Perio Maintanence

Supplies:
 Perio Kit
 Cavitron
 Patient Mirror
 Hygiene Bag
 Mouthwash

Pre-Appoinment:
 Date of Last Exam
 Date of Last Perio Cleaning
 Date of Last X-rays
 D4910 Code or D1110 Prophy Adult
o Why is pt on D4910?
o Is this a Transfer? If so, must do a transfer exam too

Appointment
 Grab patient and collect $50 (D4910)
 Review medical history, CC, and vitals
 Start check
 Perio chart with an assistant
o Recommend:
o 1-16 Facial16-1 Lingual
o 32-17 Facial17-32 Lingual
 Have faculty check and approve perio chart
o If line, request if you can begin cleaning in the meantime
 After check, begin cleaning
o This is a great time to review OHI and modify any current dental behaviors
 Have faculty check after cleaning and refine wherever requested
 Floss, Prophy, and Give patient Hygiene Bag
 Complete D4910 code and have faculty approve and dismiss pt

*Tip: any downtime, either ask if you can go to the next step, start filling out your
treatment notes/scheduling next appt, or just get to know your pt 