American Dental Association, advisory statement on use of computed tomography in dentistry

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The use of cone-beam computed tomography (CBCT) has expanded the field of oral and maxillofacial radiology and with commercially available machines appearing in dental practices The American Dental Association (ADA) has just published an advisory statement in the Journal of the American Dental Association.

The key element of the statement is captured in the practical implications in the abstract, which states: –

CBCT imaging should be used only after a review of the patient’s health and imaging history and the completion of a thorough clinical examination. Dental practitioners should prescribe CBCT imaging only when they expect that the diagnostic yield will benefit patient care, enhance patient safety or improve clinical outcomes significantly.

As they note CBCT units give a higher radiation dose that traditional dental radiographs. The UK Health Protection Agency gave the range for a typical effective patients dose from a small field of view CBCT machine as 48-652 microsieverts, this compares to 24 microsieverts for a panoramic film. This is between 2 and 27 times more.

A European Project, SEDENTEXCT undertook and evidence-based review of this area and a number of European National Guidance documents have been produced which take these into account and are available on their website.

Links

The American Dental Association Council on Scientific Affairs. The use of cone-beam computed tomography in dentistry: An advisory statement from the American Dental Association Council on Scientific Affairs. J Am Dent Assoc. 2012 Aug; 143(8): 899-902. PubMed PMID: 22855905.

SEDENTEXCT Guidelines.

Health Protection Agency – Guidance on safe use of Dental Cone Beam

 

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. He is a former editor of the Evidence-Based Dentistry Journal, the chief blogger for the Dental Elf website and a past president of the British Association for the Study of Community Dentistry. He has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Retired from the NHS he is currently a part-time senior lecturer at Dundee Dental School.

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