In the August issue of The Journal of the American Dental Association, the ADA’s Council on Scientific Affairs (CSA) presents a report with recommendations for the safe use of cone-beam computed tomography (CBCT) in dental practices.
The published recommendations provide essential principles for consideration in the selection of CBCT imaging for individual patient care. According to the guidelines, clinicians should perform radiographic imaging, including CBCT, only after professional justification that the potential clinical benefits will outweigh the risks associated with exposure to ionizing radiation. However, CBCT may supplement or replace conventional dental x-rays when the conventional images will not adequately capture the needed information.
The recommendations emphasize the application of professional judgment in clinical decision-making that is informed by the latest scientific evidence and professional guidance. A guiding principle for use of all x-rays, including CBCT, is to keep radiation exposure as low as reasonably achievable (ALARA). The new statement incorporates the ALARA principle while also recognizing the need to expand pre-doctoral and continuing dental education on CBCT use and image interpretation. Actions recommended to help achieve this principle include: consulting with a medical physicist or other qualified expert to perform equipment evaluations at installation; confirming compliance with local, state, and federal requirements at least annually; and establishing a facility quality control program.
Based on a review of the latest scientific research and input from a number of subject matter experts, the initial recommendations underwent a broad stakeholder review process, resulting in input from other ADA councils and the following organizations to develop the final statement: the American Association of Orthodontists, American Academy of Oral and Maxillofacial Pathology, American Academy of Oral and Maxillofacial Radiology, American Academy of Pediatric Dentistry, American Academy of Periodontology, American Association of Endodontists, American Association of Oral and Maxillofacial Surgeons, American Association of Physicists in Medicine, Conference of Radiation Control Program Directors, National Council on Radiation Protection & Measurements, and the US Food and Drug Administration.
