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CDT 2026: Salivary Diagnostics and Photobiomodulation
A few of the 2026 ADA CDT updates reflect a shift occurring throughout dentistry: the growing recognition and utilization of biologic diagnostics and minimally invasive therapeutic technologies. Two such code additions are the new point-of-care salivary diagnostic code (D0426) and the new photobiomodulation therapy (PBM) codes (D9128/D9129). Together, these additions suggest that dentistry is continuing to move beyond purely mechanical treatment models toward approaches centered on biology, inflammation, healing, and real-time patient assessment.
Chairside Salivary Diagnostics
D0426 Collection, preparation, and analysis of saliva sample — point-of-care
For years, salivary diagnostics have existed primarily within laboratory-based testing models using codes such as D0417 (collection and preparation of saliva sample for laboratory diagnostic testing) and D0418 (analysis of saliva sample). Advances in chairside technologies now allow clinicians to rapidly evaluate inflammatory markers as neutrophil activity and aMMP-8, microbial burden, enzymatic activity, and other biologic indicators directly at the point of care.
The introduction of D0426 now recognizes in-office salivary analysis as a distinct clinical service rather than simply a laboratory procedure. This reflects increasing interest in biologic screening, early disease identification, patient risk assessment, and real-time monitoring of oral-systemic inflammatory conditions.
Potential clinical scenarios may include:
- Chairside inflammatory screening during periodontal evaluations
- Salivary assessment in patients with suspected active periodontal disease
- Monitoring biologic response during periodontal maintenance
- Evaluating oral inflammatory burden around implants
- Risk-based preventive screening for medically compromised patients
Importantly, salivary diagnostics are not intended to replace traditional periodontal examination, radiographs, or microbial testing. Rather, these technologies may provide additional biologic information that complements existing clinical findings and enhances patient communication.
As salivary diagnostics continue to evolve, clinicians will likely see increasing integration of inflammatory biomarkers, host-response testing, microbial analysis, and oral-systemic screening into everyday dental workflows.
Photobiomodulation Therapy (PBM)
D9128 Photobiomodulation therapy — first 15-minute increment, or any portion thereof
D9129 Photobiomodulation therapy — each subsequent 15-minute increment, or any portion thereof
Another addition to CDT 2026 is the introduction of dedicated photobiomodulation (PBM) therapy codes. PBM, commonly associated with low-level laser therapy (LLLT), utilizes non-thermal light energy to modulate biologic activity, reduce inflammation, support healing, and assist with pain management including TMD.
Potential clinical applications may include:
- Management of postoperative discomfort and inflammation
- Adjunctive therapy following periodontal procedures
- Treatment support for mucositis and soft tissue lesions
- Management of temporomandibular discomfort
- Enhancement of wound healing and tissue recovery
The time-based structure of D9128 and D9129 is also notable, as it mirrors the format used for anesthesia and sedation reporting. This suggests increasing recognition of PBM as a defined therapeutic service rather than simply an adjunctive device application.
At present, many third-party payers may still consider PBM investigational or non-covered when submitted as a standalone procedure. Nevertheless, the presence of dedicated CDT codes frequently represents an early step toward broader clinical adoption, documentation consistency, and future reimbursement consideration.
Why These Codes Matter
Historically, CDT coding changes tend to follow emerging patterns of clinical utilization and technology adoption. The inclusion of point-of-care salivary diagnostics and photobiomodulation therapy in CDT 2026 signals increasing recognition that dentistry is expanding beyond conventional mechanical procedures toward biologically driven diagnostics and therapeutics.
As dentistry continues to evolve, biologic diagnostics and minimally invasive therapeutic approaches are likely to play an increasingly important role in prevention, periodontal management, implant maintenance, and oral-systemic health assessment.
Special thanks to AAP Past President Sam Low, DDS, MS, Med, for contributing to this article.
CDT 2026: Salivary Diagnostics and Photobiomodulation
A few of the 2026 ADA CDT updates reflect a shift occurring throughout dentistry: the growing recognition and utilization of biologic diagnostics and minimally invasive therapeutic technologies. Two such code additions are the new point-of-care salivary diagnostic code (D0426) and the new photobiomodulation therapy (PBM) codes (D9128/D9129). Together, these additions suggest that dentistry is continuing to move beyond purely mechanical treatment models toward approaches centered on biology, inflammation, healing, and real-time patient assessment.
Chairside Salivary Diagnostics
D0426 Collection, preparation, and analysis of saliva sample — point-of-care
For years, salivary diagnostics have existed primarily within laboratory-based testing models using codes such as D0417 (collection and preparation of saliva sample for laboratory diagnostic testing) and D0418 (analysis of saliva sample). Advances in chairside technologies now allow clinicians to rapidly evaluate inflammatory markers as neutrophil activity and aMMP-8, microbial burden, enzymatic activity, and other biologic indicators directly at the point of care.
The introduction of D0426 now recognizes in-office salivary analysis as a distinct clinical service rather than simply a laboratory procedure. This reflects increasing interest in biologic screening, early disease identification, patient risk assessment, and real-time monitoring of oral-systemic inflammatory conditions.
Potential clinical scenarios may include:
- Chairside inflammatory screening during periodontal evaluations
- Salivary assessment in patients with suspected active periodontal disease
- Monitoring biologic response during periodontal maintenance
- Evaluating oral inflammatory burden around implants
- Risk-based preventive screening for medically compromised patients
Importantly, salivary diagnostics are not intended to replace traditional periodontal examination, radiographs, or microbial testing. Rather, these technologies may provide additional biologic information that complements existing clinical findings and enhances patient communication.
As salivary diagnostics continue to evolve, clinicians will likely see increasing integration of inflammatory biomarkers, host-response testing, microbial analysis, and oral-systemic screening into everyday dental workflows.
Photobiomodulation Therapy (PBM)
D9128 Photobiomodulation therapy — first 15-minute increment, or any portion thereof
D9129 Photobiomodulation therapy — each subsequent 15-minute increment, or any portion thereof
Another addition to CDT 2026 is the introduction of dedicated photobiomodulation (PBM) therapy codes. PBM, commonly associated with low-level laser therapy (LLLT), utilizes non-thermal light energy to modulate biologic activity, reduce inflammation, support healing, and assist with pain management including TMD.
Potential clinical applications may include:
- Management of postoperative discomfort and inflammation
- Adjunctive therapy following periodontal procedures
- Treatment support for mucositis and soft tissue lesions
- Management of temporomandibular discomfort
- Enhancement of wound healing and tissue recovery
The time-based structure of D9128 and D9129 is also notable, as it mirrors the format used for anesthesia and sedation reporting. This suggests increasing recognition of PBM as a defined therapeutic service rather than simply an adjunctive device application.
At present, many third-party payers may still consider PBM investigational or non-covered when submitted as a standalone procedure. Nevertheless, the presence of dedicated CDT codes frequently represents an early step toward broader clinical adoption, documentation consistency, and future reimbursement consideration.
Why These Codes Matter
Historically, CDT coding changes tend to follow emerging patterns of clinical utilization and technology adoption. The inclusion of point-of-care salivary diagnostics and photobiomodulation therapy in CDT 2026 signals increasing recognition that dentistry is expanding beyond conventional mechanical procedures toward biologically driven diagnostics and therapeutics.
As dentistry continues to evolve, biologic diagnostics and minimally invasive therapeutic approaches are likely to play an increasingly important role in prevention, periodontal management, implant maintenance, and oral-systemic health assessment.
Special thanks to AAP Past President Sam Low, DDS, MS, Med, for contributing to this article.