/BaseFont /Times#20New#20Roman,Bold If this happens, it is usually because they were already loose or attached to unhealthy tooth. 0000004139 00000 n 3. NEW PATIENT ASSESSMENTCO & HPC:Perio Bleeding/Loose teeth/Halitosis/Bad taste/Difficulty eating/Sensitivity/Pain/Swelling/Gum boils/Aesthetics/Anything else. The colonies cause irritation and inflammation, which create an . PATIENT LOGIN. Scaling and root planing has been recommended to clear away the toxins stream Pain and soreness: Periodontal surgery is oftentimes followed with substantial pain and soreness in the gums and bony tissues. xYyxTU?*K%%UR! All rights reserved. /Linearized 1 It is essential . The dates of active therapy should be included on the claim form. 0000001341 00000 n stream /FontWeight 700 ARESTIN (minocycline HCl) Microspheres, 1 mg targets periodontal bacteria to fight infection. >> /FontName /ASJHEV+Times#20New#20Roman,Bold /Subtype /Type0 /ItalicAngle 0 Periodontal maintenance is usually necessary for patients who have been diagnosed with and treated for periodontal disease. >> Updated January 03, 2023. The most important factor, however, is how dedicated you are togood oral hygieneat home. Check with local city government as to whether any local minimum wage ordinances may apply to employees in your practice. 0 /FontWeight 700 According to the AAP, the goal of maintenance is to minimize the progression of periodontal disease in patients previously treated for gingivitis and periodontitis, to reduce tooth loss, and to increase the probability of locating and treating any future disease. /Type /Font /O 156 For practical purposes, the perio-maintenance appointment might follow a consistent format utilizing four effective chart forms or computer screens. The success of periodontal treatment is multifactorial, but your role is central and crucial in maintaining low plaque levels in the mouth, as well as managing . I realize that this disease may be painless If you're ready to learn more, call 858.679.0142 or schedule an appointment. /Ascent 905 Let's look further at these three important fundamentals. endobj << Benefits discussed included improving the lifespan of the teeth by reducing periodontal pockets and preventing progression of the condition. Maintaining regular periodontal cleanings is essential. An overview of the Cal/OSHA requirements for a dental practice to have an air compressor/tank permit. Explained referral to specialist might become appropriate. Periodontal maintenance aims to spend time cleaning in and around these areas to regularly maintain stable bone and gum tissue. endobj >> /MaxWidth 2558 27 0 obj They will then provide you with a personalized maintenance program of care to keep your gums healthy. /Supplement 0 There are three variants; a typed, drawn or uploaded signature. The following are items to include in a dental consent form:. This is a written form that gives authorization, by the patient, to allow their dentist to proceed with treatment. Enter your official identification and contact details. for periodontal treatment for periodontal disease. 800.232.7645, About California Dental Association (CDA). << Don't worry if you are prescribed periodontal maintenance. I. The way to fill out the All on four consent form on the web: To start the form, utilize the Fill camp; Sign Online button or tick the preview image of the blank. Periodontal maintenance refers to a procedure carried out to clean your teeth thoroughly. Follow. To ensure that the patient gives informed consent, this form should be comprehensive - summarizing medical issues, proposed interventions, and risks. 23 0 obj Assists with drafting specific break policies for your practice that are compliantwith California laws. Answers to members top questions about physical distancing, patient screening, the use of face coverings, and other COVID-19 prevention requirements. This resource provides a detailed list of contacts and appropriate processes to follow. For each template, the name, note text, and quick-picks are provided. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> We strive to provide a superior dental experience from our modern office to our state-of-the-art technology. 2023 Endeavor Business Media, LLC. Periodic maintenance treatment following periodontal therapy is not synonymous with a prophylaxis.". startxref hbbd``b` ]$8 V a&H #1? An updatable medical and dental history form. Please don't hesitate to contact us or . Follow the step-by-step instructions below to design your periodontal charting pdf: Select the document you want to sign and click Upload. /FontDescriptor 27 0 R https://www.linkedin.com/showcase/4000114/, 182485813 / Inflammation Info723783 | Dreamstime.com, Inflammation: A major link between oral and systemic diseases, Ancient remedies: Some healing secrets for dental pain have withstood the test of time, Nonsurgical periodontal therapy to extinguish inflammation seen in rheumatoid arthritis, Untreated periodontitis and COVID-19? READ NOW. If untreated, it leads to the loss of teeth. Importance of Periodontal Maintenance. xF)v]mkP4n3Ft8.NDd)i)uJ*vrI+!i}RvjE)p-R~]]|]Q}\] I consent to photography, filming, recording, and xrays of the procedure to be performed for the advancement of implant dentistry, provided my identity is not revealed without my further permission. CDA Foundation. Encourage vaccination with this flyer from the CDC. Periodontal disease weakens . Warned pt of postop discomfort/sensitivity/recession and advised use of high fluoride toothpaste/Sensodyne. /XHeight 250 The action you just performed triggered the security solution. Patients who require D4910 follow-up care should receive as many per year as advised for appropriate treatment, regardless of insurance coverage. 0000000017 00000 n 17 0 obj <>/Filter/FlateDecode/ID[<8110606E9AF4CE82DD2E924B55789094><1C1F7876877C594098116BF1A91BF6A5>]/Index[10 18]/Info 9 0 R/Length 55/Prev 12599/Root 11 0 R/Size 28/Type/XRef/W[1 2 1]>>stream A recent CDC report 1 provides the following data related to prevalence of periodontitis in the U.S.: 47.2% of adults aged 30 years and older have some form of periodontal disease. Referral for additional dental treatment with a general dentist, other specialist or a physician may be requested as part of my treatment plan Periodontal treatment can result in, among other things, one or more of the following complications: pain, swelling, recedes from the teeth and pockets form. If you want to reduce your risk of labor litigation, its important you understand Californias meal and rest break requirements. Maintenance therapy is an ongoing program designed to prevent disease in the gum tissues and . Each are available in English and Spanish and available as PDFs for download. >> % Plaque is soft and sticky, and is continually forming. 333 500 500 278 278 500 278 778 500 500 500 500 333 389 278 500 500 722 500 0000001901 00000 n /MediaBox [ 0 0 612 792 ] Discussed the treatment options including benefits, risks, time and cost understood by patient and all questions answered. By signing this form, I am freely giving my consent to allow and authorize Dr. David Peterson and/or his associates to render any treatment necessary or advisable to my dental conditions, including endstream endobj 11 0 obj <> endobj 12 0 obj <> endobj 13 0 obj <>stream 3 0 obj I CERTIFY I HAVE READ AND FULLY UNDERSTAND THE TERMS AND WORDS WITHIN THIS DOCUMENT AND THE EXPLANATIONS REFERRED TO OR IMPLIED, AND THAT AFTER THOROUGH DELIBERATION, I GIVE MY x[K, _@U.4 d7,2@2-[};$$\n*?dIR]~O93vx3U>a?|B -Xp.'kq2(v)J{o&VP)}qr{k'wyguW?-4swiO%]DV&W^5jUm&D^^ www%=JuTdjrRGq7zp};I"/~!3la;4Zf:=3eSI[-SNb=d(_VdJx..#nCZk~AuZ> 6c 6|lq\&-e.\pLYL?q{$0yeW&(^ >`TiHPm;0;!$HUNd:mMx,u."[_b7qXw?6zv}W}imwv]d] This website is using a security service to protect itself from online attacks. 0000003716 00000 n 24/7 Answering Software; Webchat to text; Business Messaging; Reminders; Online Scheduling; Reviews; VOIP; Text Message Marketing; [ 250 0 0 0 0 0 0 0 0 0 0 0 250 333 250 0 0 500 500 500 500 500 0 0 0 0 333 Learn more about membership with CDA. There are two levels for appealing payment disputes: first with the plan itself, then with the appropriate regulatory agency. Pt explained more than 2 minutes is likely to be required to perform all oral hygiene measures. I fully understand . Part 3 of 3, Untreated periodontitis and COVID-19: What is the evidence? Special investigations:Radiographs: Are these available from the referring dentist? /Ascent 891 500 500 500 500 0 278 278 0 0 0 0 0 722 0 0 722 0 556 722 722 333 0 0 0 889 27 0 obj <>stream The information given to the patient in these circum- 0000016211 00000 n Explained initial course of root surface debridement and tailored oral hygiene instruction would be required. These include, among others, an update of medical and dental histories, radiographic review, soft-tissue exam, dental exam, perio exam, plaque-control effectiveness, removal of subgingival and supragingival plaque and calculus, removal of microbes from pocket areas, and tooth-polishing. 0000004524 00000 n Insurers usually will not pay for a D0120 charged out on the same day as a D4910. /ItalicAngle 0 regular dental checkups and cleansing after treatment is complete. /Flags 32 as well as periodic periodontal maintenance therapy after the proposed treatment at a dental office. Sacramento, CA 95814 TEXT US. This discussion should be documented in the patient record. )5xyP+%*~xld@f4bs@w|mb5uiZdPKB(y&&Sm.x.#p3~|NdNpFh@QWM#U YWH:@f4FIZP /Ascent 891 /E 69775 Tooth loss is inevitable. <> Periodontal maintenance (following active therapy) is considered to be an integral part of effective perio treatment. /MarkInfo << /Marked true >> Copyright 1996-2023 California Dental Association. Gloves Off: Can a nightguard kill a sleep apnea patient? /FirstChar 32 A dental patient consent form is used to get proper consent from a patient who is a minor before a dental can perform treatments. Informed Consent - Periodontal Treatment Patient Name _____ Procedure _____ I understand that I have periodontal (gum and bone) disease. Informed Consent Forms October 25, 2020 14450 Print Sample informed consent forms to aid in the face-to-face informed consent discussion between the dentist and patient. Medical condition? << /FontBBox [ -568 -216 2046 693 ] This consent form lists various treatments. Choose My Signature. There are at least three good tools for cleaning between the teeth, where most periodontal disease begins. /Filter /FlateDecode Periodontal maintenance is usually necessary for patients who have been diagnosed with and treated for periodontal disease.Maintenance visits to the periodontist can help to prevent additional dental problems in the future, such as further bone and tooth loss. A progress-notes form that includes all details of the appointment [For a complimentary sample of such forms, call (800) 548-2164.]. 0 722 556 0 667 556 611 722 722 944 0 722 0 0 0 0 0 0 0 444 500 444 500 444 /Type /FontDescriptor Each table below corresponds to a category of the clinical note templates. Attach a form with this information to the paper claim form or supply with an e-claim. Although bone loss is present, healthy gum tissue can stabilize oral health. Used with permissions from TDIC. 0 0 0 0 0 0 722 0 722 722 667 611 778 778 389 0 0 667 944 722 778 611 0 722 /BaseFont /Arial,Bold SbfFLUM&/kDGaRxq63e7*'eTcn zG. endobj No Guarantee: Laser Periodontal Surgery is similar to other periodontal therapies and is not guaranteed, but have over a 90% success rate in the first 5 years following LANAP therapy. 6. SH:Smoking /day x years (what substance is smoked?) The ADA defines periodontal maintenance procedures as "D4910-Periodontal Maintenance Procedures (following active therapy) This procedure is for patients who have completed periodontal treatment (surgical and/or non-surgical periodontal therapies exclusive of D4355) and includes removal of bacterial flora from crevicular and pocket areas, scaling and polishing of the teeth, periodontal evaluation, and a review of the patient's plaque control efficiency. <>>> 800.232.7645, The Dentists Insurance Company This month we feature the periodontal maintenance necessity form. It is an agreement by the patient, or a parent or guardian. /Pages 13 0 R 35 0 obj >> Patient complaints to state dental boards concerning differences between perio maintenance and standard prophys are on the rise. Services not covered by the patient's insurance should be paid by the patient. While it was expected that the 2000 edition of the ADA's Current Dental Terminology-3 book would change the description for D4910 to include a periodic oral evaluation (recall exam), this did not happen. All rights reserved. It requires the signature of the patient, and it should be a comprehensive form that covers risks, benefits, alternatives, and medical issues. Greater clarification from the ADA is needed and hopefully will be included in the next CDT revision, possibly in 2005. PARENTAL CONSENT FORM for Dental Treatment Post Op Instructions sheets for Extractions, Root Canal treatment, Fillings, Dentures, crowns and brigdes New Patient info and med history (pdf) Download Periodontal Disease is an infection of the gums and bone which if left untreated, will eventually destroy the support for your natural teeth. Emphasised need to be careful not to bite the lip or have anything too hot till the numbness has worn off. General consent is limited to a discussion regarding the performance of certain procedures that you're recommending for that particular patient. /CIDToGIDMap /Identity Periodontal Information Leaflet & Consent Form Some of the signs of periodontitis are: Periodontal treatment Bleeding gums Healthy Gums DO NOT Bleed Swollen and tender gums . ), Periodontal case type of at least Case Type III-Moderate Periodontitis (Be aware that the American Academy of Periodontology has changed reporting from "Case Types" to the "1999 Classification for Periodontal Disease and Conditions." Use our Consent Forms in Spanish. Consent and Aftercare Forms (2) See more; Clinical Forms . /FontDescriptor 24 0 R /Ordering (Identity) /BaseFont /ASJHEV+Times#20New#20Roman,Bold /Contents 42 0 R /S 83 INFORMED CONSENT FOR PERIODONTAL FLAP SURGERY . You can email the site owner to let them know you were blocked. << /Length 5 0 R /Filter /FlateDecode >> <> D4341 periodontal scaling and root planing Four or more teeth per quadrant D4342 periodontal scaling and root planing One to three teeth per quadrant Catherine Ha, DMD, PA d/b/a Carolina Dental Associates - 5400 S. Miami Blvd., Suite 116, Durham, NC 27703 919.941.5549 PERIODONTAL SCALING AND ROOT PLANING CONSENT FORM I understand that I have periodontal (gum and/or bone) disease. 10. 0000003940 00000 n 11. 31 0 obj 10 0 obj <> endobj 4 0 obj /Resources << /Font << /F1 23 0 R /F2 26 0 R /F3 29 0 R /F4 32 0 R >> /Lang (en-US) trailer I have been informed that failure to undergo periodontal treatment may lead to, but is not limited to: Loss of bone which supports teeth Mobility . <> Periodontal disease increases with age, 70.1% of adults 65 years and older have . Browse the forms in five different categories: Consent Forms Denture Treatment Endodontic Treatment Endodontic Treatment 2 Endodontic Treatment 3 - English Endodontic Treatment 3 - Spanish Extraction of Teeth 1 Extraction of Teeth 2 Extraction of Teeth 3 Extraction of Teeth - Spanish General Consent General Consent - Spanish For practical purposes, the perio-maintenance appointment might follow a consistent format utilizing four effective chart forms or computer screens. qE[T[-v*F XEFq m# (N`7B^bUGBJS /ToUnicode 39 0 R /Subtype /TrueType 20 26 A few carriers downcode payment to what they allow for a D1110-Prophylaxis-Adult. /FontDescriptor 36 0 R /Type /Font 0000000989 00000 n 0000003910 00000 n x\{ohl1\$R)(N'J:;*i3O"E}7s/_|IUu_3I2Y^IEr[W|Cr}Z$1Wrayfyk{M|:I30j"IX$|.j]L03n7q}ZE.A== =99eI,iT?$0^cw &xV1{DH.6WwG]U;Gy`cQru2a;d H|q". Maintenance is crucial as it prevents periodontal disease from spreading. /Tabs /S Apply a check mark to indicate the answer . endobj home care) and my availability for periodic periodontal maintenance (cleaning) visits (recall professional care). Bacteria produced by plaque may colonize on the gum tissue resulting in gingivitis and periodontal disease. << /Widths 28 0 R Periodontal Status Form, 8-1/2" W x 11" H, 100/Pkg . This is a summary and FAQ of the Dental Boards continuing education regulations. [ 34 0 R ] Pt advised that good glycaemic/blood sugar control is paramount to preventing progression of periodontitis.Smoking cessation? /Type /FontDescriptor %PDF-1.3 0000004221 00000 n 0000002943 00000 n Plaque distribution chart %Advice given to improve residual plaque deposits, patient motivated and re-demonstrated technique intraorally (shown in the mirror). 30 0 obj 34 0 obj endobj xc```b`` e`e``d@ A+* @e>Q4@U!q(f`f`fXQaWFo=kEMTTV\H], ?! A prophylaxis is not payable with periodontal maintenance (D4910) or full-mouth periodontal scaling and root planing when rendered on the same day. 0000011253 00000 n /BaseFont /ASJHEV+Times#20New#20Roman,Bold MH: Checked- see medical notesFH: Any family history of Perio? Instead, a periodontal evaluation was added. (Parameters of Care 2000 may be obtained from the AAP Web site, www.perio.org.) Sacramento, CA 95814 Used with permissions from TDIC. Because it is linked to serious conditions, gum disease should be treated as soon as possible. << Use this list to compare aspects of a QA review with your practice's policies and procedures, and be even better prepared for a future on-site QA review. /Parent 13 0 R Spanish Dental Office Forms. xref BENEFITS OF LANAP LANAP therapy is designed to eliminate or substantially reduce periodontally diseased gums and/or pockets to help control or prevent future periodontal disease progression. The toxins produced by these bacteria cause our bodies to destroy the bone that supports the teeth. Treatment Instructions General Pre & Post Operation Instructions Bleach Rinse Instructions Code D4910 usually will not be paid unless performed at least three months following active therapy (i.e., either periodontal surgery or D4341, Periodontal Scaling and Root-Planing. This formserves both as a notice that complies with the Dental Boards requirement and to obtain informed consent for teledentistry. CONSENT TO PERIODONTAL SURGERY Nicholas Toscano DDS & Michael Toffler DDS. Create Document. Each visit involves scaling, polishing, and your dental hygienist will also check the depth of your perio pockets. 167.86.107.28 What is Perio Maintenance? Obtaining general consent means that the patient has given you permission to proceed with treatment and released . While the D0120 may be appropriately reported, it usually will not be covered by insurance. /Length 6630 . Discussed the risk of post-treatment sensitivity of the teeth, explained this usually lasts for a few weeks but in rare cases may remain indefinitely if does not respond to treatment for sensitivity. >> KTVX! As a result of periodontal root planing and curettage: a. 8,9 The purpose of a rigorous maintenance schedule is to allow time for tissues to heal I have had an opportunity to ask any questions I may have in Toothbrush: Demonstrated modified Bass technique in the mouthTepe sizes chosen:Other aids: Flossettes? /FontFile2 37 0 R Advised to improve plaque levels to support periodontal therapyPatient shown how to use interdental brushes properly and advised sizes:Discussed referral to periodontal specialist. % /FontBBox [ -558 -216 2000 677 ] Handpiece Lubrication & Maintenance Handpiece Cleaner & Lubricant Caps & Nozzles Handpiece Cleaners & Lubricants Handpiece Maintenance System Adapters Handpiece Maintenance System Filters Handpiece Maintenance System Oil Pads . Emitrr talks about dental treatment consent for all types of treatment: Implant, Oral, Denture. 24 0 obj Periodically check local websites as rates in these cities could change at any time. Informed consent was obtained for the attached treatment plan." If a patient refuses recommended treatment and further refuses to sign an informed refusal form or the chart notes, this notation should be made: Patient refused recommendations for treatment of periodontal disease and also refused to sign documentation of refusal. The primary objectives of periodontal maintenance therapy are, Assessment of oral hygiene maintenance by the patient and elimination of local factors and plaque. /Group << /Type /Group /S /Transparency /CS /DeviceRGB >> This discussion should be documented in the patient record. Fo All rights reserved. 0000002671 00000 n Toggle navigation. Other side effects of treatment include pain, soreness, bleeding, swelling, bruising. If plaque is not removed, it can harden and form calculus (tartar) that can exacerbate the periodontal problem. /AvgWidth 427 Dentists are now required to complete one CDC-hosted training course instead ofthe previously required four courses. 1 0 obj I request and authorize medical/dental services for me, including implants and other surgery. 21 0 obj Your IP: >> 2023 Reena Wadia. /Outlines 14 0 R Emphasised that during treatment the gums may shrink back due to recession and so the teeth can look longer with gaps in between teeth/black triangles. (Advised to use CHX during treatment if gingivae acutely inflamed/sore warned against potential allergy and to immediately discontinue if any signs of allergy), RSD Quadrant/region:LA administered:Topical applied- (Benzocaine 17.9%) x 2.2 ml 2% Lidocaine hydrochloride + 1:80,000 adrenaline as ID block x 2.2 ml 4 % Articaine hydrochloride + 1:100,000 adrenaline as infiltrationsFull mouth supragingival debridement with ultrasonicRSD using hand instruments and ultrasonic scaler. endobj One of the most neglected areas in dentistry is that of providing patients with a detailed explanation of the treatment they will be receiving and the fees they will be charged. /StemV 47 /Type /Font 0000011958 00000 n >> Use this table to determine how long to keep business records such as payroll and employee records, patient records, EOB's and more. << /DW 1000 This cleaning and maintenance of the gums, teeth, and jaw bone, especially the areas that were affected by gum disease, keeps your mouth healthy and disease-free long term. 556 667 0 0 0 0 722 0 0 0 0 0 0 0 500 556 444 556 444 333 500 556 278 333 0 /ItalicAngle 0 The advanced tools of the editor will lead you through the editable PDF template. /FontName /Arial,Bold /Descent -216 hTmk0+~ F m%~Z_Hx/[XdI` cp983ppct9ppgB nnHRuR0("i]icsUKtYS/3dv\"!IU+`.-L3+Ve Performance & security by Cloudflare. @ ;Q@7m3cn; L*N7:vcYR79=s=wyUQ"u9wBu;>q"Gkm[rleWomX;D%->9+"T'. Mwde':3P=cN'J1hwj^3l1@Qh6$"smiCKHeobtSCuE{%@ J75EQ~A^F^eE? |?#zA_Ne>c0P6}Bktf4NT\4tOZ4~X mbi&=FYTGCvk&z-]h"MYT}}MvD4=t7_Q#x*2w\vst]Gh=BO:a Z@k\9"G~q0`~}ZME1+FE(iz>`l$nhE^mIg1I6RL~&zb|i=K9,ZGjK2#dgb-7EH9a >h} m |xI|jdn.| _FD=G{,YKdI}Gronr26m}DI6-Ikam#>d]) -Jw ,ilHUI7_ZhB-vG=faV|Ubu-=*'8D>o_"^xD]|OB~]37/. INFORMED CONSENT I have been informed I have periodontal disease. Securing general consent and informed consent will involve two distinct conversations. Contact her at (800) 548-2164 or visit her Web site at www.steppingstonestosuccess.com. << A typical maintenance visit for patients with dental implants should last 1 hour and should be scheduled every 3 months to evaluate any changes in their oral and general history. /Flags 32 I agree to follow my Doctor's home care instructions. Create your signature and click Ok. Press Done. Root planing smooths the root surfaces. Perio maintenance is the short way of saying periodontal maintenance. There are several actions that could trigger this block including submitting a certain word or phrase, a SQL command or malformed data. REQUEST APPOINTMENT. This for may be used for CFRA and non-CFRA medical leaves of absence or other requested accommodations due to a qualifying disability or serious heath condition. It is therefore important to ensure proper, thorough brushing and flossing on a daily basis to remove the plaque before it has the chance to solidify into calculus. k%`*wbQ;G?mKN1YttGZ mgIB`Whd;cM mqF{ ;)h0}6x(v=8 pB 6gYqVy w.oP NPQ$ ldeC%YR87ieLm7!|)j{~Eu& AI1K"88hbe$j|&*xGi6"@9lc/sU6fMT#j7+{}c78>CKa9Cat0Q6I9xkv`Y. % hb```e``` 9oT, bPX;TSX# ` Treating the disease in its early stages can help to save you from not only oral and overall health problems, but also money! /CapHeight 677 /FirstChar 32 I have been given a chance to ask any questions associated with not treating this disease. /CIDSystemInfo 35 0 R /CropBox [ 0 0 612 792 ] Short-term employees are considered employees by the State of California and require additional documentation. The disease process has been explained to me and I understand that it is caused by bacterial toxins (poisons . 45 0 obj 26 0 obj /LastChar 121 Insurers usually pay for two "cleanings" of any type per year, and they include D4910 under that heading. While these procedures are performed often, they are frequently misunderstood by patients, inadequately explained by staff members, and incorrectly billed to insurance carriers. Periodontal disease has also been implicated as having an effect on general health and an increased incidence of stroke, heart disease, diabetes, low birth-weight babies, and some types of cancer. Dr. Thu Versteegh has advised that the above named patient has a form of periodontal disease, peri-implant disease, and/or mucogingival conditions. It should be; Voluntary: The person either the parent or guardian giving consent hasn't been put under pressure. /AvgWidth 427 TREATMENT PROCEDURES * Oral hygiene/disease prevention . This dental procedure, with the code D4910, is an ongoing, therapeutic professional teeth cleaning performed on a consistent schedule after the completion of active periodontal treatment. (home care) on a daily basis and periodic periodontal maintenance visits at a dental office after the proposed surgical treatment performed.