Current Dental Terminology (CDT) codes provide a standardized system for dental professionals to document and report procedures to third-party payers. This uniform language ensures consistency across the healthcare industry. Among the most common codes is D1110, which identifies an adult prophylaxis, the clinical term for a routine professional teeth cleaning. The D1110 code is assigned to patients typically aged 14 or older who have permanent dentition and a generally healthy periodontium, meaning they do not exhibit signs of active periodontal disease.
The Clinical Procedure
The adult prophylaxis procedure is a preventive treatment focused on controlling local irritational factors within the mouth. The process begins with a preliminary oral examination by the dentist or hygienist to assess the patient’s current dental health and identify any areas of concern. This initial step often includes a review of the patient’s medical history and current medications.
The core of the D1110 procedure is scaling, which is the precise removal of plaque, calculus (tartar), and stains from the tooth structures. This removal focuses primarily on the supragingival areas, the surfaces visible above the gumline, using specialized tools like hand scalers and ultrasonic instruments. Ultrasonic scalers use high-frequency vibrations and a water spray to efficiently dislodge larger deposits of calculus.
Following the removal of calculus, the hygienist performs coronal polishing to eliminate any remaining surface stains and residual plaque. This polishing uses a slow-speed handpiece with a soft rubber cup and a mildly abrasive paste to create a smooth tooth surface, which makes it more difficult for new plaque to adhere.
Standard Frequency and Preventive Value
The D1110 adult prophylaxis is generally recommended to be performed every six months. This standard frequency aligns with the time it takes for plaque and calculus to accumulate and begin causing irritation to the gums. The six-month interval is intended to interrupt this cycle of accumulation before it can progress into more serious conditions.
Professional cleanings help prevent the onset of gingivitis, a reversible inflammation of the gums caused by bacterial plaque buildup. By removing the calculus, the prophylaxis helps maintain the health of the gingival tissues. Regular D1110 appointments also allow for the early detection of issues like dental decay, fractured fillings, or small changes in the soft tissues that require intervention. Maintaining a healthy mouth has implications for overall systemic well-being, as chronic oral inflammation has been linked to other health conditions.
Insurance Coverage and Financial Context
The D1110 code is classified by most third-party payers as a preventive service. Due to this classification, dental insurance plans frequently provide coverage for this procedure at a high percentage, such as 80% to 100% of the cost. Many plans waive the annual deductible for preventive services, meaning the patient often has no out-of-pocket expense.
A common limitation across dental insurance policies is the frequency of coverage for D1110, which is typically restricted to two cleanings within a calendar year or a 12-month period. Some plans may require a minimum time interval, such as six months, to pass between procedures for benefits to apply. Patients with a history of periodontal disease require a different procedure, such as periodontal maintenance (D4910), which is often covered at a lower percentage and may have different frequency limitations. Coverage details can vary significantly between specific plans, so verifying the exact terms with the insurance carrier before the appointment is advisable.