Free Curodont (Self-Assembling Peptide) Note Template (D2991)
Curodont is applied to early caries lesions you are choosing not to drill, so the note has to show the lesion was right for it and how you will know whether it worked. This template documents lesion selection by tooth and surface, caries risk, consent, the application steps, and the baseline you will compare against at re-evaluation.
By Yasmin Byott, DDS, MS · Founder, ButterNote · Updated
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Curodont [product name] application (D2991), teeth: [#7 F, #10 F]. Lesions: [active, non-cavitated white spot lesions on the facial surfaces (chalky, rough to gentle probing), after orthodontic treatment]; [no cavitation; no radiographic dentin involvement]. Caries risk: [moderate]. Options reviewed, including [fluoride varnish, resin infiltration, and monitoring]; fees discussed; consent obtained. Baseline [intraoral photos] taken. Teeth cleaned and isolated with [cotton rolls and a cheek retractor]; lesions [cleaned and conditioned] per the manufacturer's instructions for use, rinsed, and dried. Curodont applied to each lesion and left undisturbed for [the time specified by the manufacturer]. Patient tolerated procedure well. Home care: [fluoride toothpaste twice daily; limit sugary snacks between meals]. Next visit: [re-evaluate the lesions with photos in 3 months].
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When to use this template
Use this Curodont note template when you apply a self-assembling peptide (P11-4) product to early, non-cavitated caries lesions, such as active white spot lesions on smooth surfaces or early proximal lesions. The peptide is applied to the cleaned lesion, diffuses into its porous subsurface, and assembles into a scaffold intended to support remineralization. A 2023 systematic review and meta-analysis in JADA, pooling six clinical trials, concluded that P11-4 likely results in a large increase in caries arrest of initial lesions compared with controls, but the evidence base is still small, which is one more reason to document a clear baseline.
The coding is where to be careful. CDT 2024 added D2991, application of hydroxyapatite regeneration medicament, per tooth, described as preparation of tooth surfaces and topical application of a scaffold to guide hydroxyapatite regeneration. It is distinct from D1354 (caries arresting medicament, such as silver diamine fluoride on an active lesion) and D1355 (caries preventive medicament). Whether a particular product and lesion qualify for D2991, how often it is covered, and whether it can be reported on the same tooth and date as other preventive codes are decided by each payer, and many plans do not cover it. Check the plan and tell the patient about any fee before treatment.
Document lesion selection by tooth and surface: the clinical appearance (for example a chalky, rough white spot, or an ICDAS score if you use it), that the lesion is not cavitated, its activity, and for proximal lesions the radiographic depth. Record caries risk, the alternatives discussed (fluoride, resin infiltration, monitoring), and consent. Take baseline photos or radiographs, because re-evaluation is a comparison. Name the product you used and follow its instructions for use for cleaning, conditioning, and application time, since the steps differ between products. Close with the supporting preventive plan and when the lesions will be re-evaluated.
Step by step: how to document this Curodont self-assembling peptide
- 1
Select the lesion
Confirm an active, non-cavitated lesion and record tooth, surface, appearance, and radiographic depth.
- 2
Consent
Review alternatives and fees, and record consent and caries risk.
- 3
Record the baseline
Take intraoral photos or radiographs of each lesion before treatment.
- 4
Clean and condition
Clean, isolate, and condition the lesion per the product's instructions for use.
- 5
Apply
Apply the peptide to each lesion and leave it undisturbed for the time the manufacturer specifies.
- 6
Plan re-evaluation
Record home-care advice and book the re-evaluation against the baseline.
Tips for using this template
- check_circleSelect and describe the lesion: non-cavitated, active, with its clinical appearance or ICDAS score, and the radiographic depth for proximal lesions.
- check_circleList every tooth and surface. D2991 is reported per tooth, and re-evaluation is per lesion.
- check_circleTake baseline photos or radiographs. Without a baseline, "improved" at re-evaluation is an opinion.
- check_circleName the product and follow its instructions for use. Cleaning, conditioning, and application time differ between products, and the note should match the one you used.
- check_circleRecord caries risk and the preventive plan around the application. A peptide does not replace fluoride, diet, and hygiene measures.
- check_circleCheck coverage first. D2991 has existed since CDT 2024, but coverage, frequency, and same-day rules vary widely by payer.
- check_circleIf the lesion is cavitated, this is the wrong tool: restore it, or consider silver diamine fluoride (D1354) for arrest.
- check_circleBook the re-evaluation and say how you will judge it: lesion size, surface texture, activity, and radiographic progression.
Standards & references
- Keeper et al. Systematic review and meta-analysis on the effect of self-assembling peptide P11-4 on arrest, cavitation, and progression of initial caries lesions (JADA 2023): Six-trial review finding P11-4 likely increases caries arrest of initial lesions compared with controls.
- RDH: CDT codes D1354, D1355, and the new D2991: Explains D2991 (application of hydroxyapatite regeneration medicament, per tooth) and how it differs from D1354 and D1355.
- ADA Code on Dental Procedures (CDT): D2991, D1354, and D1355 nomenclature and descriptors.
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