WAC 388-535-1257   Covered dental-related services for clients age twenty-one and older -- Preventive services.  The department covers dental-related preventive services only as listed in this section for clients age twenty-one and older (for dental-related services provided to clients eligible under the GA-U or ADATSA program, see WAC 388-535-1065).

     (1) Dental prophylaxis. The department covers dental prophylaxis:

     (a) Which includes scaling and polishing procedures to remove coronal plaque, calculus, and stains once every twelve months;

     (b) Only when the service is performed twelve months after periodontal scaling and root planing, or periodontal maintenance services;

     (c) Only when not performed on the same date of service as periodontal scaling and root planing, or periodontal maintenance, gingivectomy or gingivoplasty; and

     (d) For clients of the division of development disabilities according to WAC 388-535-1099.

     (2) Topical fluoride treatment. The department covers:

     (a) Fluoride rinse, foam or gel, once within a twelve-month period;

     (b) Fluoride varnish, rinse, foam or gel for clients who are age sixty-five and older, or clients who reside in alternative living facilities, up to three times within a twelve-month period;

     (c) Additional topical fluoride applications when prior authorized; and

     (d) Topical fluoride treatment for clients of the division of developmental disabilities according to WAC 388-535-1099.



[Statutory Authority: RCW 74.08.090, 74.09.500, 74.09.520. 07-06-041, § 388-535-1257, filed 3/1/07, effective 4/1/07.]