Maxillofacial Appliances: Stents, Splints and Carriers
This group covers the smaller custom appliances that support head and neck medical care: feeding aids for infants with clefts, speech aid prostheses, surgical stents that hold grafts and dressings in position, radiation carriers and shields used during radiotherapy to position the beam or protect tissue, fluoride gel carriers for patients whose salivary glands have been damaged by radiation, commissure splints that prevent the corners of the mouth contracting after burns, and medicament carriers for vesiculobullous disease.
What maxillofacial appliance involves
This group covers the smaller custom appliances that support head and neck medical care: feeding aids for infants with clefts, speech aid prostheses, surgical stents that hold grafts and dressings in position, radiation carriers and shields used during radiotherapy to position the beam or protect tissue, fluoride gel carriers for patients whose salivary glands have been damaged by radiation, commissure splints that prevent the corners of the mouth contracting after burns, and medicament carriers for vesiculobullous disease. They have little in common clinically beyond being custom-made in a dental laboratory for a medical purpose, usually as part of a hospital treatment plan.
When this treatment is used
Made on referral from an oncology, surgical, cleft or dermatology team. Radiation appliances in particular are time-critical — a fluoride carrier or a radiation shield is needed before treatment starts, not after.
The fluoride carrier, which matters more than it seems
Head and neck radiotherapy commonly destroys salivary function permanently. The resulting dry mouth produces rampant decay at the necks of the teeth within months — a pattern distinctive enough that dentists recognise it immediately — and can end in osteoradionecrosis, where the irradiated jaw fails to heal after an extraction. A custom fluoride gel carrier, worn daily for life, is the main defence. It is a small appliance with a very large effect on whether a cancer survivor keeps their teeth. Anyone who has had head and neck radiotherapy should have one, and should have a dental assessment before radiotherapy begins so that any teeth needing extraction come out beforehand rather than afterwards.
Costs and insurance in summary
Typical fee range across the group: $0–$0 where a single band applies. Several codes here are priced individually and carry their own range on their own page. Highly variable by appliance. Fluoride carriers are inexpensive; radiation and surgical appliances cost considerably more.
Benefit category: Medical / maxillofacial, variable on a typical plan. Frequently claimed through medical insurance as part of cancer or surgical care. Some dental plans cover fluoride carriers for irradiated patients.
Common restrictions: Medical submission is usually the right route; Documentation linking the appliance to the medical treatment is required; Timing matters — appliances needed before radiotherapy should be arranged early.
The codes this guide covers
Each of these describes a variant of the same procedure. Follow a code for its own fee range, its coverage notes and what distinguishes it from the rest of the group.
| Code | Variant | Typical fee |
|---|---|---|
| D5951 | Feeding aid | $500–$1,500 |
| D5952 | Speech aid prosthesis, pediatric | $1,500–$5,000 |
| D5953 | Speech aid prosthesis, adult | $1,800–$6,000 |
| D5960 | Speech aid prosthesis, modification | $500–$1,800 |
| D5982 | Surgical stent | $400–$1,200 |
| D5983 | Radiation carrier | $500–$1,500 |
| D5984 | Radiation shield | $500–$1,500 |
| D5985 | Radiation cone locator | $500–$1,500 |
| D5986 | Fluoride gel carrier — most reported | $200–$600 |
| D5987 | Commissure splint | $600–$1,800 |
| D5988 | Surgical splint | $600–$1,800 |
| D5991 | Vesiculobullous disease medicament carrier | $300–$900 |
| D5992 | Adjust maxillofacial prosthetic appliance, by report | $150–$500 |
| D5993 | Maintenance and cleaning of a maxillofacial prosthesis, by report | $100–$400 |
Common questions
What is a fluoride carrier used for?
Daily home fluoride application for patients whose salivary glands have been damaged by head and neck radiotherapy. It is the main defence against the rampant decay that follows, and is usually worn for life.
Why do I need a dental check before radiotherapy?
Because teeth needing extraction should come out before treatment. Extracting a tooth from an irradiated jaw afterwards carries a real risk of the bone failing to heal.
Are these appliances covered by dental insurance?
Sometimes, but medical insurance is usually the right route since they support medical treatment. Documentation linking the appliance to that treatment is required.