Does Delta Dental Cover Gum Cleaning? What You Should Know About Deep Cleanings and Periodontal Coverage

By Dr. Mason Haddow

Yes, Delta Dental does cover gum cleaning, but what kind of cleaning you need and why you need it determines how much is covered and what you’ll pay.

Whether you’re going in for your regular six-month visit or you’ve been told you need a deep cleaning to treat gum disease, your insurance plays a big role in the total cost. This guide breaks down what Delta Dental actually covers when it comes to gum health, how coverage differs between PPO and DHMO plans, and how to make sure you get the care you need without blowing your budget.

Key Takeaways

✔ Routine cleanings are covered 100 percent under most Delta Dental plans
✔ Deep cleaning and periodontal maintenance are covered with documentation
✔ PPO plans reimburse 50 to 80 percent, DHMO plans use fixed copays
✔ Treatment must be medically necessary to qualify
✔ Premier Image Dentistry helps patients understand and use their gum care benefits

What Is Gum Cleaning and Why Is It Important?

Gum cleaning isn’t one-size-fits-all. There are three main types:

Routine preventive cleaning (prophylaxis): For people with healthy gums
Scaling and root planing (deep cleaning): For patients with gum disease or deep pockets around the teeth
Periodontal maintenance: Ongoing care after treatment for gum disease

Each one plays a critical role in preventing tooth loss, inflammation, and even conditions like heart disease.

Types of Gum Cleaning and Dental Codes

1. Preventive Cleaning (D1110)

Standard cleaning, usually covered 100 percent by most Delta Dental plans twice a year

2. Scaling and Root Planing (D4341/D4342)

For patients with periodontal pockets or bone loss
Covered as a basic or major service, depending on your plan

3. Periodontal Maintenance (D4910)

Follow-up care every 3 to 4 months after deep cleaning
Requires a documented history of periodontal treatment

Does Delta Dental Cover Deep Cleaning (Scaling and Root Planing)?

Yes, but how much is covered depends on your plan type.

With PPO:

Typically covers 50 to 80 percent of the procedure
You may need to meet your deductible first
Often subject to annual maximum benefits

With DHMO (DeltaCare USA):

Fixed copays apply, generally $35 to $75 per quadrant
You must use your assigned provider and follow treatment protocols

You’ll usually need to show evidence of periodontal disease, such as X-rays or gum measurements.

Does Delta Dental Cover Periodontal Maintenance?

Yes, if you’ve already been treated for gum disease.

Typically covered 2 to 4 times per year in place of routine cleanings
Requires documentation of prior scaling and root planing
Coverage varies by plan, but most PPOs reimburse 50 to 80 percent
DHMO plans offer maintenance cleanings through a structured care plan

PPO vs DHMO: What’s the Difference?

PPO Plans:

More flexible
Choose your dentist
Better for those who need deep or ongoing gum treatment

DHMO Plans:

Requires you to use in-network providers
Lower premiums
Copay-based and more predictable, but fewer options

What Might Affect Your Gum Treatment Coverage?

The type of cleaning being performed
Whether it’s preventive or medically necessary
Your plan’s deductible and annual max
Proper claim documentation from your dentist
Your network status (in or out)

Cost of Gum Cleaning With and Without Insurance

Without Insurance:

Routine cleaning: $100 to $150
Deep cleaning: $200 to $400 per quadrant
Periodontal maintenance: $150 to $250 per session

With Delta Dental PPO:

Routine cleaning: Often free
Deep cleaning: $100 to $250 per quadrant after coverage
Periodontal maintenance: $50 to $100

With DeltaCare USA (DHMO):

Routine cleanings: Small copay or covered
Deep cleaning: $35 to $75 per quadrant
Periodontal maintenance: Low copay, varies by provider

How to Maximize Your Gum Cleaning Coverage

Stick to your recall schedule to avoid falling into deeper issues
Use in-network providers
Get a pre-treatment estimate before scheduling deep cleaning
Spread treatments over multiple benefit years if needed
Use FSA or HSA funds to cover what your insurance doesn’t

What If Deep Cleaning Isn’t Covered?

1. Submit Additional Documentation

Ask your provider to send X-rays or periodontal charting to justify the need.

2. Consider Timing and Budgeting

Split quadrants into multiple visits across calendar years to avoid hitting your max.

3. Ask About Payment Plans

Premier Image Dentistry offers flexible payment options and works with CareCredit so you don’t have to delay important care.

Looking for Gum Treatment in Lathrup Village?

At Premier Image Dentistry, we provide:

Comprehensive gum care, from cleanings to full periodontal therapy
In-network options for Delta Dental PPO and DHMO
Expert insurance verification and claim support
Payment plans to keep costs manageable

Book your cleaning or periodontal consultation today and take the first step toward a healthier smile.

Conclusion

Delta Dental covers gum cleanings, but the kind of cleaning and your plan type determine what’s covered and how much you’ll pay. Preventive cleanings are usually free, while deeper cleanings and maintenance require more planning.

Know your codes, understand your plan, and work with a provider who can help you get the care you need without the stress.