Tooth Gym

Cash prices

1. Deep Cleaning (Scaling and Root Planing) - 1-3teeth

   Standard service: Deep cleaning (scaling and root planing, 1-3 teeth per quadrant)

   Code D4342

   Ask what's included
   $99 per unit

   Per quadrant (1–3 teeth).

   Source: toothgym.com · checked Oct 2026
2. Deep Cleaning (Scaling and Root Planing) - 4+ teeth

   Standard service: Deep cleaning (scaling and root planing, 4+ teeth per quadrant)

   Code D4341

   Ask what's included
   $199 per unit

   Per quadrant (4+ teeth).

   Source: toothgym.com · checked Oct 2026
3. New Patient Assessment & Planning

   Standard service: New patient exam & treatment plan

   Ask what's included
   $59
   Source: toothgym.com · checked Oct 2026
4. Periodontal Maintenance (D4910)

   Standard service: Periodontal maintenance

   Code D4910

   Ask what's included
   $149 per visit
   Source: toothgym.com · checked Oct 2026
5. Scaling in the Presence of Inflammation (D4346)

   Standard service: Scaling with gingival inflammation (full mouth)

   Code D4346

   Ask what's included
   $139 per visit
   Source: toothgym.com · checked Oct 2026
6. Stain Removal Polish (No scaling)

   Ask what's included
   $59 per visit
   Source: toothgym.com · checked Oct 2026
7. Adult Prophylaxis (D1110)

   Standard service: Teeth cleaning (adult)

   Code D1110

   Ask what's included
   $129 per visit
   Source: toothgym.com · checked Oct 2026
8. Child Prophylaxis (D1120) - age 14 and under

   Standard service: Teeth cleaning (child)

   Code D1120

   Ask what's included
   $79 per visit
   Source: toothgym.com · checked Oct 2026
9. Tooth Gem/Bonding Removal

   Ask what's included
   from $40 per unit

   Starting at $40 per tooth.

   Source: toothgym.com · checked Oct 2026

Prices are published cash prices with their source and the date we last checked. Confirm with the provider before you book. Hospital prices for a billing code are often the facility charge only.