OHP and root canal therapy

by User Not Found | Dec 18, 2019

Endodontic treatment for permanent teeth – what the Oregon Health Plan (OHP) covers can be confusing.  Here’s what is covered:


Procedure

CDT Code

OHP Plan

Anterior root canal retreatment or apicoectomy

D3346 or D3410

All patients

Anterior and premolar root canal therapy

D3310 and D3320

All patients

1st molar root canal therapy

D3330

Pregnant patients who are 21+ years old

1st and 2nd molar root canal therapy

D3330

Patients under 21 years of age

Apexification

D3351 - D3353

Patients under 21 years of age or who are pregnant

 

OHP requires additional conditions to be met for these procedures to be covered.

  • The crown-to-root ratio for the tooth must be 50:50 or better.
  • The tooth must be restorable without other surgical procedures, such as crown lengthening.
  • The tooth must be restorable within the OHP dental benefit package. For instance, a posterior tooth has severe loss of coronal tooth structure and cannot be restored without a porcelain fused-to-metal crown (PFM). The tooth also needs root canal therapy. The root canal therapy would not be covered by OHP because the PFM is not covered.

Including the final planned restoration for the tooth at the time the referral is submitted is important. This is so CareOregon Dental knows if the tooth can be restored within the OHP dental benefit package prior to approving the referral.

New antibiotic use guideline for pulpal/periapical pain and intraoral swelling

As part of the American Dental Association’s commitment to the U.S. government’s fight against antimicrobial resistance (The Antimicrobial Challenge), the ADA Center for Evidence-Based Dentistry released a report, Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling, in the November 2019 issue of Journal of the American Dental Association (JADA).

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