72019Feb
3D Imaging and CBCT and Cone Beams – OH MY!

3D Imaging and CBCT and Cone Beams – OH MY!

There has been A LOT of interest lately in dental 3D imaging (technically known as Cone-Beam Computerized Tomography or CBCT)- especially regarding its use in evaluating root canal teeth and areas in the bone where teeth have been removed.  Below are some answers to the most commonly asked questions from our TKDDS community of patients.  We hope it is helpful and we WELCOME you into this important conversation!

What is a Cone Beam (CBCT)?

Cone-beam computed tomography systems (CBCT) are a variation of a CT Scan.  The data collected by the scan is used to reconstruct a three-dimensional (3D) image of specific regions of the patient’s teeth, ligaments, nerve canals, sinuses, upper and lower jaw bone.

What are the benefits?

CBCT offers a three-dimensional image vs. a two-dimensional image, like the digital x-rays taken in our office.  The CBCT allows for more visual detail and can be utilized in determining a specific diagnosis of pathology.

What are the risks?

CBCT imaging typically delivers significantly more ionizing radiation than conventional digital dental x-rays.  The cumulative effects of radiation are a serious concern and can lead to toxicity, cellular death, cancer, and many other significant health challenges.  Therefore, as a diagnostic tool, ionizing radiation (whether digital dental x-rays or CBCT) should always be viewed as a benefit vs. risk procedure.

Do we do CBCT imaging at TKDDS?

At TKDDS, we view the use of CBCT as a valuable tool used under the right circumstances and on an individual basis.  Dr. Kaur and Dr. Laabs use discernment in recommending any ionizing radiation due to the potential deleterious side-effects. Therefore, seeing our patients for a full holistic assessment, comprehensive dental evaluation, and consultation is the first step in determining if a CBCT is necessary for diagnosis and/or use as a guide for dental implant placement.  We want to be sure that the benefits outweigh the risks associated with such procedures. The TKDDS Team takes time to educate and empower our patients with all the options available as well as the advantages, disadvantages and costs for every procedure we recommend.  We do not have CBCT imaging available in our office.  If a CBCT is recommended, we refer out to local dental specialists (Oral Surgeon, Periodontist) for this diagnostic imaging.

Do we refer for these?

CBCT is becoming more known in the dental arena and many dental offices are now providing this type of imaging.  At TKDDS we work with a network of like-minded practitioners who understand the importance we place on not only the mouth but the whole body.  We work closely with a few Oral Surgeons and Periodontists who offer CBCT and refer patients to them if the benefit of CBCT out-weighs the perceived risks. Some factors we take into consideration before referring to a dental specialist for CBCT are- what are the patient’s questions and concerns? is the patient having symptoms either in the mouth or the body or both? what are the symptoms and how long has the patient been exhibiting symptoms? based on the intra-oral and extra-oral exam, is there some concern to look further into that would require ionizing radiation? do we see anything questionable on the digital dental x-rays in the patients chart? Is there any uncompleted dental treatment needed that may be causing symptoms?

What does the FDA and the ADA say about these images?

The American Dental Association (ADA) and the Food and Drug Administration (FDA) recommend dental clinicians perform digital dental x-rays and dental CBCT, only when necessary for the diagnosis or treatment of disease.  The clinical benefit of a medically appropriate digital dental x-ray or CBCT can outweigh the radiation risk. However, efforts should be made to help minimize this risk. CBCT imaging should only be used when necessary to provide clinical information that cannot be provided using other imaging modalities.

What do we recommend?

At TKDDS, we recommend having a comprehensive exam and a consultation to see if CBCT imaging would be recommended for your individualized circumstance.  If it is determined that a CBCT is necessary, we discuss the risks and benefits with you, answer all of your questions and if YOU decide to move forward with CBCT, we refer you to one of our trusted dental specialists who respects and understands our holistic philosophy.  This forms a network of trusted, holistic minded specialists who are taking into consideration your dental needs in relation to your whole-body health.

https://www.fda.gov/radiation-emittingproducts/radiationemittingproductsandprocedures/medicalimaging/medicalx-rays/ucm315011.htm