How does your practice stack up?


We have a written hygiene philosophy of care.

A hygiene philosophy is a document written by the Doctor(s) to communicate their philosophy of care for hygiene treatment. It is easier to harness the synergy necessary to achieve goals when the doctor has shared a clear vision. On the other hand, inconsistency and confusion wastes ti me while the staff attempts to second-guess the doctor’s vision themselves. This is especially true for practices with more than one hygienist. It is only natural for team members to bring past philosophies they have learned. This document provides clarity from the dentist(s). It should address the following:

  • When to provide periodontal therapy (4341–4342)
  • When to provide D1110 vs. D4346
  • When to retreat
  • When to refer
  • When to dismiss


The treatment we provide and code supports the philosophy of care and reaches healthy benchmarks in the dental industry.

Unless you refer your scaling and root planning cases to a periodontist, it could be a warning sign if your coding reflects more than 50% of your adult patients received a standard prophy (D1110). You will need to analyze the procedures provided over a 12-month period and compare your results to the Hygiene Philosophy of Care. Does your coding match the philosophy? Just as your chart notes must reflect the treatment provided, the code you select must do the same. A healthy goal would be 50% of your patient base receiving a D1110 or D4346, 40% receiving a D4910, and the remaining in active periodontal therapy as either a D4341 or D4342.


We have incorporated D4346 into the hygiene mixture of services.

D4346, sometimes called the “gingivitis code” became available for use January 1, 2017. A variety of patients, hallmarked by healthy attachment levels with relatively no bone loss, will qualify. Many practices select this code when the patient presents with generalized moderate to severe gingivitis, orthodontic brackets making access difficult, or medication induced gingival hyperplasia. All of these situations can have healthy bone/attachment levels with unhealthy tissue. Your protocols should address the sequence of appointments to use for these situations.


Our hygienists calibrate probe readings to provide consistency.

It can be common for hygienists, when comparing probe readings with each other, to get different pocket depth readings on the same patient. Calibrating with a goal to stay within 1mm of each other will provide better data for the practice and help the patient follow their progress as well. Accomplish this by probing volunteer staff members at a meeting and comparing results. Repeat this exercise periodically as a hygiene team and within a couple of weeks of a new hire in the hygiene department.


We have a team that works well together.

Systems and protocols provide consistent, high caliber treatment. The best-designed systems are only as good as the team that walks those systems out!


Challenge is a powerful motivator for change. If you found a challenge in any of the areas listed above, reach out to your Burkhart Account Manager or Burkhart’s Practice Support Team for assistance.


Your success is our success. Please reach out to us anytime.
Learn more, visit the Practice Support Team page, email us at, or call 1.800.665.5323.

Burkhart Dental Supply – Practice Support Team


Category: Practice Consulting

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