Child Dental Scheme T & C ‘s – Part 6 – Restorative Services

Metallic fillings or restorations, are usually amalgams. They may be “un-cool” fillings, but if moisture control cannot be achieved, such as with bleeding gums, then these fillings will work. The metal once mixed creates a new alloy which is self-sealing. They are wear resistant. It has worked for nearly 100 years and they last. There’s no point having a filling look nice if it’s going to fail! However the use of amalgams has declined, but when needed it’s good to have a useful alternatives.

• 88511-5 Metallic restoration – one to five surfaces – direct
  Limit of one (1) service under 88511-88515 per tooth per day.Adhesive fillings or restorations, are the “cool” fillings. These fillings are chemical adhered to the tooth, after some preparation. There are two major types of adhesive fillings: Composite resin and Glass Ionomer Cements (GIC). There are even combinations of these two filling types called Resin Modified GIC.Moisture control is very important for this type of fillings. They will leak if the preparation is contaminated especially with blood. They are much better than previous generations of these fillings.Composite resins are used for everywhere, and bond best to enamel, but do not bond as well to root surfaces which is dentine (the material under the enamel).

  GIC adhere best to dentine and not as wear resistant as composite resins. They are not suitable for heavy bite areas. However, as these materials can be bonded to each other as combination fillings to get the best of both worlds. GIC filling are often used for baby teeth. This material release fluoride as part of its chemical reaction as helps prevent decay.

  Both materials are set by a light. Some types of GICs set chemically and do not need a light.

• 88521 Adhesive restoration – one surface – anterior tooth – direct
• 88522-5 Adhesive restoration – two to five surfaces – anterior tooth – direct
• 88531 Adhesive restoration – one surface – posterior tooth – direct
• 88532-5 Adhesive restoration – two to five surfaces – posterior tooth – direct
  Limit of one (1) service under 88521-88535 per tooth per day.
  Limit of five (5) single-surface adhesive restorations (88521 or 88531) per day.
• 88572 Provisional (intermediate/temporary) restoration – per tooth
  A temporary filling is placed for there is not enough time to do a proper filling or the patient is uncooperative. Sometimes there may be or lot of fillings need to be done, so by doing some cleaning of the decay a temporary filling such as a GIC, which releases fluoride, can slow down the decay and allow a more time to carry out the treatment.

  Limit of three (3) per 3 month period.

  A benefit does not apply if a benefit has been paid for a temporary filling used with root canal items – 88411, 88414, 88415, 88416, 88417, 88418, 88421, 88455 or 88458 on the same day.

• 88574 Metal band
  This is used to hold a crack tooth, usually back, from splitting further. It can be used to diagnose a crack tooth as the pain on biting will go when the band is placed.
• 88575 Pin retention – per pin – is self-threaded into the dentine to help hold a large filling.

  Limit of two (2) per tooth per day.

  Limit of four (4) per day.

  A benefit only applies if the service is provided on the same tooth on the same day of a service under item 88511-88535.

• 88576 Metallic crown – preformed
  This is a stainless steel crown cemented on a prepared tooth to restore a large amount of tooth loss in a baby back tooth. This provides very good wear resistant. The enamel in baby teeth is a poorer quality that adult teeth so larger composite resin fillings may not adhere or last.
• 88579 Bonding of tooth fragment
  Composite resins are used here to adhere a tooth fragment back. Generally a small fragment may work.
• 88597 Post – direct
  This is cemented in to a tooth that has had it root canal cleaned and sealed. Only a part of the root treatment is removed. The post provides greater support for a large filling.

  Limit of two (2) per tooth per day.

  A benefit only applies if the service is provided on the same tooth on the same day of a service under item 88511-88535

Next week: We mark passing our 200th blog article!