E

E

Early and Periodic Screening, Diagnosis and Treatment Program (EPSDT): A federal program that provides comprehensive health care for children through periodic screenings, diagnostic and treatment services.

ECF: See extended care facility.

edentulous: Without teeth.

eligibility date: The date an individual and/or dependents become eligible for benefits under a dental benefit contract.  Often referred to as effective date.

eligible person: See beneficiary.

Employment Retirement Income Security Act (ERISA): A federal act, passed in 1974, which established new standards and reporting/disclosure requirements for employer-funded pension and welfare benefit programs.  To date, self-funded health benefit plans operating under ERISA have been held to be exempt from most state insurance laws, although the courts have held that the states can regulate the medical care provided under such plans, as by requiring mandatory review of adverse HMO determinations.

enamel: Hard calcified tissue covering dentin of the crown of tooth.

endodontics: Endodontics is the branch of dentistry which is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

endodontist: A dental specialist who limits his/her practice to treating disease and injuries of the pulp and associated periradicular conditions.

enrollee: Individual covered by a benefit plan. See beneficiary.

enteral: See definition under anesthesia.

entity: Something that exists as a particular and discrete unit. Persons and corporations are equivalent entities under the law.

EOB:  See explanation of benefits.

EPSDT: See Early and Periodic Screening, Diagnosis and Treatment Program.

equilibration: Reshaping of the occlusal surfaces of teeth to create harmonious contact relationships between the upper and lower teeth; also known as occlusal adjustment.

ERISA: See Employment Retirement Income Security Act.

established patient: A patient who has received professional services from a dentist or another dentist of the same specialty who belongs to the same group practice, within the past three years, subject to state laws.

evaluation: The patient assessment that may include gathering of information through interview, observation, examination, and use of specific tests that allows a dentist to diagnose existing conditions. Please refer to specific oral evaluation code descriptors for more complete definitions.

Evidence-Based Dentistry: An approach to oral health care that requires the judicious integration of systematic assessments of clinically relevant scientific data relating to the patient’s oral and medical condition and history, with the dentist’s clinical expertise and the patient’s treatment needs and preferences.

evulsion: Separation of the tooth from its socket due to trauma. See avulsion.

excision: Surgical removal of bone or tissue.

exclusions: Dental services not covered under a dental benefit program.

Exclusive Provider Organization (EPO): A type of preferred provider organization under which employees must use providers from the specified network of dentists to receive coverage; there is no coverage for care received from a non-network provider except in an emergency situation.

exfoliative: Refers to a thin layer of epidermis shed from the surface.

exostosis: Overgrowth of bone. See torus.

expiration date: In dentistry, the date on which the dental benefit contract expires; the date an individual ceases to be eligible for benefits.

explanation of benefits: A written statement to a beneficiary from a third-party payer, after a claim has been reported, indicating the benefit/charges covered or not covered by the dental benefit plan.

extended care facility: A facility such as a nursing home which is licensed to provide 24-hour nursing care service in accordance with state and local laws. Several levels of care may be provided—skilled, intermediate, custodial, or any combination.

extension of benefits: Extension of eligibility for benefits for covered services, usually designed to ensure completion of treatment commenced prior to the expiration date. Duration is generally expressed in terms of days.

extraoral: Outside the oral cavity.

extracoronal:  Outside the crown of a tooth.

extraction: The process or act of removing a tooth or tooth parts.

exudate: A material usually resulting from inflammation or necrosis that contains fluid, cells, and/or other debris.