What is a Comprehensive Periodontal Evaluation?
In 2011, the American Academy of Periodontology published the Comprehensive Periodontal Therapy Statement, which recommends that all adults receive an annual comprehensive evaluation of their periodontal health.
A Comprehensive Periodontal Evaluation, or CPE, is a way to assess your periodontal health by examining:
- Your teeth
- Your plaque
- Your gums
- Your bite
- Your bone structure
- Your risk factors
When your dental professional, such as a periodontist, general dentist, or dental hygienist, performs this evaluation, they will look at these six areas to determine the state of your periodontal health.
Periodontal maintenance procedures (following active therapy). The definition from CDT-3 is: “This procedure is for patients who have completed periodontal treatment (surgical and/or nonsurgical periodontal therapies exclusive of D4355) and includes removal of the 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. Typically, an interval of three months between appointments results in an effective treatment schedule, but this can vary depending upon the clinical judgment of the dentist. When new or recurring periodontal disease appears, additional diagnostic and treatment procedures must be considered. Periodic maintenance treatment following periodontal therapy is not synonymous with a prophylaxis.”
According to this definition, true periodontal maintenance procedures follow active periodontal therapy such as root planing and scaling. The goal of active therapy is to remove as much subgingival debris as possible and disrupt/destroy the bacterial proliferation. The goal in periodontal maintenance is to debride the sulcular areas of attached and non-attached plaque pathogens.
If you have been thorough in your periodontal scalings, you would not expect to find much calculus at a three-month interval. Of course, there are exceptions to every rule, and there are some patients that produce significant new calculus in three months. However, that will usually be supragingival, not subgingival. I recommend that, after a patient has been through active periodontal therapy, all their subsequent recare visits be coded 4910, periodontal maintenance.