List of Preventive Dental Codes by ADA

American Dental Association® | Updated October 2024

D1110 prophylaxis – adult

D1120 prophylaxis – child

D1206 topical application of fluoride varnish

D1208 topical application of fluoride – excluding varnish

D1310 nutritional counseling for control of dental disease

D1320 tobacco counseling for the control and prevention of oral disease

D1321 counseling for the control and prevention of adverse oral, behavioral, and systemic health effects associated with high-risk substance use

D1330 oral hygiene instructions

D1351 sealant – per tooth

D1352 preventive resin restoration in a moderate to high caries risk patient – permanent tooth

D1353 sealant repair – per tooth

D1354 interim caries arresting medicament application – per tooth

D1355 caries preventive medicament application – per tooth

D1510 space maintainer – fixed, unilateral – per quadrant

D1516 space maintainer – fixed – bilateral, maxillary

D1517 space maintainer – fixed – bilateral, mandibular

D1520 space maintainer – removable, unilateral – per quadrant

D1526 space maintainer – removable – bilateral, maxillary

D1527 space maintainer – removable – bilateral, mandibular

D1551 re-cement or re-bond bilateral space maintainer – maxillary

D1552 re-cement or re-bond bilateral space maintainer – mandibular

D1553 re-cement or re-bond unilateral space maintainer – per quadrant

D1556 removal of fixed unilateral space maintainer – per quadrant

D1557 removal of fixed bilateral space maintainer – maxillary

D1558 removal of fixed bilateral space maintainer – mandibular

D1575 distal shoe space maintainer – fixed, unilateral – per quadrant

D1999 unspecified preventive procedure, by report