Technology is rapidly changing how we practice dentistry. While Cone Beam CT has been available in the United States since the early 2000s, they have become increasingly more affordable and therefore more widespread in the practice of dentistry. From implant treatment planning, visualization of pathology in three-dimensions, to getting an image of that unknown entity in a panoramic, Cone Beam CT is a fantastic addition to the dentist’s diagnostic toolbox. This technology is here to stay and will be available in more and more dental offices.

Most dentists prefer the clinical side of dentistry, however, we are also called upon to wear the many hats of being a business owner. New technology, the Cone Beam CT included, is utilized not just for clinical purposes, but as a way to increase case acceptance and chairside efficiency. There aren’t many dentists receiving formal training in Cone Beam CT so numerous courses have popped up to fill the education gap. And while it is possible to become proficient in reading Cone Beam CT from the courses, the big question remains – is this the best use of the practicing dentists time?

Like any other radiographs acquired in dentistry, a “report” is always indicated. What is a report? It can be as simple as stating the findings. Such an example would be “#14 DO caries extending to the pulp with periapical pathology present, consistent with apical periodontitis.” Regardless of the length of such a record, a record nonetheless must be made to demonstrate that the images were reviewed, and what the findings were. A plan of action, or treatment plan, can also be thought of as the end goal of such a report. The report then gives a glimpse into the thought process behind what led the provider to provide treatment, thus becoming an important part of the patient’s medico legal record.

So what about Cone Beam CT? Just like any other radiograph, the entirety of the volume needs to be reviewed and findings documented, and as needed, what follow-up should be done. Is this something that can be done in a few minutes adequately? How can we effectively and efficiently show our patients what we’re seeing that requires further treatment or expertise? Below we’ll explore 5 ways a radiology report, specifically one written by an Oral & Maxillofacial Radiologist, can increase the dentist’s chairside efficiency.

1. Consistent Patient Communication

Dentists are visual people, and so are our patients.  We can see this clearly when it comes to the various ways we explain treatment options: models, pictures, and videos are all tools used to increase a patient’s acceptance of a treatment plan. Patient’s are also creatures of habit and expect consistent quality in the dental practice they become a part of. All this being said, a well-written and organized radiology report with images of important findings are another tool for the dentist to use chairside.

Sliding between multiple parts of a Cone Beam CT while chairside can take away important minutes needed to do other things. Spending the tedious time to capture images yourself and organize them in a way that consistently reflects the high standards of your practice is monotonous and also time consuming work. A consistent product, in this case the radiology report, is something that an Oral & Maxillofacial Radiologist can provide. Your time can be better spent reviewing the report with the patient, quickly moving through the images, because after all, “a picture is worth a thousand words.”

2. Proper Referral from the Start

How many of us have seen our own healthcare provider, only to be bounced from one referral to the next, finally reaching the correct person? I suspect many of us have had an experience similar to this and wish we could have been referred correctly in the first place. This process can frustrate our own patients, leading to wasted visits and copays spent before finally reaching the proper provider – or even result in unwanted visits back to our office as the problem persists. What about saving the patient an unnecessary visit to anyone outside your office altogether? In the world of dentistry today, our colleagues in Oral Surgery often become the filter for all our patients when we see something weird on imaging. And while I would never advocate for not sending a patient to oral surgery for pathology, wouldn’t it be nice if there was a way to know if something on imaging warranted a referral to them in the first place before the patient made the trip?

An Oral & Maxillofacial Radiologist can act as the referral gatekeeper – providing additional insight on whether something needs referral, whom it should be referred to, and if additional imaging is requested. The Oral & Maxillofacial Radiologist’s report can be further utilized as a communication tool between the referring dentist and the specialist or medical provider when sent with the patient. This eliminates the need to write an extensive referral letter as well as providing key information and images that limits the need for unnecessary phone calls when more information is often requested, all of which would cut into the time the dentist should be spending chairside.

3. Discovering More Treatment Needs

How much time can be or should be spared during chair time with the patient to review a Cone Beam CT without cutting into your time that you should be treating a patient? 3 minutes? 1 minute? Most dentists find themselves either reviewing the volume very quickly chairside or having to do so at the end of a long day, adding to the burden of work that keeps one at the office late. Having an Oral & Maxillofacial Radiologist review the entirety of the Cone Beam CT will provide documentation of additional dental treatment that might have been missed otherwise, especially those findings that are not readily visible on other two-dimensional imaging. With so little time to review a Cone Beam CT, having another set of eyes reviewing each tooth for caries and root pathology can lead to an increase in finding more dental treatment to render for the dentist. The report provides an easy roadmap of additional treatment that can easily be added to the patient’s treatment plan. All of this allows for more time to be chairside, treating patients and optimizing productivity. 

4. More time for other Business Related Items

In many offices, the dentist is also the business owner or manages some aspect of the office. With so many hats to wear throughout the day, there are countless things vying for their attention: employee drama, collection problems, or the previously mentioned referral letters and review of all imaging, to name a few. Having a radiology report frees the dentists from one more responsibility and allows their focus to be on maintaining productivity of the office and it’s staff. A radiology service that can further automate and streamline this process can free the staff to return chairside quicker upon uploading a case or to be more productive for the office by fulfilling their many responsibilities assigned to them throughout the day.

Productivity chairside relies on collections which means dealing with ever frustrating insurance companies. A radiology report is a valuable piece of information that can be utilized to provide adequate documentation for the treatment plan being rendered and therefore can result in less claim rejections for treatment provided to patients with insurance.

5. Peace of Mind

Who doesn’t like some peace of mind? While this doesn’t directly impact time spent chairside, having peace of mind that the Cone Beam CT volume has been thoroughly reviewed by an Oral & Maxillofacial Radiologist means that the dentist shares the liability instead of carrying the burden themselves. This removes some of the stress of managing a practice, especially when relying on associates to maintain the same quality when reviewing Cone Beam CT volumes.

Patients also receive peace of mind knowing that the dreaded “C” word (cancer) hasn’t been missed. It is another tool in explaining to those difficult patients that a second set of eyes have reviewed things such as quality and/or quantity of bone for dental implants, and it is not only them saying this but a dental radiology expert backing them up.

Having a radiology report is an effective tool in keeping the dentists chairside and productive. The radiology report can act as an effective communication tool with patients for case acceptance and  proper referral with time saved having to write a report yourself. It can help you find more dental treatment to be done, provide better documentation resulting in less claim rejections from insurance companies, and utilize your time to manage other business related items that can’t be easily handed off. It can give you and your patient’s peace of mind that everything is thoroughly reviewed as well as having a dental radiology expert in your corner.

Ultimately having a radiology report sets your practice apart from others and shows your patients that you go that extra mile to have everything reviewed by the specialty of dentistry who are the experts regarding Cone Beam CT.

Ryan Holmes, DDS

Oral & Maxillofacial Radiologist / Co-Founder

True View Dental Radiology