Petition to Postpone Proposed Restructuring of Caries Management Codes (D1354, D1355, D2991) - hearing on March 13, 2026

In recent years, significant advancements have transformed the field of caries management, reshaping our understanding of risk assessment, remineralization science, disease ecology, and minimally invasive treatment philosophies. These developments require that coding language evolve thoughtfully so it accurately reflects contemporary dental care. Without careful alignment between science, clinical practice, and coding structure, revisions may lead to misinterpretation, fragmented care, or unintended consequences that hinder effective disease management.

With these advancements in mind, it is essential that the American Dental Association (ADA) Code Maintenance Committee fully consider the implications of any revisions to caries management codes. We recognize and appreciate the Committee’s goal of improving clarity and consistency in dental code reporting. However, we are concerned that the current proposed changes may not fully reflect the complexity and clinical nuance of modern caries management practices.

Summary of Proposed Changes to Caries Managamenet Codes D1354, D1355, D2991

The current proposals introduce a broader restructuring of the caries management coding framework. The revisions reorganize codes around categories such as prevention, remineralization, arrest, and regeneration — categories that may be overlapping in scope or insufficiently defined for consistent clinical application — introduce additional per-tooth and full-mouth distinctions, and contemplate deletion or substantial revision of established code D2991.

Because these changes affect how caries therapies are defined, reported, and interpreted, they may carry downstream implications for coverage determinations, reimbursement structures, and clinical decision-making. As such, these revisions represent a substantive shift in how modern caries management is codified, rather than a simple clarification of terminology.

We are concerned that these revisions are moving forward without sufficient engagement from the broader dental community. Meaningful input from practicing clinicians, researchers, educators, public health professionals, and industry leaders is essential to ensure that updated coding supports best practices and improves patient outcomes nationwide.

Request for Postponement

For these reasons, we respectfully urge the ADA Code Maintenance Committee to postpone action on revisions related to caries management codes D1354, D1355, and D2991. We request that additional time be dedicated to gathering stakeholder input, reviewing implementation implications, and ensuring that any future revisions reflect the most current scientific evidence and clinical realities of caries management.

Taking the time to fully evaluate these proposed structural changes is not a delay — it is a commitment to accuracy, scientific integrity, and responsible implementation. Coding decisions influence clinical behavior, reimbursement structures, and ultimately patient outcomes. Ensuring that these revisions are thoughtfully developed will help maintain clarity in reporting, support effective disease management, and preserve alignment between modern science and clinical practice.

We encourage dental professionals and stakeholders across the country to join us in signing this petition. Coding decisions influence clinical behavior, reimbursement structures, and ultimately patient outcomes. Taking the time to get these revisions right is not a delay — it is a commitment to accuracy, scientific integrity, and responsible implementation. Your support will help ensure that modern caries management is represented clearly and appropriately in the coding language that guides our profession.