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Author
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Topic: what is this ?
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alison
unregistered
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posted 03-05-2005 07:02 PM
i went to the dentist 3/1/05 and got a cleaning . the office sent a bill already !! what is the exact definition for a " full mouth debridment " ???
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James H. Beaty, D.D.S.
unregistered
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posted 03-07-2005 09:46 AM
Alison- A full mouth debridement is utilized when a patient presents with extensive "build-up" on their teeth, making it difficult for the dentist to determine whether the patient's bone/gum tissue are healthy. The build up does not necessarily have to be visible, it can be below the gum tissue and yet quite extensive. The purpose of the procedure is to remove as much of the build-up as possible, to allow us to properly evaluate the supporting structures of your teeth. A "fine scale" appointment or root planing and scaling procedure is usually scheduled after debridement to accomplish final cleaning of the teeth. Debridements are common with patients that have not seen a dentist in quite awhile.
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Patty
unregistered
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posted 05-05-2005 01:09 PM
Dr. Beaty, You said, "A "fine scale" appointment or root planing and scaling procedure is usually scheduled after debridement to accomplish final cleaning of the teeth. Debridements are common with patients that have not seen a dentist in quite awhile." Is is possible this fine scale/final cleaning could have, might have, been done after the debridement? I just had this done on Tuesday and was under IV sedation for 3 hours.
Thanks,
Patty
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Jeffrey L. Wissot, DDS
unregistered
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posted 05-05-2005 06:01 PM
Patty, if I may interject: Three hours under sedation was more likely a thorough subgingival (below the gums) scaling and debridement than a "fine scale."Please visit: http://www.dentistry.com/perio.asp
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Roberta
unregistered
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posted 06-03-2005 02:24 PM
Hi Alison,
Are you paying full price for your dental work? If you are you might want to check out www.myfamilybenefits.info
You can save 25-80% on your dental needs. Let me know what you think!
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Marilyn
unregistered
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posted 06-23-2005 08:14 AM
Dr. Beaty,I am a bit confused. On the Full Mouth Debridement page ... you state, "The purpose of this debridement, or gross scaling, is to clean the teeth up enough to evaluate the underlying support for the teeth (bone, ligament, and tissue). If, at that time, it is deemed necessary, root planing and scaling may be recommended to treat active periodontal disease." IF that is the case, why would a new doc (1st/emergency visit) propose as Treatment Plan to have Full Mouth Debridement AND Peridontal Scaling & Root Planing?? Along with bitewings, a panoramic film was taken. It seems, since they've already decided Scaling/Planing are needed ... that debridement should not be necessary?? ALSO ... for extraction of wisdom teeth which have fully grown out/extended (don't know proper terminology) ... WHY would they bill/classify it them "impacted - soft tissue"? They have been fully out for 5+ years; not impacted at all ... BUT, with this coding, it's $75 more per tooth. I feel as if a crime is being committed against me. Am I wrong in my feelings? If what this practice is doing is not standard/ethical ... I prefer to take my business elsewhere.
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James H. Beaty, DDS
unregistered
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posted 07-06-2005 05:48 PM
Marilyn-Full mouth debridement is for the purpose of evaluation. It is legitimate to desire to debride a patient's teeth prior to making a final decision for their treatment. I understand your concern, and certainly you have a valid point that debridement is unnecessary if the doctor has determined that periodontal therapy is warranted. It is possible that the doctor's office was looking ahead, thinking you might need root planing and scaling, and were attempting to be professional and provide you with an estimate prior to therapy (just a thought). As for the wisdom teeth, a fully erupted molar should not be classified as a soft tissue impaction unless flaps of tissue still cover portions of the anatomical crown of the tooth. I can't be sure of your situation, but these are legitimate questions to ask the doctor that is providing the treatment. If everything is on the up and up, the doctor should have no problem discussing the treatment with you. Good luck.
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Cindy
unregistered
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posted 07-29-2005 10:52 PM
My grown daughter got her 6-month cleaning ie "debridement" which she said was the SAME procedure as her last cleaning by a different dentist in another state, but the bill for the "debridement" with the new dentist was $115, and they now want to do the deeper cleaning. : ( ????
She has had good hygene and dentistry. Sounds fishy to us.
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Jeffrey L. Wissot, DDS
unregistered
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posted 07-30-2005 12:14 AM
If it sounds "fishy," get a second opinion. A periodontal exam (by a GP or a periodontist) would likely be appropriate.Please visit: http://www.dentistry.com/perio.asp
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janice
unregistered
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posted 08-22-2005 04:22 PM
I just got my bill for the second "cleaning" of my teeth. I have been under dental care every six months for years. I changed dentists and guess what...before I knew it the hygienist was calling out "debridement". My teeth have never had problems but guess what I had it done which meant my dental bill now covered two visits of which one was the debridement and the second which was billed as a cleaning was to polish them. I really feel taken.
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jim
unregistered
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posted 02-02-2006 03:06 PM
I think this is a scam. In the past I went to a dentist for the first time and they did x-rays, cleaning, and exam during the same visit and I didn't have out of pockets costs. I moved to a new city last year and didn't get around to the dentist for a year.All of the sudden, I have to do 3 appts. vs 1 and then pay $150 out of pocket for this debridement followed by another cleaning. I think all of the dentists are trying to stretch it out as much as possble so they can bill the insurance company. I always knew they never missed a chance to do an x-ray. Now that have come up with another scheme as well.
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Jenna
unregistered
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posted 02-03-2006 02:44 PM
Jim, dentists have to have X rays in the chart for their record and diagnosis. If you feel you are being scammed, perhaps you should get a copy of your x-rays and see another dentist. Just a suggestion.
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A Hygienist
unregistered
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posted 02-04-2006 11:33 AM
I wish offices would inform the patient about Full mouth Debridement/root planing with more detail to avoid conflict. As a patient ask the Hygienist/ Dentist to explain the process and possably show you x-rays and intra-oral pictures and any other ways to validate their findings. This procedure will usually have some out of pocket cost but FMD should not be a shocking amount. However the scaling root planing will be more of a cost. Every patient is different and no one really wants to hear that the need something such as FMD done. But in my experience I find that some of my new patients have just been having a basic cleanings by the previous dentist and not getting the correct treatment needed in order to please the patient(ie.. not removing buildup below the gumline or not having the patient in on a 3 month recall due to things such as maybe the patient has a systemic disease or elderly and unable to throughly take care of their mouth)If you trust you Dentist and Hygienist they wont do you wrong and will give you the proper treatment plan to keep your mouth healthy. As a Hygienist I am by law, obligated to perform the proper procedure diagnosed by the findings of your comprehensive exam. If I see a patient and they have periodontal disease and calculus throught the mouth and I do a "prophy" every 6 months and neglect to anything more to help this patients condition, I can get sued or lose my license when your teeth fall out from disease. You can always get a second opinion.
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Jeffrey L. Wissot, DDS
unregistered
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posted 02-04-2006 03:04 PM
Dear "Hygienist,"Thank you for a succint and well informed post. I'm sure you present complete information to debridement candidates in your practice and have valuable charts and/or photos depicting subgingival calculus and periodontal disease. The hygiene appointment is the most important visit to a dental office, with patient education at the top of the agenda! For more information, please visit: http://www.dentistry.com/perio.asp and http://www.dentistry.com/corner2.asp
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Florence
unregistered
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posted 02-05-2006 03:29 AM
How often should a dentist be doing a debridment? I have changed jobs several times in the last 3 years and every time I have to change to a new dentist (new insurance at each new gig) the dentist says I need to do have this done. Even though, I may have already had it done just a few months earlier. I floss and brush all the time. I have only had one cavity in my 30+ years... Can you please help me understand why I shouldn't feel that this is a scam?
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Jeffrey L. Wissot, DDS
unregistered
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posted 02-05-2006 10:56 AM
It may be over aggressive dentistry. Please see a periodontist for a complete periodontal exam and charting.You should obtain records from previous dentists of the periodontal chartings (standard practice before subgingival debridement). http://www.dentistry.com/perio.asp
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dr.nalini
unregistered
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posted 02-16-2006 03:34 PM
quote:
Originally posted by jim:
I think this is a scam. In the past I went to a dentist for the first time and they did x-rays, cleaning, and exam during the same visit and I didn't have out of pockets costs. I moved to a new city last year and didn't get around to the dentist for a year.All of the sudden, I have to do 3 appts. vs 1 and then pay $150 out of pocket for this debridement followed by another cleaning. I think all of the dentists are trying to stretch it out as much as possble so they can bill the insurance company. I always knew they never missed a chance to do an x-ray. Now that have come up with another scheme as well.
hello
im a denntist takng the california state board exam in march and i am allowed to take 3 patients for cleaning and fillings ,if u need second opinion i can screen u and also my professor will screen and will tell you exactly what u need.the entire treatment is free and i think this is the best plaace you can be .if you are intrested please reply me at nmonita@yahoo.com or call me at 951 279 7612.
thanks
dr.nalini.
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skeptical patient
Junior Member
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posted 08-21-2007 02:25 PM
I am skeptical of the "full mouth debridement" as I believe it has become a way for the entire industry to charge extra (and most insurance does NOT cover this!) for what used to be standard procedure. I have very good teeth (meaning no gum disease, only a couple fillings in wisdom teeth, and all 4 wisdom teeth fully in an functional). Back when I was younger (20s and childhood) dentists/hygenists USED to actually have to work to clean my teeth. This meant using elbow-grease and the proper scaping tools and taking up to 30 minutes or so to actually thoroughly clean my teeth. Now, the "prophy" process has turned into something more like a once over and a polishing. The dentists / hygenists don't want to work hard without getting to charge extra (they still get the money for the "prophy" from the insurance companies, but want extra for the FMD. Its a crock, and the industry has given into the "law-suit" mentality where the hygenist can "lose her license" when she does not do a FMD (too lazy to do the old fashioned cleaning) and the patient develops a problem.
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nicole v
Junior Member
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posted 09-06-2007 12:44 PM
I have to agree. Something has recently changed. I have been going to the dentist since as far back as I can remember (im 34 now). Always having routine cleanings and exams at least once a year, usually every 6 months. I recently visited a new dentist and was told I should have a full mouth debridment. They said that they couldnt do a routine cleaning because "it wouldnt do anything unless the debridment is done". So I went ahead and had it done because I care about my teeth. It actually didnt take long at all and seemed to be less invasive than the cleanings that I have always had. But I walked out $205 poorer. After the $160 FMD fee and some antibiotic mouth rinse that was a whopping $45 a cupful. Im not saying that I didnt need my teeth scaled some like usual. But it seems that now a routine cleaning is just a polishing. So it does seem like things have changed and the insurance companies need to catch up with what is going on at the dental office now.
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steve2967
Junior Member
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posted 10-08-2007 05:25 AM
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AdamsGifts
Junior Member
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posted 02-12-2008 04:53 PM
I just recently changed my dentist. I saw my new dentist today for the first time. I had crowns put on my lower front teeth recently. I have excess cement that oozed out from the back of the crowns. The dentist wants to perform a full mouth debridement on me. He said that I had excess build up. I tried to explain what I thought it was and why I changed dentists. My previous dentist tried to clean off as much of the cement as he could. I told him that it wasn't enough that my tongue was getting cut on the back of my teeth. He told me that I would have to train my tongue to stay away from this area. I agree with some of the other posts. I think this is a new way for dentists to pay their tuition bills.
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lmabadie
Junior Member
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posted 04-07-2008 09:52 PM
The code D4355 "Full mouth debridement to allow and Oral Evaluation" is probably the most improperly used dental code. It is simply a way dental office use to by pass the lower fees for D1110 "Prophylaxis" which, since CDT-2004 shall be used for scaling of tooth structures (no longer coronal plaque only) and thus applicable above and below the gumline, for healthy gums and also when gingivitisis is present and for low or large amount of plaque... unless an oral exam is NOT POSSIBLE. Only then a FMD is applicable.
My advise, if you are told you need a FMD, go somewhere else, unless you have not been in the dental office for 10 years and have poor hygiene.
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kkowalsky
Junior Member
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posted 04-23-2008 12:10 PM
quote:
Originally posted by lmabadie:
The code D4355 "Full mouth debridement to allow and Oral Evaluation" is probably the most improperly used dental code. It is simply a way dental office use to by pass the lower fees for D1110 "Prophylaxis" which, since CDT-2004 shall be used for scaling of tooth structures (no longer coronal plaque only) and thus applicable above and below the gumline, for healthy gums and also when gingivitisis is present and for low or large amount of plaque... unless an oral exam is NOT POSSIBLE. Only then a FMD is applicable. My advise, if you are told you need a FMD, go somewhere else, unless you have not been in the dental office for 10 years and have poor hygiene.
I would love to quote you if I may. I have a web site or help to educate people on what they should expect to pay for different dental procedures (as well as selling discount dental plans!) and I'm often asked what's the difference between a regular teeth cleaning and a full mouth debridement.
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kkowalsky
Junior Member
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posted 04-23-2008 12:23 PM
BTW, what's up with calling a simple procedure like a teeth cleaning "Prophylaxis"? All it does is confuse those people who, unfortunately, don't go to to the dentist very often, if ever.Kenn Kowalsky
Webmaster, www.DiscountDental4u.net
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