CBCT Waivers

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Does anyone use waivers for taking CBCTs. There are 2 issues that have developed. One is when a patient is referred for a CBCT for the referrer’s use and I don’t do an evaluation of the patient but a disk is provided. The other is when I take a CBCT for my evaluation. I’ve been told that I only responsible for reading it is from a periodontist’s/dentist’s point of view. I have told the patient that they can have a radiologist read it for a fee if they want.

I would like to know your thoughts and if you have waivers (and would share them). What are our responsibilities and our limits? I called the AAP and they don’t have any information but they feel that it is an important issue to address.

Richard

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Check with David Hatcher.
http://www.ddicenters.com/about/staff/index.asp

My understanding is that we should not be responsible for things that are out of our scope of dentistry.

All the best,

John

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I have an article coming out in JOMI this month on the topic of discussion. Should bring up some interesting points.

Greg

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We are writing a waiver for referrals for CBCT when I am not involved in the treatment. I will be happy to forward when complete.
I email all of these scans to a radiologist and receive a report to minimize my liability. It costs about 100.00.

Mark

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Controversial. I hear varying opinions.

Mark

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CBCT has revolutionized practice for many of us. As far as interpretation of the scans, the AAOMR (Amer. Assoc. Oral & Maxillofacial Radiologists) has spoken clearly:
You are responsible for interpreting everything on your image. Not just dental; everything. The AAOMR and AAE did a joint position statement on this recently:

http://www.aae.org/uploadedFiles/Publications_and_Research/Guidelines_and_Position_Statements/conebeamstatement.pdf

another recent similar article:

AAOMR offers a CBCT anatomy review course:

http://www.aaomr.org/?page=Certificationcourse

I personally think a waiver stating you are only looking at the dental/alveolar findings would not hold up if, say, a malignant
mass was also notable somewhere on the scan. My advice is either get a scanner that has a very small field of view, or
take the continuing ed & get comfortable with interpreting the scans (using a radiologist PRN), or have your scans routinely
reviewed by a radiologist.

Regards,

Andy

[document redacted]

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A few years back I purchased the Kodak/Carestream CBCT. The images have been reasonably good, and although some units may be better in terms of resolution, the narrow field of view remains quite appealing. You only see structures within the scope of dental practice and this issue is eliminated. Hope this helps.

Bruce

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Thank you all for your help.

Richard

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