Dr. O's Dental Consultant Coding Info
Craze vs. Crack vs. Fracture (From an Insurance Viewpoint)
Terminology and wording used in insurance claims can make a big difference in whether a procedure is or is not reimbursed.
- Limited to enamel.
- Tip of a dental explorer instrument cannot penetrate into a craze. Might be felt by explorer, but explorer would not stick in it.
- Do not extend into dentin.
- Do not necessarily weaken the tooth.
- Do not necessarily get worse with time.
- Do not necessarily lead to fractures.
- Does not stop transilluminated light from shining all the way through the tooth.
- Are found in most adult teeth.
- Not visible on x-rays.
- Long vertical craze lines are common on anterior teeth.
- Can cross marginal ridges, and can extend along buccal and lingual surfaces.
- Do not cause pain.
- Can be considered inconsequential, and do not need to be restored except for possibly cosmetic purposes.
- More than just a superficial craze line.
- Can be thought of as an incomplete fracture.
- Can be felt with the dental explorer.
- Tip of dental explorer instrument can penetrate into a crack. An explorer would stick in the crack.
- Might or might not extend into dentin.
- Most commonly begin on the occlusal surface and extend apically.
- If in dentin, crack stops transilluminated light from shining all the way through the tooth.
- Usually not visible on x-rays unless large.
- More common in posterior teeth than anterior teeth.
- Can range in size from very small, to a large split tooth.
- Can cause Cracked Tooth Syndrome.
- Treatment needs range from nothing to filling to crown.
- A portion of the tooth is "displaced"; tooth structure is actually gone.
- Can range in size from small chips, to entire cusp missing.
- Visibility on x-rays depends on size of missing piece, and presence of other restorations.
- Treatment often requires crown or onlay.