D9945 Dental Code: Occlusal Guard Adjustment -

The D9945 dental code is a procedural code used by dentists to bill for the adjustment of an occlusal guard. Occlusal guards, also known as night guards or bite splints, are custom-made oral appliances designed to protect teeth from grinding (bruxism), clenching, or TMJ disorders.

Unlike fabrication codes (such as D9944 for guard fabrication), D9945 specifically covers adjustments—a crucial maintenance step ensuring the guard fits comfortably and functions effectively. Without proper adjustments, patients may experience discomfort, improper bite alignment, or even exacerbation of TMJ symptoms.

This article provides an in-depth exploration of D9945, including its clinical applications, adjustment techniques, billing considerations, and patient care tips.

Table of Contents

2. Understanding Occlusal Guards and Their Importance

Types of Occlusal Guards

Soft Night Guards: Made of flexible material, ideal for mild bruxism.
Hard Acrylic Guards: More durable, used for severe grinding.
Hybrid Guards: Combine soft and hard layers for balanced protection.
TMJ Splints: Specialized guards for jaw joint disorders.

Why Adjustments Are Necessary

Wear and Tear: Over time, guards may loosen or develop pressure points.
Bite Changes: Shifting teeth or dental work (e.g., crowns) may alter fit.
Discomfort: Poorly adjusted guards can cause soreness or jaw strain.

3. When Is D9945 Used? Clinical Indications

Dentists use D9945 when:
✔ The guard no longer fits due to tooth movement.
✔ The patient reports pain or discomfort.
✔ New dental work (fillings, implants) affects occlusion.
✔ The guard shows signs of uneven wear.

Table: Comparison of D9945 with Related Codes

Code	Description	When to Use
D9944	Occlusal Guard Fabrication	Initial creation of the guard.
D9945	Occlusal Guard Adjustment	Modifying an existing guard.
D9946	Repair of Occlusal Guard	Fixing cracks or breaks.

4. Step-by-Step Procedure for Occlusal Guard Adjustment

Step 1: Patient Assessment

Evaluate discomfort points.
Check guard fit and bite alignment.

Step 2: Adjusting the Guard

Trimming: Remove excess material for better fit.
Reshaping: Smooth rough edges causing irritation.
Bite Registration: Ensure even contact.

Step 3: Post-Adjustment Testing

Have patient bite down to verify comfort.
Check for pressure points using articulating paper.

(Insert image: Dentist adjusting occlusal guard)

5. Common Issues Addressed by D9945 Adjustments

Sore Spots: Caused by uneven pressure.
Loose Fit: Due to natural wear or gum recession.
Jaw Pain: Improper alignment strains TMJ.

6. Insurance and Billing for D9945

Coverage Varies: Some insurers cover adjustments under medical necessity.
Frequency Limits: Often 1-2 adjustments per year.
Documentation Needed: Notes on patient symptoms and guard condition.

7. Patient FAQs on Occlusal Guard Adjustments

Q: How often should my guard be adjusted?
A: Typically every 6-12 months, or if discomfort arises.

Q: Can I adjust the guard myself?
A: No—DIY adjustments may damage it. Always see a dentist.

Q: Will insurance cover D9945?
A: Check your plan; many cover it if medically necessary.

8. Conclusion

The D9945 dental code is essential for maintaining occlusal guard effectiveness. Regular adjustments prevent discomfort, improve longevity, and ensure optimal bite alignment. Dentists must document medical necessity for insurance, while patients should seek professional adjustments—not DIY fixes.

D9945 Dental Code: Occlusal Guard Adjustment