CBCT images: Who is reading?

The advantages that cone-beam CT (CBCT) can bring to dental diagnostics are undeniable, but the adoption of this technology by general dentists also raises some medicolegal concerns. Interpretation of the CBCT data and determining findings have always been a dicey issue in the respect of who is the most reliable to turn to.

The issue is deciding whether the dentist , the technician operating the machine , the OMS or the radiologist is the person to refer the image interpretation to and whether it is OK to cross stateliness to do so.
Dr. Bernard Friedland (BChD, M.Sc., J.D., head of the division of oral and maxillofacial radiology at the Harvard School of Dental Medicine) stated to DrBicuspid.com as with any diagnostic image, a dentist assumes liability for the interpretation of that image but many dentists are unfamiliar with the radiographic 3D anatomy of the head and neck and don't have the pathology expertise to interpret the images.
Dr. Allan G. Farman, BDS, PhD (odont.), DSc (odont), Professor of Radiology and Imaging Science at the University of Louisville School of Dentistry and a practicing specialist in Oral and Maxillofacial Radiology supports the concept:
The practitioner who operates a CBCT unit, or requests a CBCT study, must systematically examine the entire image dataset and report on anatomic variations and abnormalities in all imaged structures. If advice is needed to complete this task, then the appropriate specialist to be consulted is the Oral and Maxillofacial Radiologist.
Dania Tamimi Oral and maxillofacial radiologist comments; as an Oral and Maxillofacial Radiologist, I have the basic knowledge of a dentist, so I understand the needs of a dentist as well as being familiar with the correct terminology used by the dental community.
CBCT interpretation simply isn't included in dental school curriculums, you need adequate training and education as well as experience that you can get as the result of years of training and deep emersion in the area of the head and neck enables OM radiologists to provide a service that can save the dentist from unnecessary lawsuits.
Cone-beam CT companies provide adequate training and support to enable general dentists to take and interpret 3D images included in the purchase price. Some manufacturers will also offer additional local, regional, and national courses and sponsor Imaging Institutes. However, still the companies strongly suggest that owners seek more clinical training to better serve their patients. Third party companies like 3D Diagnostix with a team of certified radiologists would offer image interpretation services to CBCT owners.
On the other side, where some states strictly demand in-state license for interpretation of images, other states don’t require a license at all or would allow radiologists licensed in other states to provide their services across stateliness.
Cone-beam CT holds great promise for both patients and dentists and is becoming a standard of care in dental practice. With appropriate planning and use of well qualified individuals to aid in interpretation, dentists can enhance their practice and best serve the interest of their patients.

References:
- "Who should read cone-beam CT volumes?": DrBicuspid.com
- "Cone-beam CT raises new issues for dentists": Kathy Kincade, for DrBicuspid.com