Preventive dentistry is the backbone of long-term oral health—and one of the most effective preventive services we can offer is the dental sealant. But when it comes time to bill, many dentists and team members ask:

When is it appropriate to use CDT code D1351?
And just as important—how do we document it to get it paid?

Let’s decode D1351 and look at when and how to use it properly.

What Is CDT Code D1351?

D1351: Sealant – per tooth

Description:
This code is used for the application of a resin-based or glass ionomer sealant to the occlusal surface of a posterior tooth to prevent decay.

Simple enough, right? But proper usage depends on clinical indicators, patient age, and insurance policies.

When Should You Use D1351?

1. Occlusal Surfaces of Permanent Molars

This is the most common and appropriate use of D1351—especially on first and second permanent molars in children and teens. These teeth often have deep pits and fissures that are prone to decay.

2. Preventive Intent – No Existing Restorations

The tooth must be sound or at risk, but not yet restored. You should not use D1351 on a tooth that already has a filling or crown on the occlusal surface.

3. Typically Ages 6–14

Most insurance plans only cover D1351 for children, usually between ages 6 and 14. Some may extend coverage to age 18. For adults or primary teeth, coverage is rare—but the code can still be used if clinically justified.

4. No Active Decay Present

D1351 is for preventive care, not treatment. If decay is present, and you're using a sealant material to fill or repair a lesion, that may fall under a different code (e.g., a filling or interim therapeutic restoration).

When Not to Use D1351

• On a tooth that already has a restoration.

• If the sealant is placed to cover treated decay (use a restoration code instead).

• Just to “fill in” an anatomy that doesn’t need it.

• On primary teeth unless you have strong documentation and understand it likely won’t be reimbursed.

Documentation Tips for D1351

Insurance companies scrutinize sealant claims—especially when they’re outside the typical age range. Here's how to improve your chances of reimbursement:

1. Chart the Tooth Number and Surface

Specify that it's the occlusal surface of an eligible molar (e.g., #30-O).

2. Note the Eruption Status

Many payers won’t cover sealants on teeth that aren’t fully erupted. Document “Tooth fully erupted” if applicable.

3. Record the Clinical Justification

Examples:

• “Deep pits and fissures present”

• “No existing restoration or caries”

• “At risk for occlusal decay due to anatomy and hygiene challenges”

4. Keep It in Your Clinical Notes

This is important even if you don’t plan to submit to insurance. It protects you in the event of audits and supports continuity of care.

Bonus: Can You Bill D1351 and a Cleaning on the Same Day?

Yes—D1351 can be billed on the same date of service as D1120 (child prophylaxis) or D1110 (adult prophy), and even fluoride (D1206/D1208). These are all preventive codes and typically reimbursed together, provided policy limits aren’t exceeded.

Final Thoughts

D1351 is a valuable, preventive code that supports the long-term health of your patients—especially younger ones. Use it correctly by applying it:

• To occlusal surfaces of permanent molars,

• When no decay or restoration is present,

• With proper documentation.

By understanding the clinical intent and insurance nuances of D1351, you can confidently provide sealants while minimizing denials and keeping your records audit-ready.