Using CDT Code (D0180) Comprehensive Periodontal Evaluation – New/Established Patient:
A healthy mouth can be effectively determined by having a complete evaluation of the periodontal health. This consists of charting recorded for: pocket depths, bone level, bleeding, suppuration, furcation involvement, recession, mobility, clinical attachment loss (CAL) and overall health of the periodontium.
If probe depths, bone loss or CAL are 5mm or more the next step includes an assessment into whether scaling and root planing (SRP) is needed. This assessment needs to take into account the radiographic bone level, presence of calculus/bleeding and the CAL. If it is deemed the measurement is not a pseudo-pocket, the need for SRP is treatment planned and Periodontal Disease and etiology along with expected goals/outcomes must be discussed with the patient.
Along with non-surgical therapy (SRP) the possible addition of adjunctive local medicament's (Arestin, Peridex) should be evaluated for their assistance. The effectiveness of these additions should be based on scientific evidence-based research as well as your own anecdotal clinical findings of success.
I have found that trying to add Arestin to treat pockets that have measured 7-8mm or more even after effective SRP, has had a minimal effect on the pocket shrinkage. However I found overwhelming success with the addition of Arestin after effective SRP in pockets that measured 4mm-6mm.
So take the time to treat patients with quality care and provide them with the best and most effective products on the market. Happy Scaling!
