By Dr Daniel Selim*
In the current age of in-house advanced imaging in dental practices, it is imperative to ensure every image taken is documented. This goes beyond brief notes in a patient file but should involve thorough review. Dental practitioners may be the first health professional to see a patient’s maxillofacial region on imaging. As such, dental practitioners have a role in screening all scans they take.
The maxillofacial region is abutted by complicated anatomical structures. It may be easy to focus on the jaws, but often the images taken in dental practice may include parts of the floor of mouth, the tongue, the palate, the neck, cervical spine, base of skull, paranasal sinuses, nasal cavity and the upper airways. There are a mix of soft tissue and hard tissue structures, and with Cone Beam CT, we are often able to observe the hard tissues in great detail. Research has also highlighted the need for improvement in recognising pathology outside the jaws, including the maxillary sinuses and TMJ.1
As primary health professionals, we are obliged to note any findings in any of these structures that are imaged, even if we are not specifically trained in reporting. If the practitioner exposes a patient to radiation, they have a responsibility to report on the findings.2
Ideally, radiology reporting should always be done by a trained Radiologist/Oral and Maxillofacial Radiologist if access is available.
" Your practitioners and patients will have peace of mind knowing that your state of the art practice provides quality imaging and maxillofacial reporting services. "
It is estimated that approximately currently less than half of dental practitioners in Australia are reporting on their own imaging, and approximately 35% are recording findings from their own scans without writing a full report. Less than 2% are estimated to not write any notes or reports on their imaging.3,4
As with biopsies, we send samples and are given a report. Likewise, the radiograph should be accompanied by a report.
There are approximately 15 oral and maxillofacial radiologists in Australia. The vast majority of these specialists work in comprehensive radiology clinics, and all are trained in reporting X-ray, Cone Beam CT and multislice CT. Some of these specialists will also report on MRI of the TMJ.
If you are starting a practice and implementing in-house imaging, whether it is panoramic X-ray, cephalometry, or Cone Beam CT; it is critical to have the support of a radiology provider with AHPRA registered oral and maxillofacial radiologist(s). Partnering with a radiology provider will allow for provision of quality OMF radiology reports, technical support, and can improve the overall quality of service to your patients. Your practitioners and patients will have peace of mind knowing that your state of the art practice provides quality imaging and maxillofacial reporting services.
*Dr Daniel Selim is an Oral and Maxillofacial Radiologist. He is based in Sydney and is staff specialist at the Sydney Dental Hospital. He is a reporting radiologist at MFI Radiology and Spectrum Medical Imaging in Sydney.
Published in Bite Magazine May 23, 2023
References:
- June 1999 British dental journal official journal of the British Dental Association: BDJ online 186(12):630-633 DOI:10.1038/sj.bdj.4800182
- The ADA now recommends that the entire data in any Cone Beam CT be interpreted by a practitioner with suitable training and experience. Policy Statement 6.22 – Dento-Maxillofacial Cone Beam Computed Tomography
- Selim, D.G., Sexton, C., Monsour, P. (2018) Dentomaxillofacial Radiology in Australia and Dentist satisfaction with radiology reports. Australian Dental Journal, 63: 402– 413. https://doi.org/10.1111/adj.12642
- Wright, B. (2012), Contemporary medico-legal dental radiology. Australian Dental Journal, 57: 9-15. https://doi.org/10.1111/j.1834-7819.2011.01653.x