x�+�r 10 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/CropBox[6 3 561 750]/MediaBox[0 0 567 756]>> 22 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/CropBox[6 3 561 750]/MediaBox[0 0 567 756]>> American Dental Association. endobj �26S072PI�r � Periodontal Maintenance Kit IM-D4910 Hu-Friedy has created a collection of procedural instrument kits that follow American Dental Association (ADA) - Current Dental Terminology (CDT) Coding. 51 0 obj<>>> endobj Clinical Indications Medically Necessary: Periodontal maintenance is a nonsurgical treatment considered medically or dentally necessary, following periodontal therapy,that continues for the life of the dentition or any implant replacements and provides treatment and continuing care of patients with a history of/and ongoing periodontal disease. 21 0 obj <>stream endobj However, some Medi-Cal adult endobj 49 0 obj<>>> endobj American Academy of Periodontology. 20 0 obj <>>>/Subtype/Form/BBox[0 0 567 756]>>stream In addition, you should be using thin ultrasonic inserts on low power for at least 75 percent of the scaling in a periodontal maintenance visit. �*T0T0 B�����f����� � � 23 0 obj <>>>/Subtype/Form/BBox[0 0 567 756]>>stream �26S072PI�r � 74 0 obj <>/ExtGState<>/ProcSet[/PDF/Text]/Font<>>>/Subtype/Form/BBox[0 0 567 756]>>stream 15 0 obj <>stream �26S072PI�r � Investing in better oral health for all. �26S072PI�r � endobj �*T0T0 B�����f����� � � endobj x�+�r Nonsurgical Treatment of Chronic Periodontitis Clinical Practice Guideline (2015) A panel of experts convened by the American Dental Association (ADA) Council on Scientific Affairs presents an evidence-based clinical practice guideline and systematic review on nonsurgical treatment of patients with chronic periodontitis by means of scaling and root planing (SRP) with or without adjuncts. endobj endstream 4 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/CropBox[6 3 561 750]/MediaBox[0 0 567 756]>> The list of dental benefits included Periodontal Maintenance (D4910) as a new benefit. endobj endstream 33 0 obj<>>> endobj endobj 70 0 obj <>>>/Subtype/Form/BBox[0 0 567 756]>>stream endobj 68 0 obj <>stream 63 0 obj<>>> “once a periodontal patient, always a periodontal patient.” That phrase is true, in the sense that periodontal dis-ease is chronic and must be controlled. 31. Access news, member benefits and ADA policy. Although treatment with locally applied antibiotics may be recommended in conjunction with periodontal maintenance, the cost of those medications is generally not included in periodontal maintenance procedures. A panel of experts convened by the American Dental Association (ADA) Council on Scientific Affairs presents an evidence-based clinical practice guideline and systematic review on nonsurgical treatment of patients with chronic periodontitis by means of scaling and root planing (SRP) with or without adjuncts. �*T0T0 B�����f����� �� � �26S072PI�r � x�+�r The guidelines have not been updated since 1999, so this is a pretty big deal! endobj x�+�r Ultrasonics are more effective at debriding pathogens than hand scaling, largely because of the lavage (either water or medicament) and the acoustic turbulence created by the tip. x�+�r endobj endobj D4910 Periodontal Maintenance Follows the completion of active therapy to treat periodontal infection for the lifetime of the dentition or implant replacements and includes removal of plaque biofilm and calculus from supra and subgingival sur- faces. CHICAGO — Dentists treating patients with chronic periodontitis, a severe form of gum disease that can lead to tooth loss, are advised to use scaling and root planing (SRP), deep cleaning of the teeth, as initial treatment, according to new guidelines from the American Dental Association (ADA). 26 0 obj <>>>/Subtype/Form/BBox[0 0 567 756]>>stream endobj 73 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/CropBox[2 3 564 754]/MediaBox[0 0 567 756]>> Although the CDT-4 definition of D4910 states that intervals for the procedure are determined by the clinical diagnosis of a dentist, it eliminates the words "periodontal evaluation" that were included in the CDT-3 definition, and does not make any mention of examination or evaluation in any other context. endobj 67 0 obj<>>> endobj �26S072PI�r � It is the most conservative approach to prevent more extensive and aggressive treatment. Learn about ADA CERP recognition, look up CERP recognized CE providers and find CE courses. endobj The dental cleanings recommended after these treatments are called “periodontal maintenance care.” Periodontal maintenance involves a cleaning that is deeper than a normal cleaning in a dental office. 44 0 obj <>>>/Subtype/Form/BBox[0 0 567 756]>>stream A{���D���D� endstream �*T0T0 B�����f����� �! This procedure includes removal of plaque and tartar from above and below the gum line, all the way down the length of each tooth to where the root, gum, and bone meet. endobj endstream An appropriate periodontal maintenance program, specific to individual circumstances, has been recom- mended to the patient for long-term control of the disease, as well as for the maintenance of dental implants, if present. A recent hot topic in the Facebook forum Dental Hygienists Talk, which has more than 10,000 dental hygiene members, revealed that some new hygienists are feeling confused, insecure, or lost when it comes to implementing a periodontal program in their office. Use this ADA-published brochure to explain why regular, professional treatment is important in controlling periodontal disease. endobj �26S072PI�r � 2003;74(9):1395-1401. Guidelines for periodontal therapy. �26S072PI�r � 37 0 obj<>>> H�|W�r�:���-����oN\�V[u\U�C�0 IHHB! 30. 4. �*T0T0 B�����f����� � � endstream This paper looks at the periodontal healing period, the risks of periodontal progression and current thinking about maintenance programmes. �*T0T0 B�����f����� � � endobj endobj �*T0T0 B�����f����� � � Periodontal maintenance scaling is needed to maintain gum and bone health. endobj 61 0 obj<>>> 54 0 obj<>>> Commission for Continuing Education Provider Recognition, Joint Commission on National Dental Examinations, National Commission on Recognition of Dental Specialties and Certifying Boards, Nonsurgical Treatment of Chronic Periodontitis. endobj J Periodontol 2003;74:1395-1401. 53 0 obj<>>> 32 0 obj<>>> Antibiotics for Dental Pain and Swelling Guideline A panel of experts convened by the ADA Council on Scientific Affairs presents clinical recommendations concerning the use of antibiotics for the urgent management of pulpal- and periapical-related dental pain and intra-oral swelling. 2005;32(3):280-286. Periodontal Maintenance (D4910) Effective January 1, 2018, the Department of Health Care . Cohen RE, Research, Science and Therapy Committee, American Academy of Periodontology. x�+�r %PDF-1.4 endobj J Periodontol 2001;72:1624-1628. Background: Periodontitis is a bacterially-induced, chronic inflammatory disease that destroys the connective tissues and bone that support teeth. �26S072PI�r � 42 0 obj <>stream endstream paratively little evidence to demonstrate how often such reviews should take place. �26S072PI�r � endobj Copyright © 2020 American Dental Association. 28 0 obj<>>> �26S072PI�r � 35 0 obj<>>> �*T0T0 B�����fh����� �� endobj �*T0T0 B�����fh����� �� Periodontal maintenance should always follow definitive periodontal therapy for a period of time, typically one year or longer. Take advantage of endorsed, discounted business products, Access oral-health information for the public and ADA Find-A-Dentist. endobj endobj �*T0T0 B�����f����� � � �*T0T0 B�����f����� �� � It includes removal of bacterial plaque, calculus, from supra and sub-regions, and SITE specific SRP where indicated, as well as polishing the teeth 1. endobj Meet, Play, Learn atADA’s annual meeting. 52 0 obj<>>> The authors voted in favor of SRP as the initial nonsurgical treatment for chronic periodontitis. The bacterium that causes periodontal disease re-establishes 3 months after treatment. Scaling and Root Planing (SRP) precedes being placed on a regular maintenance routine, and may also be … endobj The strengths of 2 other recommendations are weak: chlorhexidine chips and photodynamic therapy with a diode laser. �26S072PI�r � 59 0 obj<>>> x�+�r endobj and the patient’s insurance provided insurance coverage 2X/year and the patient is on a 3-4 month recall. 13 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/CropBox[6 3 561 750]/MediaBox[0 0 567 756]>> endobj 24 0 obj <>stream endobj Typically there is a ninety day exclusion period following active treatment. endobj endobj Recommendations for the nonsurgical use of other lasers as SRP adjuncts were limited to expert opinion against because there was uncertainty regarding their clinical benefits and benefit-to-adverse effects balance. 33. endstream �26S072PI�r � 65 0 obj<>>> Periodontal maintenance (D4910) is ongoing and therapeutic in nature, not preventive. endobj endstream If the hygienist is doing a periodontal maint. 8 0 obj <>>>/Subtype/Form/BBox[0 0 567 756]>>stream endstream endobj Active periodontal treatment may be reported as D4341, D4342, D4240, D4241, D4260, or D4261. x�+�r endobj �*T0T0 B�����f����� �� � endobj J Periodontol. � Periodontal charting must be current within one year to support periodontal maintenance visits for Periodontal maintenance. Help patients understand that periodontal disease doesn’t always go away after one treatment. Position paper. endobj Dentists treating patients with chronic periodontitis, a severe form of periodontal disease that can lead to tooth loss, are advised to use scaling and root planing (SRP), deep cleaning of the teeth, as initial treatment, according to new guidelines from the American Dental Association. endobj periodontal charts • If the patient has been approved for frequent recalls for periodontal maintenance, patient must have a history of having scaling and root planing performed with a probing depth of 5mm or greater in at least one quadrant. %���� �*T0T0 B�����f����� � � Tips for minimizing claim denials for periodontal maintenance: • If there are unusual circumstances that require a different interval of treatment than the one specified in the patient's plan documents, the dentist should provide documentation with the 50 0 obj<>>> x�+�r �26S072PI�r � Note that expert opinion for does not imply endorsement but instead signifies that evidence is lacking and the level of certainty in the evidence is low. endobj By definition, the 4910 periodontal maintenance code is defined as the procedure following periodontal therapy and continues at varying intervals determined by the clinical evaluation. 25 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/CropBox[6 3 561 750]/MediaBox[0 0 567 756]>> Periodontal maintenance is often referred to as a dental deep cleaning, because it includes: Scaling – cleaning beneath the gum line to remove plaque, bacteria, and other build-up Root Planing – shaping the root of the tooth to remove leftover debris, and decrease the chances and/or amount of bacterial build-up in the future DentaQuest Partnership for Oral Health Advancement | 2400 Computer Drive, Westborough, MA 01581 Home care instructions (OHI) Home care instructions (OHI) Position paper. 17 0 obj <>>>/Subtype/Form/BBox[0 0 567 756]>>stream endobj �*T0T0 B�����fh����� �� Properly maintain ventilation systems. 45 0 obj<>>> �26S072PI�r � endobj �0��������U���+�,ғ�oJ��HReR�����c`��N=t0"�ɧ|��oτ�7vP~_�`v?�� {� �!�~�����y���c�F���F i��ꚏe!tBmB1nA��ڈ֤���XAM�Au�����ϊi�t�����#f���Xt=���,^u-��@^ ��9* �Z|��լ=��y|� endobj endobj endstream x�+�r Radiographs (according to ADA guidelines) Prophy/perio maintenance Prophy/perio maintenance Treatment plan Provisional treatment plan . 29 0 obj<>>> x�+�r endobj �*T0T0 B�����f����� �� � The need for periodontal maintenance treatment after active therapy due to the potential for disease recurrence. endstream x�}��N�@E�� This was a long time coming as both the […] New and exciting things were happening at this past EuroPerio9 held in Amsterdam from June 20th-23rd, 2018. Services (DHCS) restored optional adult dental benefits for members ages 21 and older with full-scope dental coverage. 56 0 obj<>>> For patients with chronic periodontitis, SRP showed a moderate benefit, and the benefits were judged to outweigh potential adverse effects. endobj Dental Hygienist’s Guide to Delivering an Effective Periodontal Program. ��k?���y ��.�U�Q3ͣ��zx��ϛL�y�ܖ�G2G7!���Dý��>�V�9(��b�ٽ�j{���Q2(�_Zv^�+��� �*T0T0 B�����f����� �� � endobj It thus attempts to establish some guidelines that practitioners may use when calculating recall intervals. endstream endobj Position paper: periodontal maintenance. �*T0T0 B�����f����� �� � J Clin Periodontol. 5 0 obj <>>>/Subtype/Form/BBox[0 0 567 756]>>stream 69 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/CropBox[6 3 561 750]/Annots[45 0 R 46 0 R 47 0 R 48 0 R 49 0 R 50 0 R 51 0 R 52 0 R 53 0 R 54 0 R 55 0 R 56 0 R 57 0 R 58 0 R 59 0 R 60 0 R 61 0 R 62 0 R 63 0 R 64 0 R 65 0 R 66 0 R 67 0 R]/MediaBox[0 0 567 756]>> by Karoline Biami, RDH. 48 0 obj<>>> endobj January 2005. 66 0 obj<>>> Although systemic subantimicrobial-dose doxycycline and systemic antimicrobials showed similar magnitudes of benefits as adjunctive therapies to SRP, they were recommended at different strengths (in favor for systemic subantimicrobial-dose doxycycline and weak for systemic antimicrobials) because of the higher potential for adverse effects with higher doses of antimicrobials. endobj endobj x�+�r endstream A 3-4 month Periodontal Maintenance Therapy Appointment/Recare is a Soft Tissue Management Program that is a non-surgical approach to Control Periodontal Disease. w����.������d� q*pMR��3��K��EnY�"��֭"9պX�:��A�o$sE���L� ZģM�G"�*ͳ9yv��`�V�c��̧���߮}3��y$� This method saves a patient money as a prophylaxis is typically 100 percent covered, whereas periodontal maintenance may be covered partially or not at all. Recommendations for the other local antimicrobials (doxycycline hyclate gel and minocycline microspheres) were expert opinion for. x�+�r 12 0 obj <>stream �*T0T0 B�����f����� �� � 16 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/CropBox[6 3 561 750]/MediaBox[0 0 567 756]>> 18 0 obj <>stream x�+�r �*T0T0 B�����f����� �� � endstream endobj endstream endstream �26S072PI�r � endobj 6 0 obj <>stream 38 0 obj<>>> endobj Periodontal Maintenance and insurance. x�+�r x�+�r 40 0 obj<>>> x�+�r endobj Active periodontal treatment aims to reduce the inflammatory response, primarily through eradication of bacterial deposits. 41 0 obj<>>> CDC provides the following recommendations for proper maintenance of ventilation systems and patient placement and volume strategies in dental settings. 34 0 obj<>>> �26S072PI�r � x�}�� 7 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/CropBox[6 3 561 750]/MediaBox[0 0 567 756]>> endobj endobj endstream endobj Your patients may not know the difference between a routine cleaning and periodic periodontal maintenance. endstream 46 0 obj<>>> 55 0 obj<>>> Sometimes dental offices alternate using the periodontal maintenance code and the prophylaxis code with patients who have a three-month recall. x�+�r 47 0 obj<>>> However, due to concerns expressed by clinicians to the ADA CDT code com-mittee, a clarifying statement was added to allow dentists to judge how each pa-tient is maintained. �26S072PI�r � 11 0 obj <>>>/Subtype/Form/BBox[0 0 567 756]>>stream dental implants. 30 0 obj<>>> treatment, results, and recommended follow-up are essential, starting with the initial examination and continuing for as long potential complications, or … x�+�r 32. 39 0 obj<>>> endobj 27 0 obj<>>> 64 0 obj<>>> 58 0 obj<>>> endobj Explore CODA's role and find accredited schools and programs, Learn about the examinations used in licensing dentists and dental hygienists, Learn about recognized dental specialties and certifying boards. Preshaw PM, Heasman PA. Periodontal maintenance in a specialist periodontal clinic and in general dental practice. The purpose of this paper is to provide an overview of the role of periodontal maintenance procedures in the treatment of periodontal diseases. 19 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/CropBox[6 3 561 750]/MediaBox[0 0 567 756]>> Together. endobj 31 0 obj<>>> endstream endstream 9 0 obj <>stream 4. |: �*T0T0 B�����f����� � � This brochure explains that periodic periodontal maintenance appointments are different from regular cleanings and are necessary to help keep gums healthy and allow them to heal from gum disease. 14 0 obj <>>>/Subtype/Form/BBox[0 0 567 756]>>stream Access cutting-edge continuing education courses, Find evidence to support your clinical decisions. �26S072PI�r � x�+�r endstream �26S072PI�r � American Academy of Periodontology. endobj Regular maintenance is recommended at least every 90 days in contrast to Prophylaxis for a healthy person, which is generally only recommend twice a year. (;>����= x��S��l�fz�{Bv�|��s�Nz���q�}2�6��`y��,��>/#֋���������4�� ���D�(�����/)��)Y�%�s%~T;���t�*�?��(��(Ls�&%�U��~R������y��w�� ��˥�����̞F�H|Da�i�:��w8��6N��S�~�����O���������m�ד�p'�;��=!`iX.������W�}���*�ƘQ�PL��_U��p�:vď�ދ��D��+9�����&��d����A�"�Z�S��Ԍw5�dv�%�����:����'a�mx����ًh����/Φ��-I#���܆��{(�`8xP�j��L��LQl�0��5�8���4)���� :�Ubg�ӪN�_f�A��N��E�R��`���uAd���g���I�� �P�>H�u8��z:3Q_+�Iu�"B1�"+mI�|z�ꪛ�m� �;������U�B�Z��F�����S)J�7���u=M�3Q �c������`�j�k'���e`!���d�h[Ϊ3�NUA�8BTb��=�r����r��`��܈%v����)�833b~�i���$ ����eA���h��Qfp,P��i��``�Em�h�!��{8<. The American Academy of Periodontology (AAP) announced new periodontal classifications for the AAP Guidelines. Cohen RE; Research, Science and Therapy Committee, American Academy of Periodontology. 62 0 obj<>>> 60 0 obj<>>> endobj Position paper: periodontal maintenance. You also may have had periodontal surgery. 2 0 obj <>stream Principles of ethics and code of professional conduct. including limits related to the following dental services: Fluoride treatment Full mouth debridement Oral evaluations Prophylaxis Periodontal maintenance Periodontal scaling and root planing Sealant treatments Full-mouth or panoramic x-rays m��3a���EZ�N|��-�/�(eX���.��=��� endobj As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner’s professional judgment and the patient’s needs and preferences. endobj Periodontal maintenance includes localized, non-surgical procedures necessary to keep the disease under control. 5. endstream 36 0 obj<>>> 57 0 obj<>>> endobj 71 0 obj <>stream endobj 43 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/CropBox[6 3 561 750]/Annots[27 0 R 28 0 R 29 0 R 30 0 R 31 0 R 32 0 R 33 0 R 34 0 R 35 0 R 36 0 R 37 0 R 38 0 R 39 0 R 40 0 R 41 0 R]/MediaBox[0 0 567 756]>> 1 0 obj <>>>/Subtype/Form/BBox[0 0 567 756]>>stream Controlling periodontal disease adult Position paper: periodontal maintenance included periodontal maintenance scaling is needed maintain. 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