Adjunctive services

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The following series of blogs will cover the different areas of dentistry. The aim is to simplify and explain the jargon that patients encounter in the normal course of dental visits. It is based on the Ontario Dental Association’s procedure categories and descriptions.

Adjunctive services

As in any endeavour, there are always going to be procedures and activities that just do not fit neatly into the usual categories. Adjunctive services are the rubric under which our profession captures these in Ontario.
Emergency not otherwise specified
Occasionally there is an emergency that truly baffles our procedure codes. It is either rarely encountered and/ or the intervention to handle it is , that a code describing it has been seen as unnecessary to date.
Sometimes the code is used infrequently and has been deleted from the code list. Other times the procedure codes have not caught up to the pace of change in the profession and one has yet to be listed. Thus, we use this open ended descriptive code to cover it.
Unclassified tx, unusual time & responsibility; Management of exceptional patient
To state the obvious, all patients are different, with widely varying physical, psychological and medical attributes. Sometimes, these specific needs require more time and care than the usual. This specialized care may inherently have greater responsibilities associated with it.
Since dental care is not a commodity like products at the supermarket, individualized more involved care cannot be adequately described by the usual procedure codes. Yet, to have descriptions for all possibilities is cumbersome and unrealistic. Hence we use these procedure codes.
Since we had always been associated with pain, we dentists are the originators of anesthesia. In dental practice today various forms of anesthesia may be available for the unique needs of our patients. General practitioners and dental anesthesia specialists use the same terminology as the medical community.

Each form of anesthesia has very specific requirements for use and the location where it is used may vary from the hospital to the dental clinic.


Being put totally to sleep with your vital functions protected and maintained artificially is referred to as general anesthesia. It is usually administered in the hospital operating room.

Deep sedation

This level of anesthesia requires specialized training and monitoring during the dental procedure. It is not as profound as general anesthesia, but it is managed in the same manner.
Conscious sedation

Conscious sedation is a less profound form of anesthesia usually employed for anxiety management in conjunction with local anesthetics.

Nitrous oxide is also known as ‘laughing gas’.

Oral sedation is generally a relatively short acting sedative oral medication.

Nitrous oxide with oral sedation is a combination of medications requiring more intense monitoring and supervision.

Parenteral conscious sedation is intravenous administration of the sedative agent also requiring more intense monitoring and supervision.
Non-pharmacological pain control and patient management

Numerous reasons belie the fact that not all patient issues and concerns can be addressed with medications. Thus, dentistry like medicine, embraces alternatives. The following have many years of professional recognition and utilization. As with the more involved anesthetic utilization, they require professional training.

Hypnosis may be used for physiological and psychological interventions that range from anxiety to pain control and management. It is collaboration between the patient and the clinician. It also has application outside of the dental and medical context.


A four thousand year tradition underscores acupuncture. It too ranges in application from acute and chronic pain management to other uses.
Administrative and communication activities have procedure codes and of course associated fees. These categories are self-explanatory so we won’t define them merely list them:

Professional communications – other health care professionals, dentists

Legal letters reports opinions

Insurance forms

Extraordinary time spent on phone

Extraordinary office time with 3rd party

House calls

Office or institutional visits, expenses, missed or cancelled appts

Preparation as expert witness

Court appearance as expert

Forensic services

Identification systems bonded (ID tags bonded to children’s teeth)


Emergeny prescriptions

Emergency dispensing

Dispensing non-emergency medications

Injections, therapeutic

Aesthetics are an important component of our society today and dental whitening is the start to improving one’s smile. We refer to whitening as bleaching.
Vital - that is the tooth has not been root canal treated and process of whitening takes place in the office.

Vital home - an office monitored take –home system is used with custom whitening trays usually for the whitening agent.

Micro abraision – a system of removing stains from the superficial surface of tooth enamel by abrading it mechanically or in combination with chemical agents.

Tobacco use cessation services

Smoking is a risk to one’s health. Most healthcare providers are concerned and recommend stopping. The habit is hard to break on one’s own. Dentistry participates in aiding patients to stop.
Lab services

Modern dentistry is a highly technical field that requires laboratory work to support today’s care. The list of treatment includes anything from mouth guards to implant supported crowns, bridges and dentures. The work may be done either

In office or by a

Commercial laboratory.

Many treatments involve extra components, especially implant related treatments. These are usually coded as Expenses along with the laboratory fee.
This ends our foray into the world of dentalese and treatment procedure codes. Should things still be unclear, ask your dental care provider or contactus@ .

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