Insurance companies are particular with the protocol and coding for  procedures regarding cleanings.  A routine cleaning (prophylaxis, or prophy for short) consists of scaling and polishing (Code D1110). If a patient comes in with lots of tartar, or other periodontal problems, more than just a one visit prophy is needed.  This might be another cleaning (prophy), or periodontal treatment depending on how bad the findings are.  But if a person needs another cleaning because there was too  much for one visit, or because there are periodontal conditions,  the prophy code D1110 should not be used for the initial cleaning.  Here’s  where insurance gets a little tricky.  In this case, a Gross Debridement code (code D4355) must be used.  Then another cleaning under the prophy code, or if needed, the more aggressive root planing  code can be used.   However, unlike a prophy code, the gross debridement code falls under periodontal treatment  and may not be covered at the same percentage as the  prophy.

So, if you just need a routine cleaning- prophy (D1110)

If you need more than routine cleaning, Gross Debridement code (D4355), followed by either prophy  (D1110)or root planings (D4341).

Now with regard to insurance, the prophy code D1110 is considered a Preventive service ( typically covered at 100%) and is covered as such, but the Gross Debridement code D4355 is considered a Periodontal, or Basic service (typically covered at 75-80%) or in some case even a Major service (typically covered at 50%).

The link between music and health has been scientifically investigated in numerous medical disciplines.  Music has been used to help treat patients with pain, stress, and anxiety (sounds like someone going to the dentist, right?), and for conditions ranging from Alzheimer’s to Cancer.  Music is not the cure, but an adjunct to stimulate the mind and nervous system.  Music also has deep emotional connections.  So what does this have to do with dental health?

Well, for starters, we try to play upbeat music throughout the office.  Since everyone has different musical tastes, we offer wireless headphones and Pandora Music (you pick your own artist and a station is created with similar music). when you are in the chair.  It is easier  to work on a relaxed patient than a fidgety one.

The Grammy’s award music to a variety of artists.  I am not sure how many artists would welcome being told their music is played in a dental office,  nevertheless, many of the Grammy winners have found their way into the ears of our patients. From Rap to Rock, from Classical to Jazz, it all has been chosen by patients for their comfort.  I was glad to learn Mumford & Son’s won the album of the year. I know their music has a beneficial effect on me, and that might be important too, for no patient wants to face an irritable dentist!

There is increasing evidence that there is a link between periodontal disease and cardiac disease.  Whether the “C-reactive” proteins found in periodontal disease contribute to cardiac disease is still under investigation, but at the very least, it is in your interest to maintain periodontal health.  While we are the topic of cardiac health, here is something we can all do to help prevent heart attacks: ASPIRIN.

Dr. Virend Somers reported in the Journal of the American College of Cardiology that most heart attacks occur during the day, particularly between 6 AM and noon.  He also noted that  he suspects sleep apnea as the cause of those heart attacks that occur during the night. If you take aspirin once a day, take it at night when the aspirin is strongest in your system while sleeping.  The aspirin can help thwart a heart attack.  SInce aspirin loses it potency in the body after 24 hours (its half-life), it is still most potent while sleeping.

SO, AFTER BRUSHING AND FLOSSING, SCRAPPING YOUR TONGUE OF DEBRIS, AND USING YOUR APPROPRIATE ORAL RINSES BEFORE GOING TO BED, TAKE YOUR ASPIRIN!

February has been designated as National Children’s Dental Health Month by the American Dental Association. Early detection of caries (the cavity is the hole left after caries attacks the tooth) is posible with  a number of new and more senstivie technologies such as lasers and  digital radiography. Advances in fluoride toothpastes and fluoride vitamins and  preventive procedures such as sealants, have marked the delcine of cavities with children.  As always, proper home care, including brushing, flossing, approriate rinses, diet and nutrition,  and regular dental appointments contribute to the well being of children and their teeth.

On behalf of the office, we wish you all the Happiest of Holidays, and look forward to 2013.     Photo by Dr. Schonberg