Periodontics
Periodontics is the area of dentistry concerned with the prevention, diagnosis, and treatment of gum disease and supporting bone structures around the teeth. Treatments may include deep cleaning (scaling and root planning), gum grafts, and maintenance therapy.
How It Works
Periodontal care focuses on the gums and the bone that support your teeth, and it covers things like cleaning under the gumline, treating abscesses, and managing gum disease without surgery. Under Canada's Dental Benefit Act, periodontal services sit alongside diagnostic, preventative, restorative, endodontic, prosthodontic, and orthodontic care as services a dentist, denturist, or dental hygienist may lawfully provide. How a plan pays for these treatments depends on the insurer, which may classify periodontics as either basic or major restorative, with waiting periods sometimes applying to more extensive procedures. Some services, such as bonding for mobile teeth or post-surgical evaluations under the Canadian Dental Care Plan, need preauthorization before they are covered.
Example:
Imagine a member of Canada's Public Service Dental Care Plan who develops gum disease and is advised to have scaling and root planing. Because that plan caps scaling combined with root planing at a set number of units each calendar year, the dentist submits a predetermination so the member can see in advance how much will be reimbursed. In documented cases of periodontitis, additional units may be approved when a treatment plan is pre-approved, and the periodontal work is reimbursed at the plan's basic-services percentage once the deductible is applied.
What to Watch For:
Check how your plan classifies periodontics, since insurers may treat it as basic or major restorative and reimburse those categories at different rates, with waiting periods possible for more extensive work. In plans like the Public Service Dental Care Plan, scaling combined with root planing is limited to a set number of units per calendar year, and extra units in cases of periodontitis depend on a pre-approved treatment plan. When the estimated cost is expected to reach your plan's predetermination threshold, submit a treatment plan to your insurer before starting treatment, and remember that certain services require preauthorization to be covered.
