Editors intro: GPs using CBCT can work together with endodontists to interpret 3D data more efficiently. Read what Dr. Cameron Howard says about incorporating 3D imaging into your practices.
As more general practitioners incorporate cone beam computed tomography (CBCT) into their workflow, how can endo-dontists make sure their referrals are using the technology in a way that is useful and effective? Endodontists, with more than a decade of 3D imaging experience, are actually in the perfect position to help GPs get the most out of their equipment while strengthening the referral relationship and ultimately benefiting the patient.
Endodontists can help their GP referrals feel more confident in using CBCT by not only emphasizing when a scan would be useful, but also when to rely on the endodontist as the specialist to take the scan. Endodontists can share with their referring doctors some basic rules of thumb to help them determine the value of a a scan: Examples include assessing overall restorative plans, the proximity of IAN to root apices, anatomy (number of roots or proximity of sinus), etc., and, of course, emphasizing the importance of the ALARA (as low as reasonably achievable) principle. However, helping GPs understand not only when a 3D scan might be helpful, but also when not to take scan can save both doctors and patients a lot of time. If there’s ever any doubt, the GP should be comfortable sending the patient to the endodontist who has years of training in reading/interpreting CBCT scans. Therefore, it’s important that endodontists convey to their referrals that part of their consultation fee is for their specialized knowledge and expertise.
Even if GPs want to capture the scan with their own in-house system, they may still defer to endodontists to read the scan. In fact, I’ve invited doctors to my practice after hours to read the scan of their patients together. As long as the image is in a DICOM format, 3D-viewing software should be able to access the scan. Additionally, as endodontists, we often have more robust 3D software, such as CS 3D Imaging (Carestream Dental), needed to make a diagnosis and plan treatment. To further aid in education and improve communication, I include screenshots from my CS 3D Imaging software in every report that I send back to the GPs. The scan, with carefully labeled views, canals, etc., paints a better picture for the GPs, and they are generally impressed with the quality of my system (CS 8100 3D, Carestream Dental). Carestream Dental also offers a free CS 3D Imaging software viewer that I can direct GPs to, so they can view the image accurately back in their own office. This is not only an excellent opportunity to educate the GP community, but also great for building personal business relationships.
Of course, I’ve found that working with GPs who have the same system as I do provides for a much more streamlined experience for everyone. With that in mind, endodontists can provide valuable insight and play an influential role when their referrals ask for recommendations on which new imaging system to invest in. For example, all systems are DICOM-compatible, but using a system that acquires images natively in DICOM and doesn’t need to be converted eliminates an extra step. This makes for easier file sharing between the GPs and endodontists. It’s just a small way endodontists can use their years of experience with 3D imaging systems to guide their GP referrals and help them find success for their mutual patients.
Endodontists have more than a decade of experience with CBCT imaging, so it’s important that they lend their years of experience to their peers and referrals regarding the technology. That means helping GPs understand possibly when not to take a scan, how to share a scan if they do, and even when the time is right, to step back and trust the specialists to provide the best care for the GPs’ patients.
Dr. Howard loves the information his CBCT provides and wants to help GPs using CBCT to better understand its benefits. Find out more about Dr. Howard’s practice here.