You had an x-ray at the dentist office years ago. You still remember seeing the strange contrast of your teeth against the black background. But the last time you had a dental check-up, your dentist recommended having a cone beam CT scan (CBCT).
The machine looked totally different and it made you feel uneasy. Is all this really necessary?
So what’s the difference between a CBCT scan and a standard x-ray? And why can’t your dentist use a normal x-ray to look at your mouth?
What Are the Different Types of Dental X-Rays?
The gold standard in dentist offices up and down the country used to be the standard x-ray. Now, technologies have moved on, and dentists have a wider range of imaging machines to choose from.
Intraoral x-rays along with the panoramic x-ray are the old standard, and extraoral x-rays are the new guard – often used to detect TMJ and Airway problems in the jaw and throat. For the purpose of brevity, I have not gone into detail with every extraoral imaging machine, but here I cover the main types.
Intraoral
- Periapical x-rays: the most common type of x-ray taken at the dentist office, these x-rays show the whole tooth – usually in clusters in one portion of your upper or lower jaw. Because this is a pinpoint technique, it’s not suitable to image your entire mouth.
- Bite-wing x-rays: this is an image of both the upper and lower teeth in one area of your mouth. Each image shows the dentist your teeth from the crown to the supporting bone of the jaw.
- Occlusal x-rays: this is used to map and find any changes in the shape of your arches in either the upper or lower jaw.
Extraoral
- Tomograms: a specialized type of x-ray that shows a particular layer of your mouth, helpful for dentists to examine specific structures normally hidden, but rarely used today.
- Panoramic x-rays: the classic image of all your teeth in both your upper and lower jaw. The image is a convenient way for your dentist to see everything on a single x-ray, helping them to spot emerging teeth, impacted teeth, and possible tumors.
- Dental computed tomography (CT): game-changing imaging that allows your dentist to look at the interior of your mouth in 3D. The imaging helps your dentist find cysts, tumors, and fractures.
- Cone beam computed tomography (CBCT): also creates 3D images, but displays soft tissue, airway, and bone as well as dental structures. Using CBCT your dentist can evaluate tooth implant placement, and discover issues with your gums, roots of teeth, jaw, as well as tonsils, adenoids, deviated septum and enlarged turbinates.
- MRI imaging: a type of 3D imaging that is useful for soft tissue evaluation of the oral cavity.
What Is the Difference Between CBCT and CT?
Dental CT and cone beam CT are types of x-ray that created 3D images of your mouth. CBCT cuts the radiation exposure dramatically when compared to medical CT. Both forms are superior to the intraoral panoramic x-rays, as they help your dentist in doing the following:
- Providing accurate measurements, including shape and dimensions of your jaw – which is useful for dental implant surgery, and taking measurements for oral appliances.
- Detecting lesions that may indicate serious disease.
- Diagnosing airway sleep disorders.
- Identifying the precise location of an infection in your tooth.
- Evaluating your sinuses, nasal cavity, and nerve canal.
Dental CT is an older technology, invented in the early 70s, that uses fan-shaped x-ray beams that move around as the patient advances in the machine. Dental cone beam CT was invented in the 90s, and the technology is based on light intensifier technology. Cone beam CT uses a cone shaped area detector which means the patient can stay static as the sensor moves around them.
The advantages of CBCT over CT is that the machine is more compact and therefore can be included in most dentistry practices – much more convenient than having to visit a separate imaging center. But also the patient receives a lower dose of radiation, and the procedure is also much quicker.
What Can a Dental CBCT Scan Help Diagnose?
As a dental CBCT x-ray can give your dentist an in-depth view of your teeth, jaw, gums, nerves, and sinuses – it can help detect and diagnose many diseases.
These diseases and complications include:
- Airway sleep disorders such as sleep apnea
- TMJ
- Bone cancer, tumors, or cysts
- Fractures
- Tooth root infections, root canals, or other problems with the core of the tooth
- Gum problems
- Nasal Anatomy, include: septum, turbinates and sinuses.
A cone beam CT scan is the easiest, quickest route to your dentist being able to diagnose conditions affecting your jaw, gums, and breathing. The sooner you get your diagnosis, the quicker your dentist is able to come up with a plan of treatment.
Preparing for a Dental CBCT Scan
It’s very straightforward to prepare for your dental cone beam CT scan, and you won’t be in the chair for long. Pregnant women must warn their dentist before going ahead with the procedure, but otherwise there are no major medical risks – and you don’t need to take any medicines or require any recovery time.
To prepare for your CBCT scan:
- Remove any hearing aids and/or glasses.
- Take off all metal jewelery and hair decorations including –
- Earrings, nose or tongue studs, and other facial piercings
- Necklaces
- Hair clips
- Remove dentures
I regularly use imagery from cone beam CT x-rays to pinpoint jaw and breathing issues that may contribute to airway sleep disorders in my patients. A CBCT scan also allows added accuracy when fitting my patient with a tailored sleep appliance, to open up the airway, and provide my patient with improved sleep. The cone beam CT scan is a modern and efficient way for dentists to evaluate their patients – an essential piece of equipment for any dentist office.
If you’d like to learn more about our AirwayCentric® approach, pick up a copy of GASP!: Airway Health – The Hidden Path To Wellness by Dr. Michael Gelb and Dr. Howard Hindin. If you’re struggling with headaches and jaw trouble in the New York area and suspect TMJ is to blame, fill out our contact form, or call to make an appointment with Dr. Gelb on (212) 752-1662.