Section III - Restorative Treatment

• Materials used for direct restorations should be recorded in the patient record.
• The same items can be claimed for both children and adults on deciduous, retained deciduous and permanent teeth.
• The filling fees cover all items required to restore the tooth - pins can still be used if required but there is no separate fee for these.
• Codes under items 3-(a) to 3-(e) may only be claimed once per tooth.
• If there is more than one filling of different surfaces required in a tooth, then these should be claimed as individual codes on the same tooth:
  • For example, a tooth requiring mesio-incisal and separate buccal composite restorations should be claimed under codes C001, C002 and C014.
  • For example, a tooth requiring mesial-occlusal-distal amalgam and separate buccal composite restorations should be claimed under codes C001, C003 and C004.
• Amalgam fillings should not normally be provided for:
  • patients under 15 years age
  • retained deciduous teeth
  • patients who are pregnant or breastfeeding
  • patients where there is a letter from secondary care recommending amalgam should not be used due to specific medical needs.
• If, in the clinical judgement of the dentist, resin cannot be provided for these patients, then alternative materials may be used in exceptional circumstances. The reasoning should be noted and recorded in the patient record.
• Amalgam fillings must not be used in incisors or canines.
• Paragraph 7 of the Terms of Service, Schedule 1 of the NHS (GDS)(Scotland) 2010 Regulations still applies – items 3-(a) to 3-(e) cannot be claimed again by the same dentist*(see same dentist interpretation in Section XII – Interpretation) for the same surface(s) within 11 complete calendar months of the original treatment, unless repair or replacement is required as a result of trauma.

3-(b) Filling (2 surfaces)

• Additional incisal fees for anterior teeth are no longer available.
• To claim a composite resin involving 2-surfaces (for example mesio-incisal), a claim under item 3-(b) Filling (2 surface) along with a claim under item 3-(d) Composite Supplement would be appropriate.
• The narrative for item 3-(b) is the same as for item 3-(a).

3-(c) Filling (3 surfaces or more)

• The narrative for item 3-(c) is the same as for item 3-(a) and 3-(b).

3-(d) Composite Supplement

• This item can be claimed with 3-(a), 3-(b) or 3-(c) where the composite resin is in an incisor or canine or a premolar or molar that does not involve the occlusal surface.

3-(e) Posterior Composite Supplement

• This item can be claimed with items 3-(a), 3-(b) and 3-(c) and can only be claimed in connection with treatment involving the restoration of the occlusal and/or mesial and/or distal and marginal ridge of a premolar or molar tooth for:
  • patients under 15 years age
  • patients who are pregnant or breastfeeding
  • patients where there is a letter from secondary care recommending amalgam should not be used due to specific medical needs.

3-(f) Endodontic Treatment: Incisor/Canine/Lower Premolar; 3-(g) Endodontic Treatment: Upper Premolar; 3-(h) Endodontic Treatment: Molar

• These items encompass all access, extirpation, shaping, decontamination and filling of root canals, where this is a part of the routine provision of root treatment, except where access and extirpation has been completed in an unscheduled appointment under item 1-(c) at a separate emergency appointment.
• Appropriate radiographs must be available to support claims under this item.

3-(i) Pulpotomy

• This item is restricted to the treatment of deciduous and retained deciduous teeth.

3-(j) Root Canal Re-Treatment Supplement

• This item can only be claimed along with items 3-(f), 3-(g) or 3-(h) if doing a root canal re-treatment, but not for re-pulpotomy.
• This item can only be claimed where it is necessary to remove previously placed root filling material prior to undertaking treatment under items 3-(f), 3-(g) or 3-(h). It cannot be claimed where the same dentist*(see same dentist interpretation in Section XII – Interpretation)* has previously claimed items 3-(f), 3-(g) or 3-(h) for the same tooth within the last 11 complete calendar months.
• All claims under item 3-(j) must be able to be supported by a pre-operative radiograph showing the presence of radiopaque filling material within the root canal(s) of the relevant tooth.

3-(k) Internal Bleaching

• This item is exclusively for the internal bleaching of successfully root filled permanent incisor or canine teeth.
• This item must be supported by a pre-operative clinical photograph showing the discolouration and a pre-operative radiograph showing the presence of an adequate radiopaque filling within the root canal(s) of the relevant tooth.
• Patients must be 18 years or older at the start of any course of treatment that includes item 3-(k).
• This cannot be claimed alongside crowns, posts, inlays/onlays, conventional bridges or resin retained bridges on the same tooth.
• If internal/external bleaching is required for a successfully root filled tooth, then an external bleaching tray can be claimed for the specific tooth under item 7-(h).