CBCT—Balancing Benefits and Risks
The ADA Council on Scientific Affairs has issued new guidance on the use of cone-beam computed tomography (CBCT) in dentistry. Their findings appear in an advisory statement in the August issue of the Journal of the American Dental Association.
The Council concluded that clinicians should prescribe CBCT imaging only when they expect that the diagnostic yield will benefit patient care, enhance patient safety or improve clinical outcomes significantly.
The advisory statement discusses:
- Principles for the safe and appropriate use of CBCT imaging procedures, including sound clinical justification, optimal radiation protection and using the smallest field of view necessary for diagnostic purposes
- Precautions for the safety of the patient and the dental team
- Appropriate education and training for CBCT imaging and evaluation
Read the entire advisory statement in the August issue of JADA.
The U.S. Food and Drug Administration (FDA) has also posted an informational webpage on dental cone-beam computed tomography. The FDA is promoting the safe use of CBCT in dental and maxillofacial imaging, particularly in the pediatric population. Recommendations are provided for parents, patients and health care providers to help reduce unnecessary radiation exposure from CBCT.
EPA seeks to reduce mercury waste from dental offices
Planning for the summer issue of the ADA Professional Product Review began shortly after the U.S. Environmental Protection Agency (EPA) announced that it would propose a rule intended to reduce mercury waste from dental offices. The agency plans to focus its technology assessment on amalgam separators. Several states and municipalities currently require dental offices that place or remove amalgam restorations to use these devices.
In anticipation of the EPA's proposed rule, the ADA Laboratories purchased and evaluated nine separators available in the U.S. to determine their amalgam removal efficiency. The bottom line—all nine amalgam separators passed the ISO 11143 requirement of 95 percent amalgam removal efficiency. However, you'll want to read what the Review has to say about each separator's features and bypass mechanisms. The Review also features the article, "Amalgam Separators: Practical Issues for Purchasing, Installing and Maintaining Amalgam Separators," to help dentists with buying decisions. The EPA is expected to publish a final rule in the next two years.
This is the second issue of the Review that's online as a digital magazine and as a PDF that you can print. An executive summary of this issue appears in the August Journal of the American Dental Association. We'd like to hear your feedback. And, we'd also like to know what products or product categories are of most interest to you in your practice. Drop us a line at firstname.lastname@example.org.
Exchanging patient information seamlessly and securely
Imagine that you are a dentist who wants to consult an endodontist some distance away about a problem a patient is having. You need to send her the patient's x-rays in a fast and secure manner. Today, you may have trouble transmitting the images digitally if you and the other dentist use different systems. To make the transfer seamless, the systems must be interoperable. That's where the ADA is contributing to a solution.
The ADA is working to ensure that dental offices can exchange diagnostic digital images and patient data securely with other healthcare entities, no matter what system they use. The ADA's Standards Committee on Dental Informatics (SCDI) serves as the sponsor of the Dental Domain under the independent standards group known as Integrating the Healthcare Enterprise (IHE). SCDI is leading the team of experts that is developing the standards and testing the software that will make that goal a reality.
"We are responding to ADA members who have told us, 'I can't exchange my dental images with the specialist down the street because we have different software and computer systems'," said Dr. Kirt Simmons, Dental Domain co-chair for IHE. "This collaboration [between the ADA and IHE] is working on solutions that will help dentists to select interoperable systems allowing for the secure and private exchange of images while maintaining HIPAA compliance."
By 2014, SCDI will sponsor the first IHE Connectathon, an annual event where vendors of dental systems will test their systems for conformance to the new interoperability standards, as verified by independent judges. An interoperability demonstration is also planned for the 2014 ADA Annual Session.
Interoperability of digital dental imaging files is made possible through DICOM, a standardized file format that makes possible the export and import of digital medical images and data between systems in a secure manner. More information on DICOM and interoperability of digital dental imaging systems can be found in ADA Technical Report No. 1057, Guidelines for Digital Imaging Systems and Interoperability in Today's Dental Practice available through the ADA Catalog.
HIPAA compliance is a major factor when considering exchange of digital images. The ADA makes available numerous information sources on HIPAA at ADA.org/HIPAA.
For more information about the IHE Dental Domain, please contact Paul Bralower at 1-800-621-8099, ext. 4139 or email@example.com.