Odontoplasty: Understanding the Procedure and When It's Done

Odontoplasty Defined

Odontoplasty is a dental procedure that involves reshaping or recontouring the structure of a tooth. Sometimes referred to as enameloplasty, odontoplasty is a minimally invasive treatment where small amounts of tooth enamel are gently removed to improve the tooth’s shape, surface, or alignment. This procedure is often performed for cosmetic reasons, but it can also address functional issues such as minor chips, uneven edges, or slight overcrowding. In dental billing, odontoplasty is typically reported under CDT code D9971 (odontoplasty – 1 to 2 teeth; includes removal of enamel projections), which is important for accurate insurance claims and documentation.

Why and When is Odontoplasty Performed?

Odontoplasty is recommended in several scenarios, including:

• Smoothing out rough or jagged tooth edges after chipping or minor trauma
• Improving the appearance of slightly misshapen or uneven teeth
• Removing small enamel projections that may cause irritation or interfere with bite
• Preparing teeth for other dental procedures, such as orthodontics or restorative work

It’s important to note that odontoplasty is not suitable for addressing extensive decay, large fractures, or structural issues that require crowns or fillings. Dentists will assess whether this conservative approach is appropriate based on the patient’s needs and oral health goals.

Procedure Overview: What Patients Can Expect

Odontoplasty is a straightforward, pain-free procedure that usually does not require anesthesia. Here’s what patients and dental teams can expect:

• Assessment and Planning: The dentist examines the tooth and discusses the desired outcome with the patient. Accurate documentation is key for both clinical and billing records.
• Reshaping: Using a fine dental bur or sanding disc, the dentist carefully removes small amounts of enamel to achieve the desired shape. The process is quick and preserves as much healthy tooth structure as possible.
• Polishing: The tooth is polished for a smooth, natural finish.
• Post-Procedure Instructions: Patients are advised on oral hygiene and any follow-up care. Since the procedure is minimally invasive, recovery is immediate and there are no dietary restrictions.

For dental billers, it’s essential to document the clinical indications for odontoplasty and the specific teeth treated. This ensures accurate claim submission and reduces the risk of denials.

Cost and Insurance Coverage for Odontoplasty

The cost of odontoplasty varies depending on the number of teeth treated and the complexity of the case. On average, fees range from $50 to $300 per tooth. Insurance coverage for odontoplasty can be limited, as many plans consider it a cosmetic procedure. However, if odontoplasty is performed for functional reasons—such as removing enamel projections that cause irritation—there may be partial coverage.

Best practices for dental billing teams include:

• Insurance Verification: Always verify benefits before treatment and document the reason for odontoplasty in the patient’s chart.
• Accurate Coding: Use CDT code D9971 and include supporting clinical notes with the claim.
• Claim Appeals: If a claim is denied, submit an appeal with detailed documentation, photos, and a narrative explaining the medical necessity.
• Patient Communication: Clearly explain potential out-of-pocket costs and provide an itemized estimate to avoid billing surprises.

Discussing Odontoplasty with Your Dentist

If odontoplasty appears on a treatment plan or Explanation of Benefits (EOB), patients should feel comfortable asking their dental team about the procedure. Office managers and billers can support these conversations by:

• Explaining the purpose and benefits of odontoplasty in clear, patient-friendly language
• Reviewing insurance coverage and financial responsibilities before treatment
• Providing written information or handouts to help patients understand their options

By following these best practices, dental offices can ensure patients are well-informed, claims are processed smoothly, and the practice maintains a high standard of care and compliance.