Deep Periodontal Cleaning: $225 per Quadrant

Cost of periodontal cleaning When we asked dentists about their average fee for one quadrant of deep perio cleaning, the answer was about $225.

"There is some abuse of this code, making it harder for our office to get reimbursement from third party providers," said a periodontist.

Not surprisingly, a periodontal cleaning costs somewhat more from a periodontist than a general dentist.

Dental lasers for gum disease

"Doing this in conjunction with a Laser gets better results." (California dentist)
"Laser is also included in the scaling fee, but if they have to return for additional laser, that charge is $120." (Illinois hygienist)
"RDT includes laser." (Illinois dentist)
"I recommend the Periolase for this type of treatment - better results." (Colorado dentist)
"$170 fee per quad for Laser Pocket Debridement; $30 fee for Laser decontamination at perio maintenance visits." (General dentist)

Periodontal cleaning fees

"It's easy money done in conjunction with quadrant dentistry." (District of Columbia dentist)
"There is room for adjusting that default fee - number of teeth, difficulty of patient compliance, etc." (Oklahoma dentist)
"We are priced too low for what we offer." (New Jersey dentist)

Coding issues

"Full moth debridement is only rarely used the way the code is written and is (ab)used by dentists as a code for a 'difficult prophy.' It is a code that should be changed or deleted." (Indiana periodontist)
"I do believe you need pockets to deep scale 4341 scaling in the presence of disease. Complex prophylaxis was eliminated years ago as an ADA code." (Wisconsin dentist)
"I am a periodontist and there is some abuse of this code making it harder for our office getting reimbursement from third party providers." (California periodontist)
"We need a code or severity grading of the 'prophy'... There has to be some indication of conditions somewhat between relative health and full-blown disease." (Maryland dentist)
"There is no descriptor or procedure code for 'deep periodontal cleaning.' It would be better to use the correct terminology, which is scaling and root planing, 1 to 3 teeth or 4 or more." (Texas periodontist)

Long-term treatment

"This may not be definitive care for a periodontal inflammatory periodontal response (acute or chronic) and is only of value in an overall treatment plan of reevaluation. Patient education with the goal of long term co-therapy by the practice and effective lifestyle changes and control by the patient of their own health is the goal. Identify and control the cause, repair the damage and restore the normal. Follow up with reevaluation, maintenance and intervention on site by site when necessary." (Ohio periodontist)

Sonicare toothbrushes

"With completion of 4 quads of SC/RP we give a Sonicare toothbrush." (Texas dentist)
"We also give our patients a Sonicare toothbrush and Perioguard with 4 quads of PSRP." (Illinois dental office worker)

The role of debridement

"Debridements are only done so that a perio evaluation can be made." (Ohio dentist)
"We don't scale/root plane by quadrant for patients w/'normal' perio pockets. We either root debride by segments, usually quadrants for patients who have diseased perio pockets ($275/hour), or we do periodontal maintenance ($119) for patients with controlled periodontal disease." (Maine dentist)

"Normal" pockets?

"You do not do SRP on a patient with 'normal periodontal pockets.'" (California periodontist)
"Normal periodontal pockets? No such a thing. A periodontal pocket is NOT normal." (Ohio periodontist)
"On a patient with 'normal' periodontal pockets we do not root plane-that is done on the initial scaling and root planing appointments. Fees for that procedure vary from $45/quad to $200/quad depending on number of teeth and severity of the periodontal disease." (North Dakota dentist)

Note: Survey sample included 127 respondents.