Practice: Anatomic Assessment and Legal Issues: The New Standards of Care

The ultimate quest of all forms of imaging is to reveal the anatomic truth; that is, to portray the anatomy as it exists in nature. Thoughtful clinical application of image acquisition requires matching the uses and limitations of the available imaging choices to achieve the desired diagnostic information (imaging goal) while keeping the risks and costs to the patient as low as possible.

Until the recent introduction of CBCT scanners, standard 2-D imaging provided a moderate contribution to overall treatment planning when considering the diagnostic potential, costs of study, and risks to the patient. CBCT-dedicated maxillofacial imaging scanners provide broader imaging tools for anatomic assessment and have become widely available.

Visualization and analysis of 3-D information can benefit a dental practice by providing data that will improve diagnosis, risk assessment, treatment outcome, and treatment efficiency, and reduce treatment complications. The introduction of CBCT creates the opportunity for clinicians to acquire the highest quality diagnostic images with an absorbed dose that is comparable to other dental surveys and less than a conventional CT.

Standard of care has been elevated such that 3-D imaging should be part of the patient discussion of options when planning orthodontics, implant placement, surgical extractions, and difficult orthodontics. Practitioners are advised to be prudent by discussing the risks, benefits, and alternatives options, and if the patient declines the ideal recommended treatment, the dentist should obtain and document the informed refusal. This will result in improved outcomes, increased patient satisfaction, and effective risk management of potential claims. (California Dental Association Journal, Volume 37, Number 9)

To read more on the uses and benefits of 3-D imaging, as well as its impact on the standard of care, and provides tips on risk management, guidance and how to handle legal issues affecting standard of care, you can download the full article from:

http://www.cda.org/library/cda_member/pubs/journal/jour0909/curley.pdf