Splint

A dental splint is used to immobilize teeth that have become mobile due to trauma, periodontal disease, or post-surgical healing requirements. The concept is similar to splinting a fractured bone: by connecting the unstable tooth to its neighbors, the splint distributes occlusal forces across multiple teeth and allows the periodontal ligament and supporting structures to heal. Splints can be temporary, designed to remain in place for a few weeks during acute healing, or permanent, intended to provide long-term stabilization for teeth with chronic mobility from advanced periodontal attachment loss.

The two main categories of dental splints are extracoronal and intracoronal. Extracoronal splints are bonded to the external surfaces of the teeth, typically using composite resin and a wire, fiber ribbon, or mesh. They are less invasive and commonly used for trauma stabilization. Intracoronal splints require preparation of a channel or groove within the tooth structure to embed the stabilizing material, providing a more rigid and durable connection. This approach is used when long-term or permanent stabilization is needed. Each type has its own CDT code: D4321 covers provisional splinting for extracoronal stabilization, while D4320 covers provisional splinting for intracoronal stabilization.

Billing for splints requires attention to the clinical context. When splinting is performed as part of a trauma case, the procedure may fall under the patient's medical insurance rather than dental coverage, particularly if the injury is accident-related. Practices should document the cause of the injury, the number of teeth involved, the type of splint used, and the anticipated duration. For periodontal splinting, the clinical notes must demonstrate that the mobility is due to bone loss and that the splint is necessary to maintain tooth function. Some insurance plans consider splinting to be an elective procedure and may deny coverage, so verifying benefits before treatment and collecting patient responsibility upfront is advisable. The splint removal visit should also be accounted for in the treatment plan, though it is often included as part of the follow-up care and not billed separately.