Thursday, May 24, 2018

Diabetic screening dental code

What is the diabetic screening dental code?

Diabetic screening dental code is D0411. It is new for 2018.

Diabetic screening dental code use.

We do not have an HbA1c monitor in the office but are considering getting one. From what I have read some plans pay for this but most do not. The cost is minimal though and we are considering using it for surgical patients as a screening tool, especially for dental implants.

The criteria we are setting up is to use it for patients over 40 years old who have not been see a medical doctor in over a year.

What does the diabetic screening dental code say?

D0411 says “HbA1c in-office point of service testing.”

Insurance payments for dental code D0411.

If anyone is submitting this dental code, please share what fee is being paid. Also how many plans are paying this. Thanks!

What devices test HbA1c?

The are many cheap options for testing HbA1c these days.

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Tuesday, May 8, 2018

Baby bottle decay and white crowns

How we fix baby bottle decay with white baby crowns

Baby bottle decay is a fairly common issue we see in very young children that drink juice from a baby bottle. It impacts the front four teeth the worst and can cause the the teeth be need a lot of dental work at a very young age.

So how to we fix baby bottle decay when it occurs?

When we see baby bottle decay on such young children we need quick action! It does not take long for these cavities to result in pain or even the need for removal! Besides the risk of pain and infection there is also the psycho-social aspects of not having any front teeth for many years. In the past metal crowns were the only option available. This lead to some kids being teased and picked on at school by others. Today we can use a completely ceramic crown that looks very real!

This stainless steel crown alternative is a zirconia pediatric white dental crown!

Sally’s story…

Sally was brought in by her mother when she saw brown stains on her daughter’s front teeth. Unfortunately these were not stain and we all decay. Sally was very young and Dr. Briney and her parents knew she needed something that looked like real teeth. They knew that young kids need to feel confident about their smile therefore they choose our white kids crowns for her treatment.

Baby bottle decay was fixed with white kids crowns.

White kids crowns on the front four teeth.

 

Sally is really happy and thinks her teeth look “pretty” furthermore her parents are very happy with the natural looking result.

Have baby bottle decay and need some kids white crowns?

If your child has baby bottle decay, we can help! Do you now want something that will look natural for the next phase of your child’s life? We will help you the same as we help many families in the same situation. Dr. Briney is our pediatric dentist and offers sedation for children too young to complete the work while awake. To learn more about Dr. Briney check out her bio! Finally, just give us a call if you have any questions or check out our pediatric white dental crown page or our youtube channel!

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Tuesday, April 10, 2018

Dental implant removal code

Dental implant removal code and dental implant removal cost

Dental implant removal code and dental implant removal cost tend to be something that dentists search for so my if you are not a dentist jump down to the bottom and read on the dental implant removal cost.

What is the dental implant removal code?

The ADA dental code for dental implant removal is D6100. This is a dental code that asks for a description. The exact wording in the 2018 ADA is, “This procedure involves the surgical removal of an implant. Describe procedure.” Not sure what description they want as the code seems pretty descriptive by itself. The may be other dental codes that you use with D6100. The most likely would be a bone grafting code. The bone grafting dental code to use is the same that you use when extracting a tooth, which is D7953.

Case I needed to know dental implant removal code for

A mini dental implant that needs removal

What does a dental implant removal cost?

This dental code does not get a lot of use, therefore I am not sure how accurate sites like fair health consumer is. However, they do have dental code D6100 so you can look up the dental code for dental implant removal. Since removal is so rare the thought of what to charge usually does not come up until the situation present itself.

The fees I have seen range from $450-$1000, but I think a lot of it should depend on the severity and circumstances of the case. Another recommendation I have seen is to charge 2x your surgical fee. This seems to fit with what my fair health consumer estimate is. We charge $615 for removal but that assumes straight forward case. That fee is about $300 less than the fair health consumer average for my zip code. Usually my practice is right at or above so it appears we’re doing this for cheaper than we should.

Need the removal of a dental implant?

If you have a dental implant that needs removal, we can help. Typically an implant that needs removal has bone loss and can be done relatively easily, if the dentist has the right tools. Since the right tools are usually owed by a dentist that places that kind of implant, it is best to find a dentist that uses the system of implant that you have. Many systems have specific attachment sizes and require specific tools. However, there are also bits that will remove anything, therefore it is not critical.

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Monday, April 9, 2018

High resolution dental veneers photos

High resolution dental photos of dental veneers

This page has our high resolution dental photographs so that you can see the detail of our work. This page will take longer to load because of the size of the files.

Dental veneers

Before and after photos of dental veneers and replacement of dental veneers.

High resolution of dental veneers that we replaced

Patient had 10 upper veneers placed that he was unhappy with. They were chalky, flat, and unnatural so we removed them all and made new dental veneers just on the front four. He was very happy with the natural look of these veneers.

Replacement of dental veneers

We replaced 2 dental veneers that were likely placed at a young age before the teeth had finished erupting.

Image of full mouth veneers.

Full mouth of dental veneers.

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High resolution dental implant photos

High resolution dental photos of dental implants

This page has our high resolution dental photographs so that you can see the detail of our work. This page will take longer to load because of the size of the files.

Dental implants

Matching a single central incisor is the most difficult thing to do in cosmetic dentistry. Before and after photos of dental implant crowns.

High resolution photo of a dental implant crown.

A single dental implant crown.

Single dental implant crown

Single dental implant crown

Image of a single immediate dental implant crown

Single immediate dental implant crown

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Friday, April 6, 2018

My dental implant fell out

My dental implant fell out!

My dental implant fell out is something we hear from time to time from a patient after we put in a dental implant. Almost always that is not exactly the case.

My dental implant fell out!

Typically when a patient calls to tell us this, something other than the dental implant falling out is what is actually going on. The first thing we really want to see is a photo of whatever it is that came out. In order of things that I have personally seen patients call and say, “My dental implant fell out!” are

  • The healing abutment is without question the number one thing that patients call about when saying “My dental implant fell out!”
  • The rest of these are much less common but the abutment screw is one we have had patients call about.
  • Patients also occasionally call when a blood clot or our perio pack fall out.
  • Finally, probably the least common thing patients call about is the actual dental implant falling out.

The healing abutment is what the patient is calling and saying my dental implant fell out

This is common. I don’t know exact percentage but I would guess around 5% for me. This occurs for several reasons and we can limit the percentage by tightening with our torque wrench. I personally do not use a torque wrench for this but many do. Another reason this occurs is the healing abutment is not fully down all the way because it is tight against bone or tissue. Eventually as the healing process begins the bone and tissue change and the healing abutment loosens.

My dental implant fell out!

Healing abutments are the most common thing to fall out. Their size and shape varies from company to company but most look fairly similar to these two.

The prosthetic screw is what they mistake for the dental implant.

This does not happen often because the the whole abutment would come out as well but in some cases it is possible for just this to come out. The prosthetic screw attaches the abutment to the dental implant, I know that is probably too technical, sorry! Anyway, here is a picture of a prosthetic screw looks like. They are all very similar and very small.

 My dental implant fell out

Prosthetic screw not a dental implant

The loss of the perio pack is what we sometimes see patients calling in about and saying my dental implant fell out.

This basically looks like a bloody clot. There are different versions of perio packs and they look different. I’m not going to show this cause they look like a bloody ball of slime.

My dental implant fell out – yes it really is the dental implant!

If this happens it is a real bummer! This does happen but it is rare. I have seen plenty of failures but it is unusual that a dental implant actually falls out and the patient brings it back. I have only seen it once (well it actually happened twice on the same individual). We made him a dental bridge!

When the dental implant fell out

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Tuesday, April 3, 2018

Too young for dental implants

What is too young for dental implants?

Too young for dental implants? What are the age limitations for dental implants?

Who is too young for dental implants?

This is a question we sometimes hear from patient’s parents and the answer is it depends! The short version is we can place the dental implant when the individual stops skeletal growth, as it turns out his never really stops in the jaw bones but I will touch on that more later. We often state the minimum age is 18-20, however if we can wait until mid-twenties I feel that is safer.

It was once our believe that once the child stopped growing vertically we were fine to move forward with dental implants. However, many cases and a lot or research is showing that late jaw bone growth is common and we have continual movement and growth of out jaw bones throughout life. Unfortunately, a dental implant acts like an ankylosed tooth, in other words it stays in place and does not move with bone growth the way teeth do. This creates a potential for functional and esthetic issues.

In a fantastic lecture seen here from Bahat, you can see what happens to dental implants over the years. They stay put and the teeth move down creating a look of teeth that are too short and do not hit together when biting. It is unknown at what age this patient was but I am guessing she was young.

What is too young for dental implants?

What can you do for someone who is too young for dental implants?

There are several options to temporarily close spaces while waiting for growth to finish. These options are in our alternatives for dental flipper page.

What happens when we place a front dental implant on someone that is too young?

This is far easier to show than to tell, but basically it appears that the crown has sunk into the jaw. In females the tooth may also look too far forward. This is because there is differences in how make and female bone growth occurs. The example shown above is a great example. In reality the bone continues to change and teeth continue to slowly erupt. This leaves the dental implant behind and it’s crown therefore appears shorter. Cases of this can be seen in literature and on dental blogs like dentaltown.

Video on when is too young for dental implants – hint we never stop growing so never totally save!

So is there ever an age where we can guarantee that someone is no longer too young for dental implants?

The short answer to that is NO! The same issues can occur later in life but at this point we can not predict who it will occur to. For instance the case seen below also from Baht’s lecture is someone that I assume is much older based on amount of dentistry they have. I will add that this situation is likely very rare. I have never seen it in my practice and likely have a thousand or more implants in our practice.

Image of patient that had a dental implant too young?

This patient was not too young but had the same growth issue! This was only 2 years apart!!

 

Criteria that helps determine if the patient is too young for dental implants.

Besides age and skeletal growth there are a few other issues that may help us. Even though cranial facial changes occur throughout life they very from person to person. The most prominent changes occur on individuals with long and short faces, so be aware of those people.

More information on dental implant issues including late growth issues can be found on our blog on dental implant problems.

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