based Dentistry Spring 2006 Group 4 Kevin Hancock Jess ... Eviden...MedicineAndFamily
This document discusses Invisalign orthodontic treatment compared to traditional braces. It provides information on what Invisalign is, its advantages like aesthetics and comfort, and disadvantages like limited control over tooth movement. Two studies on Invisalign outcomes are summarized, finding limited evidence due to small sample sizes and high dropout rates. A third study directly compared Invisalign and braces treatment, finding Invisalign scored lower on post-treatment evaluation and had shorter treatment times but less ideal occlusions. In conclusion, Invisalign may not achieve as satisfactory results as braces for all patients.
Awareness of Orthodontic Treatment in School Children of Karnataka State – A ...IOSR Journals
Abstract : Aims: To assess the awareness of Orthodontic treatment among school children in Karnataka. Settings and Design: School settings and Descriptive cross-sectional survey. Methods and Material: A cross-sectional epidemiological survey was conducted in all the 30 districts of Karnataka. School children in the age group of 10-16 years were the target population. Population proportionate technique was employed for the sample size estimation. A total sample of 9505 was randomly selected from 102 schools all over Karnataka. A pre-structured questionnaire was used to record the awareness of children towards orthodontic treatment. Statistical analysis used: One way Anova, Scheffe’s post hoc-test. Results: Our study showed an average awareness of orthodontic treatment in Karnataka school children. Conclusions: The awareness was influenced by the literacy rate as districts with higher literacy showed higher awareness of children towards orthodontic treatment and districts with lower literacy rate showed lesser awareness of children towards orthodontic treatment.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Oral Health–Related Quality of Life in Children and Adolescents of Indian pop...Dr. Anuj S Parihar
Background: Kids and teenagers are more prone to oral diseases. Poor oral health has a significant impact on oral well-being–associated quality of life. Thus, we performed an investigation to examine the outcome of oral health status on
the quality of life of children and adolescents in Indian population, by using the Oral Health Impact Profile-14 (OHIP-14).
Materials and Methods: A total of 100 children, ranging between 1 and 19 years of age who attended Indian hospitals from November 2016 to October 2019, were included in the study. The DMFT Index (Decayed, Missing, and Filled Teeth) and OHIP-14 were used as data collection tools. Association of the total OHIP-14 score and seven subscales associated with it was evaluated using Spearman’s correlations.
Results: The results showed statistically noteworthy association between the toothbrushing regularity, number of dental appointments, history of oral trauma, smoking, and subdomains of OHIP-14 (P < 0.05)
Conclusion: Dental and oral health of an individual has a great impact on their quality of life.
Emergency management of dental trauma knowledge of hong kong primary and seco...Cecilia Young 楊幽幽
ORIGINAL ARTICLE
Emergency management of dental trauma: knowledge of Hong Kong primary and secondary school teachers
Cecilia Young 楊幽幽
KY Wong 黃堅祐
LK Cheung 張念光
Objectives To investigate the level of knowledge about emergency management of dental trauma among Hong Kong primary and secondary school teachers.
This study evaluated the socio-demographic determinants of dental service utilization among 741 secondary school students in Nigeria. The results showed that only 27.9% of students had visited a dentist before, mainly when experiencing pain. There was a statistically significant association between student type (boarding vs day) and class (junior vs senior secondary) with utilization. However, logistic regression found no socio-demographic factors predictive of utilization. In conclusion, while knowledge of dentists was high, actual utilization of dental services remained poor with no socio-demographic predictors of that utilization.
This document discusses how to apply evidence-based dentistry to patients. It notes that evidence-based practice aims to inform clinical decisions, not impose them, by considering factors specific to individual patients. When applying research findings, clinicians must consider if statistical significance translates to clinical significance for patients, if study populations match their patient, and if treatment settings can be replicated. The patient's preferences, resources, and social factors must also influence treatment decisions.
Contents lists available at science directnurse education tRAJU852744
This study aimed to determine how nursing students transfer theoretical knowledge to clinical practice and the difficulties they experience. The researchers conducted focus group interviews with 30 nursing students. The students reported that their theoretical knowledge was extensive but they struggled to apply it clinically. They lacked clinical skills and were afraid to touch patients from a fear of making mistakes. The students also reported not receiving adequate guidance from instructors in clinical settings. Some instructors were too distant or strict, making students hesitant to ask questions. Communication problems were also experienced with some nurses and clinical instructors who did not cooperate with students.
Decay risk exists for all patients to varying degrees in occlusal pits and fissures, interproximal surfaces and facial surfaces. Orthodontic treatment increases the risk of decay for a variety of reasons. Oral hygiene is more difficult; wires are in place for two to three years or longer with little opportunity to obtain bitewing radiographs; excess resin around brackets acts as a plaque trap; patients sometimes believe that because they are being seen regularly at the orthodontic office, they don’t need to visit their regular dentist until treatment is completed.
Reprinted with permission of the Ontario Dental Association and Ontario Dentist, 2012.
Prevalence,riskfactors and treatment needs of traumatic dental injuries to an...Dr. Anuj S Parihar
The document summarizes a study that assessed the prevalence of traumatic dental injuries (TDIs) to permanent anterior teeth among 6-15 year old schoolchildren in Bhopal, India. The study found an overall TDI prevalence of 8.6%. Boys had a higher prevalence than girls at a ratio of 2.22:1. Falls at home were the most common cause, and overjet greater than 5.5 mm and inadequate lip coverage were significant risk factors. Most fractured cases occurred with Class I malocclusion. While TDIs were common, many injuries went untreated.
Establishing and maintaining a successful dental practice requires careful planning in several areas:
1) Factors like location, building selection, equipment purchases, and office design must be considered to attract patients and ensure efficient work flow.
2) Effective personnel, patient, and financial management is also important, including maintaining organized records and accounting systems.
3) Dental professionals must provide quality care while protecting their own health, complying with legal and ethical standards, and preventing job hazards.
4G technology provides high-speed wireless internet access and multimedia services to users. It allows downloading of full-length movies within 5 minutes and streaming of high-definition content. 4G uses packet switching for voice and video calls, using network resources only when transmitting data. While 4G provides higher speeds and bandwidth than 3G, implementing the new technology poses challenges such as high costs and the need for more advanced hardware.
Presentasi Sidang Tesis di STT Apollos di jakarta.Roy Kumowal
Tesis ini membahas budaya jujuran dalam pernikahan adat Dayak Bulusu di Desa Sesua, Kalimantan Utara. Tesis ini meninjau pemberian jujuran secara teologis dengan melihat pandangan Alkitab dan gereja, serta tujuan asli budaya tersebut bukan untuk prestise sosial. Metode penelitian yang digunakan adalah kualitatif deskriptif dengan wawancara dan dokumentasi sebagai sumber datanya.
This document discusses how the online puzzle game Foldit uses crowdsourcing to design new antiretroviral drugs. Foldit presents protein structures and players manipulate them to fold the proteins correctly. In 2011, Foldit players designed a protein structure involved in HIV that scientists had been unable to determine in over 10 years, showing how crowdsourcing can solve scientific problems. The document outlines other examples of crowdsourcing and discusses its implications, including paradigm shifts in open science and combining gaming, science and computation to advance discoveries.
This study examined whether cognitive skills, personality factors, and academic performance predicted clinical competence among anesthesiology residents. The researchers administered cognitive, personality, and academic tests to 67 residents and evaluated their clinical performance over time. Certain cognitive tests involving divided attention, mental arithmetic, and visual target detection predicted poorer clinical performance, as did introversion and inflexibility on personality tests. Poorer performance on anesthesia knowledge tests early in training also predicted worse clinical performance. The predictive value of these findings requires confirmation in a larger, multicenter study.
A phase I/II trial to evaluate the safety, feasibility and activity of salvag...Enrique Moreno Gonzalez
The current standard treatment of patients with relapsed or refractory diffuse large cell B-Cell lymphoma (DLBCL) primarily consists of intensified salvage therapy and, if the disease is chemo-sensitive, high dose therapy followed with autologous stem cell transplantation. In the rituximab era however, this treatment approach has shown only limited benefit. In particular, patients relapsing after rituximab-containing primary treatment have an adverse prognosis, especially if this occurs within the first year after therapy or if the disease is primarily refractory. Therefore there is an ultimate need for improved salvage treatment approaches.
1) The document discusses shell and tube heat exchangers and provides calculations for their basic design.
2) It defines key terms like Btu, calorie, joule, watt, temperature scales, pressure units, and specific heat.
3) The main heat exchanger equation is presented along with the process for designing a heat exchanger through an iterative approach to calculate the required heat transfer area.
Megyesy pressure vessel hand book [11th ed.]Gowtham M
The document discusses the history and importance of chocolate in human civilization. It notes that chocolate originated in Mesoamerica over 3000 years ago and was prized by the Aztecs and Mayans for its taste. Cocoa beans were used as currency and their cultivation was tightly regulated. The document highlights how chocolate spread around the world following the age of exploration and is now one of the most popular flavors globally.
Google Earth is a virtual globe program that displays satellite images of Earth allowing users to view locations from above. It supports 3D models and GIS data. Users can search locations, enter coordinates, view places in 23 languages. Features include Street View, a flight simulator, and sky viewing mode to see stars. It requires basic system specifications and is available in free, Plus, and Pro versions with different export and data options.
Fourth generation (4G) mobile systems are characterized by high-speed data rates from 20 to 100 Mbps, allowing for high-resolution video and television. 4G aims to provide seamless connectivity across heterogeneous networks with high quality of service for multimedia. Key components of 4G include multi-antenna systems, software-defined radio, adaptive modulation and coding, IPv6, and a multi-tier, multi-device network architecture to deliver high speeds and network capacity exceeding 3G.
Periodontal surgery is a procedure used to treat gum disease and abnormalities in the tissues around the teeth. It aims to eliminate causes of disease, reduce pocket depths, reduce gum inflammation, and prevent recurrence. It involves anesthetizing the area, marking pockets, removing gum tissue and calculus, and placing a periodontal dressing. Post-surgery, patients should rest, have a soft diet, rinse with salt water, and take medications like painkillers, antibiotics, and medications to prevent excessive bleeding. The goal is to treat the disease, prevent further progression, and maintain healthy gums and tissues.
Eugene f. megyesy-pressure_vessel_handbook_12th editionGowtham M
The document is an introduction to the Pressure Vessel Handbook, which provides concise summaries and essential information for designing and constructing pressure vessels. It compares the scope and purpose of the Pressure Vessel Handbook to the ASME Boiler and Pressure Vessel Code. The Handbook covers carbon steel pressure vessels made by welding, utilizing the most economical and practical construction methods according to Code rules. It aims to make information easily accessible, while the Code establishes broader rules and does not serve as a design handbook. The Handbook is updated every three years to reflect changes to the Code and industry developments.
Google Earth is available in four versions - a free basic version, a $20/year Plus version with additional features, a $400/year Pro version for commercial use, and an on-site Enterprise version without a published price. It is used by small businesses for tasks like finding hotels and restaurants, and large businesses can track assets. Government agencies also use it for purposes like environmental monitoring, infrastructure projects, and homeland security.
International Journal Of Biomedical and Advance Researchyehezkeil
1. The study assessed the clinical and antimicrobial effects of a sodium chlorite-based toothpaste and mouthwash compared to a conventional alcohol-based oral care product in 50 patients with chronic periodontitis over 12 months.
2. At 12 months, the sodium chlorite group showed significantly greater reductions in gingival index, plaque index, and levels of four pathogenic bacteria compared to the conventional product group.
3. The results suggest that the sodium chlorite-based oral care products may be more effective than conventional alcohol-based products in improving oral health outcomes for patients with periodontitis.
Motivational interviewing in improving oral health aclinicabril2015
This systematic review analyzed randomized controlled trials that evaluated the effectiveness of motivational interviewing (MI) compared to conventional education (CE) in changing oral health behaviors and outcomes. The search yielded 221 papers, of which 20 papers describing 16 studies met the eligibility criteria. The quality of the included studies varied. Concerning periodontal health, 5 trials found MI improved oral hygiene compared to CE, while 2 trials found no difference. Two trials on smoking cessation in adolescents found no effect of MI. MI was found to outperform CE in improving outcomes in studies on preventing early childhood caries, adherence to dental appointments, and abstinence from drugs/alcohol to prevent facial injuries. The review concluded that the evidence for the effectiveness
The document outlines a course on dental materials and technology, including an introduction to important concepts in dental materials science, a classification of dental materials based on structure and use, and a schedule of topics to be covered such as impression materials, polymers, metals, ceramics, composites and their applications in dentistry.
This document discusses a study that assessed awareness and knowledge of forensic odontology among dental professionals in India. The study found that most participants (93.5%) had studied forensic odontology basics in undergraduate studies. However, around 78.4% were unaware of preserving dental records for future forensic needs. While 75.3% understood signs of child abuse and 56.3% could document bite marks, most (77.9%) did not know that dentists can be expert witnesses. The study concludes there is a general lack of forensic odontology knowledge and practice among Indian dental practitioners.
SELF MEDICATION PRACTICES FOR ORAL HEALTH PROBLEMS AMONG DENTAL PATIENTS IN B...iosrphr_editor
This study examined self-medication practices for oral health problems among dental patients in Bangalore, India. The study found that 100% of the 175 dental patients surveyed practiced self-medication. Toothache was the most common triggering factor reported. Analgesics and herbal remedies were commonly used for self-treatment. Most participants consulted pharmacists for advice on self-medication and would see a dentist only if problems persisted after self-medicating. The high prevalence of self-medication indicates a need for education programs to increase awareness of risks.
Whats teeth got to do with it fall2011 seminar brochureShirley Gutkowski
This document provides information about an upcoming seminar titled "What's Teeth Got To Do With it? Oral complications of medications and life-saving treatments". The seminar will be presented by Shirley Gutkowski, a dental hygiene expert, and will cover the latest advances in oral care for patients taking medications or receiving treatments that can impact oral health. Attendees will learn how to effectively teach clients oral hygiene techniques, evaluate referrals for oral care, and understand how good oral hygiene can reduce illness. The seminar is aimed at nurses, physician assistants, and other healthcare professionals and will provide 3 hours of continuing education credit.
This document discusses a panel convened by the Macy Foundation to examine issues related to the dental curriculum, specifically regarding diagnosis and primary health care. The panel consisted of 10 experts in dental education. They discussed how changes to the dental curriculum could expand the scope of dental practice to include more precise evaluation of oral diseases, diagnosis of systemic diseases, and primary health care screening in the dental office. This would help train dental practitioners to better promote oral and systemic health as part of an evolving healthcare system.
This document discusses opportunities for expanding the role of dentistry in diagnosis and primary health care. A panel of experts convened by the Macy Foundation examined issues related to the dental curriculum. The panel discussed how training dental students to more precisely evaluate oral, dental, and craniofacial diseases, as well as help diagnose systemic diseases, could begin changing the scope of dental practice. The dental profession must consider practice models relevant for the 21st century that emphasize diagnosis and the dentist's role as a full member of the healthcare team.
Interdisciplinary Seminars and First-Aid Textbook on Dental Trauma for Medica...Cecilia Young 楊幽幽
Interdisciplinary Seminars and First-Aid Textbook on Dental Trauma for Medical Students and Practitioners
Cecilia Young*
Independent Researcher, Hong Kong
*Corresponding Author: Cecilia Young, Independent Researcher, Hong Kong.
Received: May 29, 2018 ; Published: June 21, 2018
This study evaluated parental acceptance of 8 behavior management techniques (BMTs) used in pediatric dental practice among 200 Thai parents. The techniques included tell-show-do, voice control, passive restraint, active restraint, parental presence/absence, oral sedation, nitrous oxide/oxygen, and general anesthesia. Parents rated the techniques on a 100mm visual analog scale after watching video demonstrations. Tell-show-do received the highest rating while parental presence/absence received the lowest. Parental dental anxiety was associated with lower acceptance of parental presence/absence. Children's previous experience with certain techniques increased parental acceptance of those techniques. The study provides insights into Thai parental perspectives on commonly used BMTs to help dent
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document summarizes evidence on interventions to reduce early childhood caries (ECC). ECC is a serious public health problem affecting many children. Studies show training primary care providers in risk assessment, fluoride varnish application, and referral can increase access to preventive dental care and reduce ECC rates and treatment needs, though more research is still needed on integrating medical and dental services.
Psr:
La detección temprana de las enfermedades periodontales
puntuación del sistema y entender cómo funciona, recomendar un tratamiento basado en las interpretaciones del código ,
y discutir el sistema PSR con los pacientes.
Dental Myth, Fallacies and Misconceptions and its Association with Socio-Dent...DrRipika Sharma
Introduction: It is important to know about the myths and misconceptions, especially in India, where general and oral health is
embroiled in various myths and ritualistic practices.
Objectives: The purpose of this study is aimed at assessing the prevalence of dental myth and utilizes socio-dental impact
locus of control scale (SILOC) health model, as the theoretical framework to understand the dental myth and belief and possible
reasons for noncompliance with recommended health action.
Materials and Methods: A cross-sectional study was conducted by the out-patients attending dental institute, in Bengaluru
city. A total of 150 individuals were included, data were collected using a pretested and validated three-part questionnaire
including demographic data, questions regarding dental myth, and seven items SILOC. Data obtained were statistically analyzed
using descriptive statistics, t-test, and spearman’s rank correlation.
Results: Almost all the participant believed in one or more dental myth. About 71.3% of the participant had high (≥11) SILOC
scores. Statistically significant difference (P < 0.001) was found between mean SILOC scores and gender with males having
a lower mean score (14.94) as compared to females (18.62). When SILOC scores and myth scores were compared against
socioeconomic status, it showed statistically significant difference (P < 0.001), between them. The SILOC scores highly correlated
with myth scores.
Conclusion: Various dental myth and false perception still lurk in the minds of the population, to discourage the unhealthy
practices; we the health professionals have to provide intensive health education and promote the adoption of healthy practices.
It would be prudent to familiarize professionals to understand these myths and beliefs as they act as barriers toward seeking
treatment.
Key words: Culture, Gender, Internal-external control, Oral health, Social class
This document provides an overview of oral hygiene and preventive care. It discusses establishing a preventive program through assessing patients, developing intervention plans, implementing clinical services, and evaluating progress. Key aspects include patient counseling, compliance, and motivational interviewing. It also outlines the learning process, individual patient planning, and basic steps for oral hygiene like tooth brushing, flossing, and regular dental checkups.
Evidence Based-Practice in prosthodontics involves making clinical decisions based on the best available scientific evidence, clinical expertise, and patient values and preferences. It has several key components including determining the clinical question, finding and appraising relevant evidence, and applying evidence to individual patients. Evidence based practice has advantages like enhancing treatment efficiency and outcomes, minimizing risks, and improving patient-provider collaboration. Relevant evidence can be accessed from sources like Cochrane Library, dental journals, textbooks, and clinical practice guidelines.
Evidence based dentistry, public health , Prosthodontics and EBD,
history of ebd steps, evidence based medicine,evidence based practise. steps in ebd. advantages ,disadvantages, limitations.
prosthodontic considerations.
This study aimed to evaluate the knowledge and concerns of 124 dental health professionals in southern India regarding COVID-19. A survey was administered to assess understanding of COVID-19 transmission, oral manifestations, appropriate testing and emergency procedures. The results found good knowledge of COVID-19 and precautions, but some lack of awareness regarding appropriate testing and managing contaminated air. While most respondents understood transmission risks and emergency protocols, there was uncertainty around testing patients and using mouthwashes as prevention. This highlights gaps in knowledge that could be addressed with further education for dental professionals on COVID-19 clinical guidelines.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
1. Dr. Bashar Bakdash
Periodontology III
Spring Semester, 2012
School of Dentistry
University of Minnesota
Course and Faculty Evaluation
By Dental Hygiene Students
Percentage of Individuals Over 65 Who Reported
Having Most of Their Natural Teeth*
*Lost 5 teeth or less-CDC 2002
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24
2. Dr. Bashar Bakdash
Periodontology III
Spring Semester, 2012
School of Dentistry
University of Minnesota
Percentage of Individuals 65 Years & Older Who United State Population 65 Years of Age and Over:1950-2030
Reported Having Most of Their Natural Teeth*
46.8
59.4
48.9 54.2
50.2
*Lost 5 teeth or less-CDC 2002 Data
Percentage of Independent Dentists Employing Dental Hygienists
0 1 2 3+
Number of full and part-time hygienists
Source: American Dental Association, Survey Center, 2005 Survey of Dental Practice
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24
3. Dr. Bashar Bakdash
Periodontology III
Spring Semester, 2012
School of Dentistry
University of Minnesota
Average number of patients seen weekly per dental hygienist in
the primary private practice of independent dentists, 2000-2004
Number of Weekly Patients
Year
Source: American Dental Association, Survey Center, Surveys of Dental Practice
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4. Dr. Bashar Bakdash
Periodontology III
Spring Semester, 2012
School of Dentistry
University of Minnesota
Integrating Periodontics Dental Team Involvement
Into the General Practice
!Analysis of the dental team:
!!!!!""!- Desire and motivation to make the transformation
Dental team involvement
- The role of each member of the team
Educational and clinical considerations !Analysis of the practice style:
- Willingness to critically analysis the exiting practice
- Commitment to invest time, energy and funds required
Educational and Clinical Considerations
! Didactic and clinical education and updates
! Record keeping and quality assurance
! Instruments and equipment needed
! Recall system
! Referral philosophy and process
! Dealing with exiting and new patients
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5. Dr. Bashar Bakdash
Periodontology III
Spring Semester, 2012
School of Dentistry
University of Minnesota
Periodontal Treatment Protocol (PTP)
Classification of Periodontal Diseases
! Gingival Diseases
! Chronic Periodontitis
! Aggressive Periodontitis
! Periodontitis as a Manifestation of Systemic Diseases
! Necrotizing Periodontal Diseases
! Abscesses of the Periodontium
! Periodontitis Associated with Endodontic Lesions
! Developmental or Acquired Deformities and Conditions
Periodontal Treatment Protocol (PTP)
Periodontal Patient Referral
Visit 1
Sample Visit 2
Scripts ! Developing strong relationships with general practitioners
! Developing the dental hygienist as a referral source
Billing
Codes Visit 3
Procedures Forms
Patient Referral
Literature
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6. Dr. Bashar Bakdash
Periodontology III
Spring Semester, 2012
School of Dentistry
University of Minnesota
Professional Partnership Programs
6 of 11
24
7. Dr. Bashar Bakdash
Periodontology III
Spring Semester, 2012
School of Dentistry
University of Minnesota
Conclusion
" This study indicates that four demographic
!!!variables have statistical influence on the
!!!number of referrals per month from a general
!!!practitioner to a periodontist.
" These variables are: female gender, practicing
!!!with one other dentist, employing two or more
!!!hygienists, and being more than 5 miles away
!!!from the nearest periodontist.
Periodontal Patient Referral
#When in doubt, seek periodontal consultation
!!!!and/or a second opinion
#Provide information relevant to:
1. Chief concerns as expressed by the patient and therapist
!!!! 2. Health status and the need for special consideration
3. Any past experience with periodontal treatment
4. Anticipated dental therapeutic procedures
5. A quality full-mouth set of radiographs
Periodontal Patient Referral
Periodontal Patient Referral
#The majority of patients with:
#Expect to receive back from the periodontist: - Early (1-2 mm of CAL)
!! !1. Periodontal diagnosis and prognosis !!!!- Moderate (3-4 mm of CAL)
2. Proposed periodontal treatment plan and possible alternatives !!!chronic periodontitis that are diagnosed early can be
typically treated and maintained in the general practice
!3. Needs for coordinated treatments, including but not limited to !endontic,
!!! TMD, orthodontic, oral surgery, restorative,!prosthetic reconstruction
!! with!or without implants and the recommended schedule for periodontal
!!!!maintenance
!!!!!4. Patient interest and willingness to accept and follow-up on!the !proposed
!!! periodontal!treatment
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8. Dr. Bashar Bakdash
Periodontology III
Spring Semester, 2012
School of Dentistry
University of Minnesota
Periodontal Patient Referral Periodontal Patient Referral
#Aggressive forms of periodontitis: #Advanced (more than 5 mm of CAL) chronic
periodontitis with sites depict either:
- Localized or generalized periodontitis in Children or
!!!!adolescents -Progressive deepening of pockets with CAL and/or!bone
- Individuals 30 years of age and older with significant !!!loss as seen on radiographs
!!!bone loss (over 4mm or 1/3 of the root length) -Infrabony defects that have the potential for
!!!!!regenerative therapy
- Multiple-rooted teeth with more than 4 mm of CAL with
!!!furcation involvements that will complicate therapy
- Mucogingival defects that exhibit progressive recession
!!!!and/or are of an esthetic concern
Periodontal Patient Referral Periodontal Patient Referral
#Other clinical situations such as: # Other clinical situations such as:
- Comprehensive periodontal appraisal prior to initiating !!!!- Mucogingival defects that exhibit progressive recession
!!!orthodontic or extensive restorative therapy in adults !!and/or are of an esthetic concern
!!!!- Atypical periodontal diseases associated with immune !!!!- Tooth/teeth extraction in conjunction with ridge
!!!response or systemic health !!!preservation!or augmentation
- Excision of proliferating or excessive gingival tissues - Exposure of impacted teeth in conjunction with
- Crown lengthening surgery as indicated for restorative !!!orthodontic treatment
!!!and/or esthetics purposes
!!!!- Surgical placement of root-formed dental implants
Conclusion
" The main reason for non-compliance was that
!! the patients did attend their own dentist
!!!exclusively for maintenance therapy.
" Tooth loss and periodontal deterioration was
!!!more marked in this group than patients who
!!!in addition attended the specialist office for
!!!maintenance therapy.
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9. Dr. Bashar Bakdash
Periodontology III
Spring Semester, 2012
School of Dentistry
University of Minnesota
Dental Insurance
U. S. Expenditure on Health Care
Reporting In DIAGNOSTIC CONDITION U.S. EXPENDITURE
Periodontics Heart Conditions…………….. 90 Billion
Oral Health Conditions……… 71 Billion
Cancer……………………….. 62 Billion
Trauma - Related Disorders….. 58 Billion
Mental Disorders…………….. 52 Billion
COPD, Asthma………………. 49 Billion
Source: Agency for Healthcare Research and Quality Medical Expenditures Panel Survey, 2004
Dental Expenditures (in Billions of $) by "Selected Calendar Year 1970-2008
Percentage of Patients Covered Under a Dental Insurance Plan
" Only 6-7% of all insured
patients reach their yearly
maximum
" the average total expenditure
per insured is less than $400
No
40% Yes
60%
Source: Waldman HB: Favorable dental economics could belie coming crisis. Calif Dent Assoc J 29:839-845, 2001 Source: American Dental Association, Survey Center, 2000 Public Opinion Survey
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10. Dr. Bashar Bakdash
Periodontology III
Spring Semester, 2012
School of Dentistry
University of Minnesota
Distribution of Dental Insurance Benefit Dollars Periodontal Procedures & Dental Insurance Benefit Dollars
Among Various Areas of Dentistry
About 50% performed
by non-periodontists
Background Information Background Information
! Dental benefits plans vary greatly from carrier to carrier
! Many carriers created contracts based on previous
! Not all carriers are legally required to adhere to the
CDT codes, and until these contracts expire, they
American Dental standard. While in many states there will not change over to the new CDT codes
are statutory provisions that designate the American
! Insurance carriers typically have large in house
Dental Association as the standard for dental carriers,
computer systems that are complex and may take
not-for-profit carriers (such as Delta and Blue Cross) time to re-program them
are not governed by such provisions
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11. Dr. Bashar Bakdash
Periodontology III
Spring Semester, 2012
School of Dentistry
University of Minnesota
Insurance Coding and Communication Tips
! Dentist Vs dental hygienist provided services
! Determine the overall medical, oral, dental and periodontal status
! Use appropriate CDT codes regardless of the patient insurance
! Clinical evaluation codes
! Preventive codes
! Non-surgical codes
! Surgical codes
Colgate Oral Care Report, Volume 16, Number 4, 2006 ! Implant codes
2003 AAP Workshop on Contemporary
Science in Clinical Periodontics
The leadership Curve shows the leadership level required
and the horizontal axis shows the clinical range of clinical
care that will be provided. Clinical, Organizational and
relshioship skills are also illustrated
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12. Periodontal Insurance Reporting
Dr. Bashar Bakdash
Division of Periodontology
Department of Developmental and Surgical Sciences
School of Dentistry
University of Minnesota
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13. Classification of Gingival and Periodontal Diseases*
Gingival Diseases
-Plaque-induced gingival diseases
-Non-plaque-induced gingival lesions
Chronic Periodontitis
-Localized
-Generalized
Aggressive Periodontitis
-Localized
-Generalized
Periodontitis as a Manifestation of Systemic Diseases
Necrotizing Periodontal Diseases
-Necrotizing ulcerative gingivitis (NUG)
-Necrotizing ulcerative periodontitis (NUP)
Abscesses of the Periodontium
-Gingival abscess
-Periodontal abscess
-Pericoronal abscess
Periodontitis Associated with Endodontic Lesions
-Endodontic-periodontal lesion
-Periodontal-endodontic lesion
-Combined lesion
Developmental or Acquired Deformities and Conditions
-Localized tooth-related factors that predispose to plaque-induced
gingival diseases or periodontitis
-Mucogingival deformities and conditions around teeth
-Mucogingival deformities and conditions on edentulous ridges
-Occlusal trauma
* Adapted from: Armitage GC: Development of a Classification
System for Periodontal Diseases and Conditions, Ann Periodontol
4:1, 1999.
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14. Overview
In late 2008 the American Dental Association published the CDT-2009/2010 of the Code on
Dental Procedures and Nomenclature. The fact that codes are published does not mean that the
procedure(s) is/are accepted/reimbursable in a given dental benefits plan or by each individual
carrier. There are several factors contributing to these issues:
1. Dental benefits plans vary greatly from carrier to carrier.
2. Not all carriers are legally required to adhere to the American Dental standard. While in
many states there are statutory provisions that designate the American Dental
Association as the standard for dental carriers, not-for-profit carriers (such as Delta and Blue
Cross) are not governed by such provisions.
3. Many carriers created contracts based on previous CDT codes, and until these contracts
expire, they will not change over to the new CDT codes, and
4. Insurance carriers typically have large in-house computer systems that are complex, and it
takes time to re-program them.
The following is a summary of the American Dental Association CDT-2009/2010 Periodontal
and related codes:
Clinical Oral Evaluations Codes
The codes in this section recognize the cognitive skills necessary for patient evaluation.
The collection and recording of some data and components of the dental examination maybe
delegated; however, the evaluation, diagnosis and treatment planning are the responsibility of the
dentist. As with all ADA procedure codes, there is no distinction made between the evaluations
provided by general practitioners and specialists. Report additional diagnostic and/or definitive
procedures separately.
D0120 periodic oral evaluation – established patient
An evaluation performed on a patient of record to determine any changes inthe patient’s dental
and medical health status since a previous comprehensiveor periodic evaluation. This includes an
oral cancer evaluation and periodontal screening where indicated, and may require interpretation
of information acquired through additional diagnostic procedures. Report additional diagnostic
procedures separately.
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15. D0140 limited oral evaluation – problem focused
An evaluation limited to a specific oral health problem or complaint. This may require
interpretation of information acquired through additional diagnostic procedures. Report
additional diagnostic procedures separately. Definitive procedures may be required on the same
date as the evaluation. Typically, patients receiving this type of evaluation present with a specific
problem and/or dental emergencies, trauma, acute infections, etc.
D0150 comprehensive oral evaluation – new or established patient
Used by a general dentist and/or a specialist when evaluating a patient comprehensively.
This applies to new patients; established patients who have had a significant change in health
conditions or other unusual circumstances, by report, or established patients who have been
absent from active treatment for three or more years. It is a thorough evaluation and recording of
the extraoral and intraoral hard and soft tissues. It may require interpretation of information
acquired through additional diagnostic procedures. Additional diagnostic procedures should be
reported separately. This includes an evaluation for oral cancer where indicated, the evaluation
and recording of the patient’s dental and medical history and a general health assessment. It may
include the evaluation and recording of dental caries, missing or unerupted teeth, restorations,
existing prostheses, occlusal relationships, periodontal conditions (including periodontal
screening and/or charting), hard and soft tissue anomalies, etc.
D0160 detailed and extensive oral evaluation – problem focused, by report
A detailed and extensive problem focused evaluation entails extensive diagnostic and cognitive
modalities based on the findings of a comprehensive oral evaluation. Integration of more
extensive diagnostic modalities to develop a treatment plan for a specific problem is required.
The condition requiring this type of evaluation should be described and documented.
Examples of conditions requiring this type of evaluation may include dentofacial anomalies,
complicated perio-prosthetic conditions, complex temporomandibular dysfunction, facial pain
of unknown origin, conditions requiring multi-disciplinary consultation, etc.
D0170 re-evaluation – limited, problem focused (established patient; not
post-operative visit)
Assessing the status of a previously existing condition. For example:
- traumatic injury where no treatment was rendered but patient needs follow-up monitoring;
- evaluation for undiagnosed continuing pain;
- soft tissue lesion requiring follow-up evaluation.
D0180 comprehensive periodontal evaluation – new or established patient
This procedure is indicated for patients showing signs or symptoms of periodontal
disease and for patients with risk factors such as smoking or diabetes. It includes evaluation of
periodontal conditions, probing and charting, evaluation and recording of the patient’s dental and
medical history and general health assessment. It may include the evaluation and recording of dental
caries, missing or unerupted teeth, restorations, occlusal relationships and oral cancer evaluation.
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16. Preventive Codes
D1110 prophylaxis – adult
Removal of plaque, calculus and stains from the tooth structures in the permanent and
transitional dentition. It is intended to control local irritational factors.
Topical Fluoride Treatment (Office Procedure)
Prescription strength fluoride product designed solely for use in the dental office, delivered to the
dentition under the direct supervision of a dental professional. Fluoride must be applied
separately from prophylaxis paste.
D1204 topical application of fluoride (prophylaxis not included) – adult
D1206 topical fluoride varnish; therapeutic application for moderate to high
caries risk patients
Application of topical fluoride varnish, delivered in a single visit and involving the entire oral
cavity. Not to be used for desensitization.
D1310 nutritional counseling for control of dental disease
Counseling on food selection and dietary habits as a part of treatment and control of periodontal
disease and caries.
D1320 tobacco counseling for the control and prevention of oral disease
Tobacco prevention and cessation services reduce patient risks of developing tobacco-related
oral diseases and conditions and improves prognosis for certain dental therapies.
D1330 oral hygiene instructions
This may include instructions for home care. Examples include tooth brushing technique,
flossing, and use of special oral hygiene aids.
Non-Surgical Periodontal Codes
D4320 provisional splinting – intracoronal
This is an interim stabilization of mobile teeth. A variety of methods and appliances may be
employed for this purpose. Identify the teeth involved and the nature of the splint.
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17. D4321 provisional splinting – extracoronal
This is an interim stabilization of mobile teeth. A variety of methods and appliances may be
employed for this purpose. Identify the teeth involved and the nature of the splint.
D4341 periodontal scaling and root planing – four or more teeth per quadrant
This procedure involves instrumentation of the crown and root surfaces of the teeth to remove
plaque and calculus from these surfaces. It is indicated for patients with periodontal disease and
is therapeutic, not prophylactic, in nature. Root planing is the definitive procedure designed for
the removal of cementum and dentin that is rough, and/or permeated by calculus or contaminated
with toxins or microorganisms. Some soft tissue removal occurs. This procedure may be used as
a definitive treatment in some stages of periodontal disease and/or as a part of pre-surgical
procedures in others.
D4342 periodontal scaling and root planing – one to three teeth per quadrant
This procedure involves instrumentation of the crown and root surfaces of the teeth to remove
plaque and calculus from these surfaces. It is indicated for patients with periodontal disease and
is therapeutic, not prophylactic, in nature. Root planing is the definitive procedure designed for
the removal of cementum and dentin that is rough, and/or permeated by calculus or contaminated
with toxins or microorganisms. Some soft tissue removal occurs. This procedure may be used as
a definitive treatment in some stages of periodontal disease and/or as a part of pre-surgical
procedures in others.
D4355 full mouth debridement to enable comprehensive evaluation and diagnosis
The gross removal of plaque and calculus that interfere with the ability of the
dentist to perform a comprehensive oral evaluation. This preliminary procedure
does not preclude the need for additional procedures.
D4381 localized delivery of antimicrobial agents via a controlled release
vehicle into diseased crevicular tissue, per tooth, by report
FDA approved subgingival delivery devices containing antimicrobial medication(s) are inserted
into periodontal pockets to suppress the pathogenic microbiota. These devices slowly release the
pharmacological agents so they can remain at the intended site of action in a therapeutic
concentration for a sufficient length of time.
D4910 periodontal maintenance
This procedure is instituted following periodontal therapy and continues at varying intervals,
determined by the clinical evaluation of the dentist, for the life of the dentition or any implant
replacements. It includes removal of the bacterial plaque and calculus from supragingival and
subgingival regions, site specific scaling and root planing where indicated, and polishing the
teeth. If new or recurring periodontal disease appears, additional diagnostic and treatment
procedures must be considered.
For implant maintenance procedures, please refer to Code D6080, Page 11 of this document.
D4920 unscheduled dressing change (by someone other than treating dentist)
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18. Periodontal Surgical Codes
Local anesthesia is usually considered to be part of periodontal procedures. Also surgical
services include usual postoperative care.
Site: A term used to describe a single area, position, or locus. The word “site” is frequently
used to indicate an area of soft tissue recession on a single tooth or an osseous defect adjacent to
a single tooth; also used to indicate soft tissue defects and/or osseous defects in edentulous tooth
positions.
- If two contiguous teeth have areas of soft tissue recession, each area of recession
is a single site.
- If two contiguous teeth have adjacent but separate osseous defects, each defect is a single site.
- If two contiguous teeth have a communicating interproximal osseous defect, it should be
considered a single site.
- All non-communicating osseous defects are single sites.
- All edentulous non-contiguous tooth positions are single sites.
- Depending on the dimensions of the defect, up to two contiguous edentulous
tooth positions may be considered a single site.
D4210 gingivectomy or gingivoplasty – four or more contiguous teeth or tooth
bounded spaces per quadrant
Involves the excision of the soft tissue wall of the periodontal pocket by either an external or an
internal bevel. It is performed to eliminate suprabony pockets after adequate initial preparation,
to allow access for restorative dentistry in the presence of suprabony pockets, or to restore
normal architecture when gingival enlargements or asymmetrical or unaesthetic topography is
evident with normal bony configuration.
D4211 gingivectomy or gingivoplasty – one to three contiguous teeth or tooth
bounded spaces per quadrant
Involves the excision of the soft tissue wall of the periodontal pocket by either an external or an
internal bevel. It is performed to eliminate suprabony pockets after adequate initial preparation,
to allow access for restorative dentistry in the presence of suprabony pockets, or to restore
normal architecture when gingival enlargements or asymmetrical or unaesthetic topography is
evident with normal bony configuration.
D4230 anatomical crown exposure – four or more contiguous teeth per quadrant
This procedure is utilized in an otherwise periodontally healthy area to remove enlarged gingival
tissue and supporting bone (ostectomy) to provide an anatomically correct gingival relationship.
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19. D4231 anatomical crown exposure – one to three teeth per quadrant
This procedure is utilized in an otherwise periodontally healthy area to remove enlarged gingival
tissue and supporting bone (ostectomy) to provide an anatomically correct gingival relationship.
D4240 gingival flap procedure, including root planing – four or more
contiguous teeth or tooth bounded spaces per quadrant
A soft tissue flap is reflected or resected to allow debridement of the root surface and the
removal of granulation tissue. Osseous recontouring is not accomplished in conjunction with this
procedure. May include open flap curettage, reverse bevel flap surgery, modified Kirkland flap
procedure, and modified Widman surgery. This procedure is performed in the presence of
moderate to deep probing depths, loss of attachment, need to maintain esthetics, need for
increased access to the root surface and alveolar bone, or to determine the presence of a cracked
tooth, fractured root, or external root resorption. Other procedures may be required concurrent to
D4240 and should be reported separately using their own unique codes.
D4241 gingival flap procedure, including root planing – one to three
contiguous teeth or tooth bounded spaces per quadrant
A soft tissue flap is reflected or resected to allow debridement of the root surface and the
removal of granulation tissue. Osseous recontouring is not accomplished in conjunction with this
procedure. May include open flap curettage, reverse bevel flap surgery, modified Kirkland flap
procedure, and modified Widman surgery. This procedure is performed in the presence of
moderate to deep probing depths, loss of attachment, need to maintain esthetics, need for
increased access to the root surface and alveolar bone, or to determine the presence of a cracked
tooth, fractured root, or external root resorption. Other procedures may be required concurrent to
D4241 and should be reported separately using their own unique codes.
D4245 apically positioned flap
Procedure is used to preserve keratinized gingiva in conjunction with osseous resection and
second stage implant procedure. Procedure may also be used to preserve keratinized/attached
gingiva during surgical exposure of labially impacted teeth, and may be used during treatment of
peri-implantitis.
D4249 clinical crown lengthening – hard tissue
This procedure is employed to allow restorative procedure or crown with little or no tooth
structure exposed to the oral cavity. Crown lengthening requires reflection of a flap and is
performed in a healthy periodontal environment, as opposed to osseous surgery, which is
performed in the presence of periodontaldisease. Where there are adjacent teeth, the flap design
may involve a larger surgical area.
D4260 osseous surgery (including flap entry and closure) – four or more
contiguous teeth or tooth bounded spaces per quadrant
This procedure modifies the bony support of the teeth by reshaping the alveolar process to
achieve a more physiologic form. This may include the removal of supporting bone (ostectomy)
and/or non-supporting bone (osteoplasty). Other procedures may be required concurrent to Code
D4260 and should be reported using their own unique codes.
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20. D4261 osseous surgery (including flap entry and closure) – one to three
contiguous teeth or tooth bounded spaces per quadrant
This procedure modifies the bony support of the teeth by reshaping the alveolar process to
achieve a more physiologic form. This may include the removal of supporting bone (ostectomy)
and/or non-supporting bone (osteoplasty). Other procedures may be required concurrent to Code
D4261 and should be reported using their own unique codes.
D4263 bone replacement graft – first site in quadrant
This procedure involves the use of osseous autografts, osseous allografts, or non-osseous grafts
to stimulate periodontal regeneration when the disease process has led to a deformity of the bone.
This procedure does not include flap entry and closure, wound debridement, osseous contouring,
or the placement of biologic materials to aid in osseous tissue regeneration or barrier
membranes. Other separate procedures may be required concurrent to Code D4263 and should
be reported using their own unique codes. Definition for the term “site” precedes Code D4210.
D4264 bone replacement graft – each additional site in quadrant
This procedure involves the use of osseous autografts, osseous allografts, or non-osseous grafts
to stimulate periodontal regeneration when the disease process has led to a deformity of the bone.
This procedure does not include flap entry and closure, wound debridement, osseous contouring,
or the placement of biologic materials to aid in osseous tissue regeneration or barrier membranes.
This code is used if performed concurrently with Code D4263 and allows reporting of the exact
number of sites involved. Definition for the term “site” precedes Code D4210.
D4265 biologic materials to aid in soft and osseous tissue regeneration
Biologic materials may be used alone or with other regenerative substratessuch as bone and
barrier membranes, depending upon their formulation and the presentation of the periodontal
defect. This procedure does not include surgical entry and closure, wound debridement, osseous
contouring, or the placement of graft materials and/or barrier membranes. Other separate
procedures may be required concurrent to Code D4265 and should be reported using their own
unique codes.
D4266 guided tissue regeneration – resorbable barrier, per site
A membrane is placed over the root surfaces or defect area following surgical exposure and
debridement. The mucoperiosteal flaps are then adapted over the membrane and sutured. The
membrane is placed to exclude epithelium and gingival connective tissue from the healing
wound. This procedure may require subsequent surgical procedures to correct the gingival
contours. Guided tissue regeneration may also be carried out in conjunction with bone
replacement grafts or to correct deformities resulting from inadequate faciolingual bone width in
an edentulous area. When guided tissue regeneration is used in association with a tooth, each site
on a specific tooth should be reported separately. Other separate procedures may be required
concurrent to Code D4266 and should be reported using their own unique codes. Definition for
the term “site” precedes Code D4210.
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21. D4267 guided tissue regeneration – nonresorbable barrier, per site (includes
membrane removal)
This procedure is used to regenerate lost or injured periodontal tissue by directing differential
tissue responses. A membrane is placed over the root surfaces or defect area following surgical
exposure and debridement. The mucoperiosteal flaps are then adapted over the membrane and
sutured. This procedure does not include flap entry and closure, wound debridement,
osseous contouring, bone replacement grafts, or the placement of biologicmaterials to aid in
osseous tissue regeneration. The membrane is placed to exclude epithelium and gingival
connective tissue from the healing wound. This procedure requires subsequent surgical
procedures to remove the membranes and/or to correct the gingival contours. Guided tissue
regeneration may be used in conjunction with bone replacement grafts or to correct deformities
resulting from inadequate faciolingual bone width in an edentulous area. When guided tissue
regeneration is used in association with a tooth, each site on a specific tooth should be reported
separately with this code. When no tooth is present, each site should be reported separately.
Other separate procedures may be required concurrent to D4267 and should be reported using
their own unique codes. Definition for the term “site” precedes Code D4210.
D4268 surgical revision procedure, per tooth
This procedure is to refine the results of a previously provided surgical procedure. This may
require a surgical procedure to modify the irregular contours of hard or soft tissue. A
mucoperiosteal flap may be elevated to allow access to reshape alveolar bone. The flaps are
replaced or repositioned and sutured.
D4270 pedicle soft tissue graft procedure
A pedicle flap of gingiva can be raised from an edentulous ridge, adjacent teeth, or from the
existing gingiva on the tooth and moved laterally or coronally to replace alveolar mucosa as
marginal tissue. The procedure can be used to cover an exposed root or to eliminate a gingival
defect if the root is not too prominent in the arch.
D4271 free soft tissue graft procedure (including donor site surgery)
Gingival or masticatory mucosa is grafted to create or augment the gingiva at another site, with
or without root coverage. This graft may also be used to eliminate the pull of frena and muscle
attachments, to extend the vestibular fornix, and to correct localized gingival recession.
D4273 subepithelial connective tissue graft procedures, per tooth
This procedure is performed to create or augment gingiva, to obtain root coverage to eliminate
sensitivity and to prevent root caries, to eliminate frenum pull, to extend the vestibular fornix, to
augment collapsed ridges, to provide an adequate gingival interface with a restoration or to cover
bone or ridge regeneration sites when adequate gingival tissues are not available for effective
closure. There are two surgical sites. The recipient site utilizes a split thickness incision,
retaining the overlying flap of gingiva and/or mucosa. The connective tissue is dissected
from the donor site leaving an epithelialized flap for closure. After the graft is placed on the
recipient site, it is covered with the retained overlying flap.
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22. D4274 distal or proximal wedge procedure (when not performed in
conjunction with surgical procedures in the same anatomical area)
This procedure is performed in an edentulous area adjacent to a periodontally involved tooth.
Gingival incisions are utilized to allow removal of a tissue wedge to gain access and correct the
underlying osseous defect and to permit close flap adaptation.
D4275 soft tissue allograft
Procedure is performed to create or augment the gingiva, with or without root coverage. This
may be used to eliminate the pull of the frena and muscle attachments, to extend the vestibular
fornix, and correct localized gingival recession. There is no donor site.
D4276 combined connective tissue and double pedicle graft, per tooth
Advanced gingival recession often cannot be corrected with a single procedure. Combined tissue
grafting procedures are needed to achieve the desired outcome
Implants
Report surgical implant procedure using codes in this section; prosthetic devices should be
reported using existing fixed or removable prosthetic codes. Local anesthesia is usually
considered to be part of Implant Services procedures.
Pre-Surgical Services
D6190 radiographic/surgical implant index, by report
An appliance, designed to relate osteotomy or fixture position anatomic structures, to be utilized
during radiographic exposure planning and/or during osteotomy creation for fixture installation.
Surgical Services
Report surgical implant procedure using codes in this section.
D6010 surgical placement of implant body: endosteal implant
Includes second stage surgery and placement of healing cap.
D6012 surgical placement of interim implant body for transitional endosteal implant
Includes removal during later therapy to accommodate the definitive, which may include
placement of other implants.
D6040 surgical placement: eposteal implant
An eposteal (subperiosteal) framework of a biocompatible material and fabricated to fit on the
surface of the bone of the mandible or permucosal extensions that provide support and
attachment of a This may be a complete arch or unilateral appliance. Eposteal implants upon the
bone and under the periosteum.
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23. D6050 surgical placement: transosteal implant
A transosteal (transosseous) biocompatible device with threaded posts both the superior and
inferior cortical bone plates of the mandibular and exiting through the permucosa providing
support and attachment dental prosthesis. Transosteal implants are placed completely
bone and into the oral cavity from extraoral or intraoral.
D6100 implant removal, by report
This procedure involves the surgical removal of an implant. Describe procedure.
D6080 implant maintenance procedures, including removal of prosthesis,
cleansing of prosthesis and abutments and reinsertion of prosthesis
This procedure includes a prophylaxis to provide active debriding of the implant and
examination of all aspects of the implant system, including the occlusion and stability
of the superstructure. The patient is also instructe in thorough daily cleansing of the implant.
Other Service Codes
D9910 application of desensitizing medicament
Includes in-office treatment for root sensitivity. Typically reported on a “per visit” basis for
application of topical fluoride. This code is not to be used for bases, liners or adhesives used
under restorations.
D9911 application of desensitizing resin for cervical and/or root surface,
per tooth
Typically reported on a “per tooth” basis for application of adhesive resins. This code is not to be
used for bases, liners, or adhesives used under restorations.
D9920 behavior management, by report
May be reported in addition to treatment provided. Should be reported in 15-minute increments.
D9930 treatment of complications (post-surgical) – unusual circumstances, by report
For example, treatment of a dry socket following extraction or removal of bony sequestrum.
D9940 occlusal guard, by report
Removable dental appliances, which are designed to minimize the effects of bruxism (grinding)
and other occlusal factors.
D9941 fabrication of athletic mouthguard
D9942 repair and/or reline of occlusal guard
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24. D9950 occlusion analysis – mounted case
Includes, but is not limited to, facebow, interocclusal records tracings, and diagnostic wax-up;
for diagnostic casts, see Code D0470.
D9951 occlusal adjustment – limited
May also be known as equilibration; reshaping the occlusal surfaces of teeth to create
harmonious contact relationships between the maxillary and mandibular teeth. Presently includes
discing/odontoplasty/enamoplasty. Typically reported on a “per visit” basis. This should not be
reported when the procedure only involves bite adjustment in the routine post-delivery care for a
direct/indirect restoration or fixed/removable prosthodontics.
D9952 occlusal adjustment – complete
Occlusal adjustment may require several appointments of varying length, and sedation may be
necessary to attain adequate relaxation of the musculature. Study casts mounted on an
articulating instrument may be utilized for analysis of occlusal disharmony. It is designed to
achieve functional relationships and masticatory efficiency in conjunction with restorative
treatment, orthodontics, orthognathic surgery, or jaw trauma when indicated. Occlusal
adjustment enhances the healing potential of tissues affected by the lesions of occlusal trauma.
D9971 odontoplasty 1-2 teeth; includes removal of enamel projections
Unspecified Periodontal Procedures
D9999 Unspecified Periodontal Procedure, by report
Use for a procedure, which is not adequately described by a code. Describe procedure.
Let the insurance company know exactly what you have done or propose to do. Your report
can help establish rapport with the insurance company consultants who will be receiving the
claim. It’s easier for the consultant to approve a claim when thorough information is
provided.
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