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Fast Facts - WEIRD Facts on Prophylaxis Code Distribution

Fast Facts

Fast Facts: Perio Edition Episode 24
[Andrew Johnston, RDH]
Welcome back,  everyone. You are listening to another episode of Fast Facts- Perio Edition brought to you by A Tale of Two Hygienists in partnership with DentistRX. And now, please welcome your host, Katrina Sanders.
[Katrina Sanders, RDH]
Hello and welcome back to another episode of Weird Facts: Perio Edition, a discussion with your host, Katrina Sanders. Wait did she say that right? Weird facts? That's right! I'm going to be integrating a new segment from time to time called Weird Facts, where we're going to take a look at something that honestly is just weird, but something that we need to have a conversation about you guys, as clinicians!
So this week, we are following the information that we learned last week about the prevalence of diseases of the periodontium, and this week's Weird Facts is going to focus on the prophylaxis code distribution.
So it should be important to notate from last week that we reviewed the fact that about 47.2% of our adult patient population has periodontitis the irreversible form of a disease of the periodontium. 27.6% of our patients have moderate to severe gingivitis, the reversible, although inflammatory, condition that affects a disease of the periodontium and 3.2% of our patients are considered truly healthy, while the remaining 22% are considered incipient gingivitis.
Of course, this breakdown of numbers and the math behind it is all due, saluting my father, Bob Sanders, for helping me with that. So according to my dad, about 25.2 % of our patients are truly considered healthy or incipient patients. The remaining nearly three quarters of our patients have either moderate to severe gingivitis or periodontitis, meaning that if we are assessing, diagnosing, planning, implementing and subsequently educating our patients on this disease process, that three quarters of an average patient population within our practices should be treated with some sort of an advanced therapeutic treatment modality.
However, this week's weird facts come to us from a research study done by the ADA in 2016. And this research study looked at the distribution of the disease D1110 prophylaxis code. Essentially, the ADA wanted to understand how often is an adult patient across the United States treated with a prophylaxis code, a D1110 code versus any other procedural code in the dental operatory. So what they did was they took the dental claims that were submitted throughout the year and they categorized these dental claims into patient populations ages 19 to 30, ages 35 to 49, and then, of course, ages 50 to 64.
What we found was staggering and weird... First, in the patients age 19 to 30 for about 72.3% of those individuals were treated with a D1110 procedure code, meaning about 27.7% of those patients were treated with any other procedural code. That could be 4910 perio maintenance code. That could be a 4341, 4342, that could be the 4355 full mouth debridement code, but it should be noted that in this age category three quarters of those individuals on average were treated with a prophylaxis and about one fourth of those individuals were treated with any other procedural code.
As we move up into the next age category, patients aged 35 to 49, we now see that those individuals may start integrating some comorbidities that may elevate their risk for perio.
However, we found that in this age bracket, 87.5% of those patients were treated with a prophylaxis code, meaning the remaining 12.5% of those individuals were treated with any other procedural code. And finally, we move into the patients aged 50 to 64, now our academy tells us as our patients age, their risk for perio increases. So one would hope that we would start to see that we would integrate periodontal procedural codes in a greater population of these patients versus utilizing the D1110. However, as you may suspect in this age category, 95.4% of those individuals were treated with a D1110 prophylaxis procedural code, meaning the remaining 4.6% of individuals were treated with any other procedural code.
This has been weird facts with Katrina Sanders. My hope is that in sharing facts like this that it creates a greater awareness for the dental clinician about the responsibility we have to identifying disease, educating our patients on it and treating it while it is in its earlier stages. While, it is cheaper, easier, more pain free for us to treat. Have a great week!
Please feel free to reach me on Instagram @thedentalwinegenist or on my website Cheers.
[Andrew Johnston, RDH]
Thank you for listening to another episode of Fast Facts - Perio Edition, brought to you in part by DentistRX makers of the InteliSonic line of power brushes. Find out more by visiting their website at We'll see you next week for another Fast Fact!

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