The following series of blogs will cover the different areas of dentistry. The aim is to
simplify and explain the jargon that patients encounter in the normal course of dental
visits. It is based on the Ontario Dental Association’s procedure categories and
descriptions.
Adjunctive services
As in any endeavour, there are always going to be procedures and activities that just do
not fit neatly into the usual categories. Adjunctive services are the rubric under which
our profession captures these in Ontario.
Emergency not otherwise specified
Occasionally there is an emergency that truly baffles our procedure codes. It is either
rarely encountered and/ or the intervention to handle it is , that a code describing it has
been seen as unnecessary to date.
Sometimes the code is used infrequently and has been deleted from the code list. Other
times the procedure codes have not caught up to the pace of change in the profession
and one has yet to be listed. Thus, we use this open ended descriptive code to cover it.
Unclassified tx, unusual time & responsibility; Management of exceptional patient
To state the obvious, all patients are different, with widely varying physical,
psychological and medical attributes. Sometimes, these specific needs require more
time and care than the usual. This specialized care may inherently have greater
responsibilities associated with it.
Since dental care is not a commodity like products at the supermarket, individualized
more involved care cannot be adequately described by the usual procedure codes. Yet,
to have descriptions for all possibilities is cumbersome and unrealistic. Hence we use
these procedure codes.
Anaesthesia
Since we had always been associated with pain, we dentists are the originators of
anesthesia. In dental practice today various forms of anesthesia may be available for
the unique needs of our patients. General practitioners and dental anesthesia
specialists use the same terminology as the medical community.
Each form of anesthesia has very specific requirements for use and the location where
it is used may vary from the hospital to the dental clinic.
General
Being put totally to sleep with your vital functions protected and maintained
artificially is referred to as general anesthesia. It is usually administered in the
hospital operating room.
Deep sedation
This level of anesthesia requires specialized training and monitoring during the
dental procedure. It is not as profound as general anesthesia, but it is managed
in the same manner.
Conscious sedation
Conscious sedation is a less profound form of anesthesia usually employed for
anxiety management in conjunction with local anesthetics.
Nitrous oxide is also known as ‘laughing gas’.
Oral sedation is generally a relatively short acting sedative oral
medication.
Nitrous oxide with oral sedation is a combination of medications requiring
more intense monitoring and supervision.
Parenteral conscious sedation is intravenous administration of the
sedative agent also requiring more intense monitoring
and supervision.
Non-pharmacological pain control and patient management
Numerous reasons belie the fact that not all patient issues and concerns can be
addressed with medications. Thus, dentistry like medicine, embraces alternatives. The
following have many years of professional recognition and utilization. As with the more
involved anesthetic utilization, they require professional training.
Hypnosis
Hypnosis may be used for physiological and psychological interventions
that range from anxiety to pain control and management. It is
collaboration between the patient and the clinician. It also has
application outside of the dental and medical context.
Acupuncture
A four thousand year tradition underscores acupuncture. It too ranges in
application from acute and chronic pain management to other uses.
Administrative and communication activities have procedure codes and of course
associated fees. These categories are self-explanatory so we won’t define them merely
list them:
Professional communications – other health care professionals, dentists
Legal letters reports opinions
Insurance forms
Extraordinary time spent on phone
Extraordinary office time with 3rd party
House calls
Office or institutional visits, expenses, missed or cancelled appts
Preparation as expert witness
Court appearance as expert
Forensic services
Identification systems bonded (ID tags bonded to children’s teeth)
Drugs/medications
Emergeny prescriptions
Emergency dispensing
Dispensing non-emergency medications
Injections, therapeutic
Bleaching
Aesthetics are an important component of our society today and dental whitening is the
start to improving one’s smile. We refer to whitening as bleaching.
Vital
- that is the tooth has not been root canal treated and process of
whitening takes place in the office.
Vital home - an office monitored take –home system is used with
custom whitening trays usually for the whitening agent.
Micro abraision – a system of removing stains from the superficial surface of
tooth enamel by abrading it mechanically or in combination with
chemical agents.
Tobacco use cessation services
Smoking is a risk to one’s health. Most healthcare providers are concerned and
recommend stopping. The habit is hard to break on one’s own. Dentistry participates in
aiding patients to stop.
Lab services
Modern dentistry is a highly technical field that requires laboratory work to support
today’s care. The list of treatment includes anything from mouth guards to implant
supported crowns, bridges and dentures. The work may be done either
In office or by a
Commercial laboratory.
Many treatments involve extra components, especially implant related treatments.
These are usually coded as Expenses along with the laboratory fee.
This ends our foray into the world of dentalese and treatment procedure codes. Should
things still be unclear, ask your dental care provider or contactus@ dentistry870.ca .