Dentaltown June 2019 - 36

message board

started sending every scan to a radiologist (?) for evaluating everything on the scan. I get the
report and give a copy to the patient. Is this necessary, or just CYA? ■
3/6/2019

drwillie
Member Since: 10/14/02
Post: 57 of 120

I think it's CYA. IMHO, the jury is still out on whether we're truly responsible for everything that can be seen on a CBCT. Has this been tested in court? What are the precedents? ■
3/6/2019

ttowndds
Member Since: 12/19/13
Posts: 59 and 60 of 120

I have a CBCT and would never practice without one. I take very limited views of areas
that I cannot diagnose with conventional radiographs or if I am doing an implant. That said, if
something serious was showing on a CBCT in a limited view, it would likely show on a PA or
pan. This is why I take limited-view.
That said, I think it is sad that we cannot do what's best for the patient because we're scared
we might not diagnose something that isn't in our scope of practice. IMO, what is best for the
patient is to take the scan and hope that we would catch something that could be serious, rather
than not take the scan at all. Not taking the scan at all has a 100% chance of not catching a
lesion and that you are going in more blind. As a patient, I know what I'd want.
If this was really true legally, I know a lot of ENTs who should be sued for missing dental
lesions, even when they are leaking into the sinus.
To those who mention that you don't really "need" a CBCT: You are correct, sort of. It's like
a lot of things in our offices; we don't really need a lot of it. We don't need electric handpieces,
lasers, Cerecs, cameras, etc, but we have them to provide our patients with the best care possible.
IMO, you should take a CBCT for every implant case. The day something goes wrong and you
get sued on an implant case, your chances of winning without a CBCT are pretty low, especially
with nerve injury.
To those who don't do endo or place implants: I use mine for diagnostics nearly every day,
most commonly with upper molar TAs. You would be shocked at how big of an abscess someone
can have that shows normal on a PA. (Same goes for other teeth, but most commonly in the
upper molars.) I've had probably 10 cases in the past 12 months where someone was positive
it was one tooth hurting but the CBCT showed a PARL two teeth away or on the other arch.
I have taken countless CBCT's for an implant or endo and it showed PARLs on other teeth as
well. Honestly, I'd say that 10-15% of the time I catch PARLs unexpectedly when taking a
CBCT for an implant.
For me it's like this: If you or a family member were in pain and the doctor couldn't figure it
out, yet you knew he didn't have all the diagnostic tools to help you, you'd find a new doctor. ■
3/6/2019

Does better tech always mean better dentistry?
Check out this full discussion online to read a variety of opinions on bringing CBCT
scans into general practice. Is this a good idea or just a waste of money? See what
others are saying. Search "CBCT everytime" on dentaltown.com/messageboard and
this board will be one of the top results.

36

JUNE 2019 // dentaltown.com


https://www.dentaltown.com/Search.aspx?q=cbct+everytime http://www.dentaltown.com

Dentaltown June 2019

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