D9946 is the CDT code for an occlusal guard, hard appliance, partial arch. It is a fabricated partial-arch hard or rigid guard used for bruxism and clenching management and occlusal protection. D9944 is the hard full-arch version and D9945 is the soft full-arch version.
Last updated June 2026 · Reviewed by the PracticeAlpha billing team
Use D9946 when fabricating a partial-arch hard occlusal guard for the patient. The guard is a rigid appliance that covers only part of the arch and is used to manage bruxism and clenching and to protect the occlusion. The combination of a hard material and partial-arch coverage is what separates D9946 from the full-arch and soft guard codes.
Common clinical scenarios: A patient who needs a durable rigid guard but only over a portion of the arch. Bruxism or clenching where a partial-coverage hard appliance is the chosen design. Occlusal protection in a localized area where a full-arch guard is not the plan.
Do NOT use D9946 for: A hard full-arch guard (use D9944). A soft full-arch guard (use D9945). A sleep apnea or snoring appliance (use the D9947 to D9949 series). An athletic mouthguard. A repair or reline of an existing guard, which is reported with its own separate code.
Click any code to see the difference.
A rigid guard covering only part of the arch. Partial coverage with a durable hard material for the targeted area.
A rigid guard covering the entire arch. Same hard material as D9946, but full-arch coverage rather than partial.
Billing tip: Both are hard guards, so the arch coverage is the only difference. Partial arch is D9946, full arch is D9944. The clinical note should state whether the guard covers part of the arch or the whole arch so the code matches the appliance delivered.
Occlusal guards are often excluded or limited by the dental plan. Some plans do not cover guards at all, and others cap the benefit or restrict it to specific diagnoses. Verify the guard benefit before treatment so the patient knows what the plan will and will not pay, and to avoid a surprise balance after delivery.
A guard claim needs a clear bruxism or TMD diagnosis to support medical necessity. Without a narrative describing the grinding, clenching, wear, or temporomandibular symptoms, the payer has no basis to approve the appliance. Document the diagnosis and the clinical findings that justify the guard.
Most plans that cover guards allow one within a set time window. If the patient received an occlusal guard within that period, a new one is denied regardless of need. Check the guard history before treatment and, if a replacement is genuinely required, submit a narrative explaining why.
Billing an occlusal guard when the device was a sleep apnea appliance, or the reverse, triggers denials. D9946 is a bruxism guard. Sleep apnea appliances live in the D9947 to D9949 series and route to a different benefit. The documentation has to make clear which device was delivered, including that the guard is partial arch and hard.
Record the diagnosis driving the guard, such as bruxism, clenching, or a temporomandibular disorder. This diagnosis is the primary support for the medical necessity of the appliance.
State that the guard is a hard material covering a partial arch. Documenting both the material and the arch coverage keeps D9946 distinct from the soft and full-arch guard codes.
Document the wear facets, muscle soreness, fractured restorations, or other findings that show the grinding or clenching is causing harm. Specific findings strengthen the claim more than a general statement.
Make clear in the record that the device is an occlusal guard for bruxism, not a sleep apnea or snoring appliance. This keeps the claim in the correct benefit category.
Verify the guard benefit and any frequency limitation before treatment. Record what the plan covers and note any prior guard so the frequency window is clear on the claim.
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Learn about our billing servicesD9946 is the CDT code for an occlusal guard, hard appliance, partial arch. It is a fabricated partial-arch hard or rigid occlusal guard used for bruxism and clenching management and occlusal protection. D9944 is the hard full-arch version and D9945 is the soft full-arch version.
D9946 is a hard partial-arch occlusal guard. D9944 is a hard full-arch occlusal guard. Both are rigid, but the coverage is the difference. D9946 covers only part of the arch, while D9944 spans the entire arch.
D9946 is a hard partial-arch occlusal guard. D9945 is a soft full-arch occlusal guard. They differ in both material and coverage. D9946 is rigid and partial arch, while D9945 is soft and spans the whole arch.
Common reasons: occlusal guard benefits being excluded or limited by the plan, a missing bruxism or TMD diagnosis narrative, frequency limitations on a prior guard, confusion between guard codes and sleep apnea appliances, and documentation that does not specify partial arch and hard material.
No. An occlusal guard such as D9946 protects the teeth from bruxism and clenching. A sleep apnea or snoring appliance is a different device with its own codes in the D9947 to D9949 range. Billing an occlusal guard code for a sleep apnea appliance is a coding error.
No. D9946 covers the fabrication of the hard partial-arch occlusal guard itself. Later adjustments, relines, and repairs of an existing guard are reported with their own separate codes, not under D9946.
Search all 206 CDT codes in our dental coding guide.