Canadian Dental Procedure Codes: A Comprehensive Guide - Insurdinary (2023)

From quadrants to tooth numbers, dentistry has its own mysterious language.

Industry-specific language helps dentists do their job. But when it comes to your teeth, you want to understand what's going on — especially when it's time to pay for your dental work.

Canada's universal health care system doesn't cover most dental procedures. Canadians pay for dentistry out of pocket or through private insurance.

But the truth is thatit's hard to find a Canadian plan that covers all dental costs. That means that after a trip to the dentist,you'll be paying for at least part of your dental bill out of your own pocket. And that means that you'll want to know exactly what the dentist is charging you for.

If you want to learn to speak the lingo of Canadian dental procedure codes, this guide is for you. Keep reading to learn what Canadian dental codes mean and how they differ among provinces. Most importantly, we'll explain why they matter for your dental insurance claims, and how you can avoid overpaying for dental fees.

Jump To:

  • What Are Canadian Dental Procedure Codes?
  • Canadian Dental Code Categories
  • Why Are Dental Codes Important?
  • How Can I Avoid Overpaying?

What Are Canadian Dental Procedure Codes?

The Canadian dental procedure codes are a system of categorizing dental services. Different countries use different systems to standardize their dental procedures. The Canadian dental industry uses this unique system to keep its services consistent across the country.

The Canadian Dental Association (CDA) develops and regulates this system. Every dental service has a unique 5-digit number. Canadian dentists use these codes to record their services, communicate within the industry, and bill clients.

This coding system gives structure to the Canadian dental industry. Without a standardized system, Canadian dentists wouldn't know exactly how to define or charge the work they do. It allows Canadian dentists to standardize their work.

It also allows governing bodies to regulate how dentistry is performed, and how much dentists charge for each service. Finally, it lets insurance companies decide how much of the cost of dental procedures they will cover.

The Canadian Dental Procedure codes are recognized across Canada. Each province uses slightly different codes, though they are similar enough for Canadian dentists and insurance companies to use consistently. However, Quebec uses a significantly different coding system.

Canadian Dental Code Categories

Let's take a look at the nitty-gritty of dental procedure codes.

There are over 1,300 unique codes (plus, the Canadian Dental Association introduces new codes all the time as new dental procedures emerge). There are also specialized sets of codes for dental hygienists, as well as dental specialists. That's a lot of numbers.

But don't worry: There's no need to get familiar with every single code. The Canadian Dental Association breaks down dental services into 10 basic categories. Each 5-digit code fits into one of these categories.

Diagnostic Services

Codes 00001-09999 refer to all dental services that diagnose diseases and problems. Dental exams start from 01011, which refers to dental exams for children up to 3 years old. They increase in price and complexity to in-depth exams for maxillofacial and dental problems.

This range also includes tests, X-rays and other photography,professional consultations, and making models of teeth such as dental casts.

Preventative Services

Codes 10000-19999 include services that prevent dental disease and maintain oral health. Since these tend to be the most common reasons Canadians visit the dentist, you'll see this range of codes most frequently.

In this range, you'll see regular services such as cleaning, fluoride treatment, polishing, and scaling. Less common services like oral appliances and nighttime retainers fall into this category as well.

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Restorative Services

Codes 20000-29999 include services that restore your teeth after damage. They may include tooth crowns (whether applying them or removing them to re-apply), and tooth fillings.

Tooth fillings have many different components, from the pin that holds the filling to the tooth's root to the visible core and crown. Each of these services has a unique code and can be billed separately.

Endodontic Services

Codes 30000-39999 relate to procedures that treat the live part of your tooth (including the nerve and pulp) rather than the bony enamel.

Root canals (removing the soft tissue and nerve from inside a tooth when it becomes infected) are the most well-known procedure from this service range. Children who still have their primary teeth can also suffer from pulp infection. In their case, they will have a pulpectomy (removing the soft tissue without the nerve) to keep the infection from spreading.

Periodontal Services

Codes 40000-49999 deal with corrective procedures to the gum and periodontium.

In periodontal disease, bacteria infect your gums and cause them to pull away from your teeth. To correct this problem, you may need periodontal services like in-depthteeth scaling and root planing.

Removable Prosthetics

Codes 50000-59999 account for insertion, removal, maintenance, and repair of removable dentures.

Dentures can be costly. Remember that these codes only account for the service costs for denture maintenance. The actual costs of dental prosthetics, such as partial or full dentures, aren't included.

Fixed Prosthodontic Services

Codes 60000-69999 include non-removable dentures and other permanent appliances. Services such as inserting, maintaining, and removing semi-permanent permanent retainers fall into this category.

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Oral and Maxillofacial Surgical Services

Codes 7000-79999 refer to reconstructive surgeries of the mouth and jaw. These may include inserting dental implants into the bone, reconstructive jaw surgery, and dental extractions (pulling a tooth). It can also include soft tissue surgeries such as biopsies and surgical gum reconstruction.

Orthodontic Services

Codes 80000-89999 include dental services that adjust tooth spacing without surgery, especially inserting, adjusting, and removing braces. This includes traditional wire braces, as well as newer appliance types such as aligners and spacers.

Adjunctive General Services

Finally, codes 90000-99999 refer to miscellaneous services not covered by other categories. They can range as widely as court appearances to botox administration, as well as general anesthesia for dental surgery, tooth whitening, and professional consulting.

Single and Multiple Units

The last digit in a code often refers to how many units of that service you received. For instance, the dental code 11111 refers to 1 unit of scaling (scraping plaque buildup from your teeth).

A "unit" of scaling means the amount of scaling that the dental hygienist did in 15 minutes. If it took 30 minutes to scale your teeth, you would be charged for 2 units of scaling instead. The code for 2 units of scaling is 11112; the code for 3 units is 11113, and so on.

Why Are Dental Codes Important?

To your dentist, Canadian dental procedure codes are professionally useful. They standardize their work and make it possible to bill efficiently.

But to you, they're important because they determine how much you pay for your dental work.

As Canadians know, there are some excellent full-coverage insurance plansout there that will cover your dental costs. However, insurance usually covers most, not all, dental expenses. That means even if you have insurance, you'll likely pay some dental costs out of pocket.

But how much will you pay? Canadian dental procedure codes have the answer.

Dental Codes and Insurance

When you look at the invoice your dentist's office issues, you'll see the services you received along with their 5-digit dental procedure code.

For instance, you'll see something like:

  • 11111: 1 unit of scaling
  • 02112: 2 radiographic images

They'll be listed along with the amount that the dentist is charging you for each service.

Many insurance plans cover a fixed amount for each standardized service. Most commonly, they cover the amount that your province suggests that those standardized services are worth. That amount is determined by your province's dental fee guide.

Provincial Fee Guides

Every Canadian province and territory has its own Dental Association, and each provincial association issues a fee guide for the dentists who work inthat province. This is a guide that states how much a dental procedure is worth under normal conditions, and sets the norm for the prices that all provincial dentists use.

By listing every standardized dental procedure by its code number, the fee guide suggests how much each dentist should charge for those procedures.

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Dental Fees Vary

While your province's dental association issues a suggested fee amount for every service in the Canadian dental procedure code, the final amount that you pay for a service is up to your dentist.

Dental practices are private businesses. That means they are free to charge as much or as little for their services as they choose.

For example, if your provincial fee guide suggests charging a $45 fee for a service, your dentist may charge $40, $50, or whatever they choose.

But your insurance provider usually only covers the suggested fee for a dental procedure. In the example above, your insurance may cover the suggested fee of $45. If your dentist charges $50, you will end up paying the difference out of pocket.

Of course, dental procedures can be much more costly than this example. Braces, prostheses, and surgeries can cost hundreds or even thousands of dollars, and the difference between the suggested cost and your dentist's actual cost can be proportionally larger. That means you can end up paying a surprising amount for your dental work.

How Can I Avoid Overpaying?

Being able to interpret your dental codes helps you understand the world of dental lingo. But with so many Canadians avoiding costly dental work, can it help you avoid overpaying for dental procedures?

The Canadian Dental Association doesn't publish its updated national fee guide to the general public. Since the fee guideline is costly to write and maintain, dentists must purchase access to it to cover its production costs. Some provinces make their fee guide publically available, but they caution that it is so technical that it can be hard for those outside the industry to read.

We don't know exactly what fees the Canadian Dental Association suggests to its members. But that doesn't mean you can't find lower prices for coded dental procedures.

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Choose Your Dentist

If your insurance only covers the suggested fee, you don't necessarily have to pay out of pocket. Instead, compare the prices of different dentists in your area.

You might not be able to know exactly which dentists are sticking to the suggested dental fees. However, you may still find a range of prices.

Some dentists choose to keep their fees at or under the suggested cost to stay competitive in the dental market. Others charge more than the suggested cost, whether to offset their own fees or for other reasons. While you won't know exactly which fees are within the suggested range— the range that your insurance is more likely to cover— you can still find the lowest cost and avoid higher out-of-pocket costs.

Choose Your Insurance

While 32% of Canadians still don't have dental insurance, there's no doubt that in Canada, having dental insurance coverage is a must. But there are tons of options to choose from, and the plan you pick will significantly impact what you finally end up paying.

If you're worried about paying unexpected out-of-pocket costs at the dentist, look for a plan that has high monthly coverage. A bargain plan costs less upfront, but may not fully cover your costs. Especially if you expect to have dental expenses in the future, such as aligners, choose a plan that will defray your costs.

Canadian Dental Procedure Codes: A Comprehensive Guide - Insurdinary (4)Canadian Dental Procedure Codes: A Comprehensive Guide - Insurdinary (5)

Canadian Dental Procedure Codes: A Comprehensive Guide - Insurdinary (6)

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Canadian Dental Procedure Codes, Explained

Canadian dental procedure codes are the basis for dental costs and coverage. They're the key to understanding your dental expenses and insurance. With this guide, you'll be able to understandyour dental procedure codes and take ownership of your dental costs.

With so many dental options, choosing an insurance plan can be overwhelming. Insurdinary compares the most comprehensive health and dental insurance quotes so that you can find the Canadian dental plan that meets your needs.

Best of all, Insurdinary finds the best monthly rates in Canada, so you know that you're not overpaying for your insurance.If you're looking for affordable dental insurance in Canada, get started with Insurdinary today.

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FAQs

Are dental codes the same across Canada? ›

dental procedure codes are the same throughout Canada! the fee guides are updated annually by each provincial dental association. many dental treatments are a combination of multiple dental procedure codes.

What is the dental code for comprehensive exam? ›

Comprehensive Oral Evaluation, new or established patient: This code applies when a general dentist and/or dental specialist examines the patient.

What is dental procedure code 11112? ›

The second important code allows you to have your cleaning done more than once or twice a year, this is the scaling code — code 11112,11113, or 11114. Each insurance company will allot a certain number of scaling units.

What is dental code D7280? ›

D7280 – Surgical access of an unerupted tooth

This procedure includes an incision, the reflection of tissue, and the removal of bone as necessary to expose the crown of an impacted tooth not intended to be extracted.

What is the difference between CDT and CPT codes? ›

Consider type of coverage – dental or medical: A major factor governing CDT vs. CPT code use is the type of coverage that the patient has. To assign a CDT dental code on the claim for a dental procedure, the patient must have dental insurance.

Are dental codes universal? ›

The best thing about ADA dental codes is that they're universal. All dentists who belong to the ADA use D0210 to represent a complete series of radiographic images.

What is dental code D2392? ›

D2392 Resin-based composite - two surfaces, posterior.

What is a dental comprehensive? ›

A comprehensive dental exam includes far more than just cleaning your teeth. It involves a complete and thorough patient examination covering everything from pre-existing conditions, gum health, even screenings, and diagnostic exams to guarantee optimal oral health. But not all dentists are as thorough as others.

What is difference between D4910 and D1110? ›

D1110 is meant for healthy tissue. D4910 is meant to be used after periodontal treatment such as scaling/root planing or osseous surgery. It is meant to describe a more in-depth procedure than a prophylaxis in the presence of a disease state.

How do dentists number teeth in Canada? ›

Universal Numbering System

Tooth number 1 is the tooth farthest back on the right side of your mouth in the upper (maxillary) jaw. Numbering continues along your upper teeth toward the front and across to the tooth farthest back on the top left side (which is number 16).

What is a procedure code Canada Life? ›

The Canadian dental procedure codes are a system of categorizing dental services. Different countries use different systems to standardize their dental procedures. The Canadian dental industry uses this unique system to keep its services consistent across the country.

What is the code for dentures? ›

D5110: This code refers to a complete upper denture that is worn in the maxillary (upper) jaw. D5120: This code refers to a complete lower denture set that is worn in the mandibular (lower) jaw. D5130: Immediate denture (maxillary), includes limited follow-up care.

What is dental code D5282? ›

D5282. Removable unilateral partial denture – one piece cast metal (including retentive/clasping materials, rests, and teeth), maxillary.

What is dental code D6056? ›

D6056 Prefabricated abutment - A connection to an implant that is a manufactured component usually made of machined high noble metal, titanium, titanium alloy or ceramic. Modification of a prefabricated abutment may be necessary, and is accomplished by altering its shape using dental burs/diamonds.

What is dental code D9944? ›

D9944 occlusal guard – hard appliance, full arch

D9945 occlusal guard – soft appliance, full arch.

How many CDT codes are there? ›

Effective January 1st, 2022 CDT has 16 additions, 14 revisions, and 6 deletions, including eight codes adopted in March of 2021 for vaccine administration and molecular testing for a public health-related pathogen. In other words, we have pandemic-related codes listed below.

Can dentists use CPT codes? ›

Dentists using CPT procedure codes and coding must select the code for the procedure or service which most accurately identifies the service performed. Any additional procedures performed, or pertinent special services, must also be listed.

Is dental coding different from medical coding? ›

The short answer is yes. Medical and dental claims require distinctly different forms of claim submission. They also require totally different information and procedure coding.

Do dentists have to use ICD 10 codes? ›

Dentists, by virtue of their clinical education, experience and professional ethics, are the individuals responsible for diagnosis. As such, a dentist is also obligated to select the appropriate diagnosis code for patient records and claim submission.

What do dentist codes mean? ›

The code letter refers to different parts or surfaces of the tooth. For example, "M" stands for mesial (the front surface of the tooth). "D" stands for distal (the back surface). An "O," which stands for occlusal, is the top surface of a back tooth.

What is the number 3 tooth? ›

Number 1: 3rd Molar commonly known as wisdom tooth. Number 2: 2nd Molar. Number 3: 1st Molar. Number 4: 2nd Bicuspid also known as 2nd premolar.

What is dental code D3220? ›

D3220. Therapeutic pulpotomy (excluding final restoration) – removal of pulp coronal to the dentinocemental. junction and application of medicament.

What is dental code D6240? ›

D6240. Pontic – porcelain fused to high noble metal. D6241. Pontic – porcelain fused to predominantly.

What is dental code D7953? ›

If performing an extraction of either a natural tooth, or bone grafting after implant removal, this is the correct code. (D7953)—Bone replacement graft for ridge preservation.

What are the components of a comprehensive dentistry program? ›

Students who participate in the Comprehensive Dentistry program will perform all phases of dentistry on a post-graduate level. Phases include, but are not limited to, crown and bridge, implant supported prosthesis, root canal therapy, partial and full dentures, porcelain onlays and inlays and porcelain laminates.

What is the difference between preventive and comprehensive dental? ›

General dentistry revolves around primary dental care for people of all ages. Preventive dentistry, on the other hand, is a more modern or advanced way of keeping your teeth healthy by preventing gum diseases and tooth decay.

What is a comprehensive periodontal evaluation? ›

A Comprehensive Periodontal Evaluation, or CPE, is a way to assess your periodontal health by examining: Your teeth. Your plaque. Your gums. Your bite.

What is the difference between D1110 and D1120? ›

Code D1120 would accurately report a prophy performed on a patient with all primary dentition or one with primary and permanent dentition. Code D1110 would accurately report a prophy performed on a patient with all permanent dentition.

What does dental code D4910 mean? ›

DENTISTS' CONCERNS. Dentist perspective. According to the Code on Dental Procedures and Nomenclature, this procedure is performed following periodontal therapy and continues for the life of the dentition.

Can you go from perio maintenance to prophy? ›

Meaning, if a perio maintenance patient has been periodontally stable for a few years, according to the ADA, they can be put back to prophy status if the dentist deems it appropriate.

What does 7 mean at the dentist? ›

5 mm - 7 mm with bleeding: Besides almost certain gum disease, bone loss and tissue damage are also possible. 7 mm+ with bleeding: Pockets deeper than 7 mm means advanced gum disease is certain. Surgical intervention may be appropriate to resolve the disease.

What numbering system does Canada use? ›

Telephone numbers in Canada follow the fixed-length Bell System format, consisting of the country code +1, followed by a three-digit area code, a three-digit central office code (or exchange code) and a four-digit station code. This is represented as 1 NPA NXX XXXX, in which the country code is "1".

What tooth numbering system is used in Canada? ›

The most commonly used system is the Fédération Dentaire Internationale (FDI) system and this is the one used in Quebec, in Canada and in most European countries. Each tooth is represented by a 2-digit number.

Are dental implants covered by insurance Canada Life? ›

Eligible dental implants will be covered. Replacement fillings for the same tooth and surface will be covered for eligible children only every 12 months after the initial filling was done, instead of once every 24 months.

What is the dental procedure code for a flipper? ›

Acrylic (resin) partial denture (temporary flipper)
Interim partial denture (mandibular)D5821
Interim partial denture (maxillary)D5820

Is there a dental code for Invisalign? ›

The codes used for clear aligners are those that would be used for any comprehensive orthodontic treatment. After the claim for Orthodontic Treatment has been submitted, the Periodic Orthodontic Treatment Visit (D8670) is billed at the next visit.

What is dental Code D3333? ›

D3330 Root canal-molar: Root canal: back tooth. D3331 Treatment of root canal obstruction: Removal of a separated instrument, finding a Ca+ canal. D3332 Incomplete root canal therapy: Inoperable or fractured tooth, root canal procedure not completed. D3333 Internal root repair: Repair of perforation defects.

What is D5130 dental code? ›

Immediate denture (D5130)—Includes limited follow-up care only. Does not include required future rebasing/relining procedure(s) or a complete new denture.

What is the code for partial dentures? ›

D5000-D5899 Prosthodontics, Removable
CodeDescription of ServicePrior Authorization
D5213Maxillary partial denture; cast metal framework with resin denture bases (including any conventional clasps, rests and teeth)Yes
26 more rows

What is dental code D8090? ›

D8090—Comprehensive orthodontic treatment of the adult dentition. This code is commonly used for adults who are undergoing occlusion and alignment corrections.

What is dental code D7922? ›

D7922 placement of intra-socket biological dressing to aid in hemostasis or clot stabilization, per site.

What is dental code D5120? ›

□ D5120 Complete Denture - Mandibular.

What is dental code D6054? ›

D6054. Implant/abutment. supported removable denture for. partially edentulous arch. D6055 Dental implant supported connecting bar A device attached to transmucosal abutments to stabilize and anchor a removable over denture prosthesis.

What is dental code D8999? ›

D8999 Unspecified orthodontic procedure, by report – Used for procedure that is not adequately described by a code.

What is dental code D6115? ›

The final All-on-Four prosthesis can be reported using code D6114/D6115 for the fixed complete denture prosthesis for each arch restored. This is commonly referred to as a “hybrid prosthesis.”

What is dental Code D3331? ›

D3331 Treatment of Root Canal Obstruction

This code is used in addition to the endodontic code describing the tooth involved and the number of canals.

What is dental Code D2391? ›

Code D2391 (one-surface posterior resin-based composite) explicitly states that it should be “used to restore a carious lesion into the dentin.” The rationale for the requirement that the lesion extends into dentin can be questioned.

What is dental Code D9947? ›

Codes are as follows: D9947 — Custom sleep appliance fabrication and placement.

Which tooth numbering system is used in Canada? ›

The most commonly used system is the Fédération Dentaire Internationale (FDI) system and this is the one used in Quebec, in Canada and in most European countries. Each tooth is represented by a 2-digit number.

How do Canadians number teeth? ›

Quadrant 1 is the upper right, 2 is the upper left, 3 is the lower left, and 4 is the lower right. If you were facing a person then quadrant 1 is YOUR upper left and then go clockwise and you are going 2, 3, 4. Within each quadrant of your mouth there are 8 teeth. Teeth 1 and 2 are the incisors.

How many CDT codes are there? ›

Effective January 1st, 2022 CDT has 16 additions, 14 revisions, and 6 deletions, including eight codes adopted in March of 2021 for vaccine administration and molecular testing for a public health-related pathogen. In other words, we have pandemic-related codes listed below.

What is a procedure code Canada Life? ›

The Canadian dental procedure codes are a system of categorizing dental services. Different countries use different systems to standardize their dental procedures. The Canadian dental industry uses this unique system to keep its services consistent across the country.

What does 7 mean at the dentist? ›

5 mm - 7 mm with bleeding: Besides almost certain gum disease, bone loss and tissue damage are also possible. 7 mm+ with bleeding: Pockets deeper than 7 mm means advanced gum disease is certain. Surgical intervention may be appropriate to resolve the disease.

What are tooth surface codes? ›

Tooth Surface Code
CodeCode value
BBuccal – The surface of the tooth which is closest to the cheek.
DDistal – The surface of the tooth facing away from an invisible line drawn vertically through the center of the face.
FFacial – The surface of a tooth that is directed towards the face.
5 more rows

What are the 4 quadrants of teeth? ›

Dentists divide the mouth into four areas, or quadrants.
  • Quadrant 1 — top right.
  • Quadrant 2 — top left.
  • Quadrant 3 — bottom left.
  • Quadrant 4 — bottom right.
22 Jul 2019

What tooth is number 3? ›

Number 1: 3rd Molar commonly known as wisdom tooth. Number 2: 2nd Molar. Number 3: 1st Molar. Number 4: 2nd Bicuspid also known as 2nd premolar.

How do dentists count teeth? ›

Universal method – starting at the rear right upper molar and preceding to the rear left upper molar, teeth are numbered 1 to 16. Then, the bottom teeth are numbered from left to right 17 to 32. This numbering system allows for all 32 teeth, including wisdom teeth, to be present.

What is tooth number 54? ›

(N) 54. Primary Mandibular Left Central Incisor. (O) 55. Primary Mandibular Right Central Incisor.

What are the new CDT codes for 2022? ›

  • 2022 CDT Codes.
  • Effective January 1, 2022.
  • New. Description.
  • D3911. intraorifice barrier. D3921. decoronation or submergence of an erupted tooth. ...
  • Revised. Description.
  • D0120. periodic oral evaluation – established patient. D0180. ...
  • D4276. combined connective tissue and pedicle graft, per tooth. D5862.
1 Jan 2022

How many CDT codes are there 2022? ›

1, 2022. CDT 2022 is the complete upcoming edition of the most up-to-date codes and descriptors, and the CDT 2022 Coding Companion compiles more than 200 frequently asked coding questions and more than 140 common dental coding scenarios.

What is difference between D4910 and D1110? ›

D1110 is meant for healthy tissue. D4910 is meant to be used after periodontal treatment such as scaling/root planing or osseous surgery. It is meant to describe a more in-depth procedure than a prophylaxis in the presence of a disease state.

Are dental implants covered by insurance Canada Life? ›

Eligible dental implants will be covered. Replacement fillings for the same tooth and surface will be covered for eligible children only every 12 months after the initial filling was done, instead of once every 24 months.

What is the dental code for tooth extraction? ›

D7140 – extraction, erupted tooth or exposed root (ele- vation, and/or forcep removal). The descriptor of this code includes routine removal of tooth structure, minor smoothing of socket bone and closure as necessary.

What is the dental procedure code for a flipper? ›

Acrylic (resin) partial denture (temporary flipper)
Interim partial denture (mandibular)D5821
Interim partial denture (maxillary)D5820

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