The radiation protection implications of the use of cone beam computed tomography (CBCT) in dentistry – what you need to know (UK)

Introduction

Dental Cone Beam CT (CBCT) scanners are now being installed and used in a rapidly increasing number of dental practices within the UK. Although the evidence base for their use is growing, there is currently little guidance available for dentists to inform them of the different radiation protection requirements for this type of radiography equipment. Suitable guidance is urgently needed to ensure that appropriate radiation safety measures are in place for the protection of staff and patients, and to advise practices using CBCT scanners with respect to radiation safety legislation. Working procedures and precautions that are well-established for conventional dental x-radiography equipment will in many circumstances not be adequate for CBCT.

In response to this, the Health Protection Agency’s Radiation Protection Division has convened a working party (WP) to look into the radiation protection issues associated with CBCT equipment. In addition to HPA’s own expertise in radiation protection the WP draws on the expertise of consultant dental radiologists, national bodies with regulatory roles in dentistry, dental surgeons with experience of working with CBCT scanners, enforcing authorities and medical physicists with experience of CBCT. The work of the WP mirrors the work being done on a Europe-wide scale under the SEDENTEXCT project1, but this project will not publish formal guidance until 2011. The WP expects to publish its formal guidance for the UK later this year, following a consultation exercise, in a freely available web-based format. However due to the increasing popularity of CBCT equipment and the current vacuum of guidance, the WP agreed that it was necessary to make dentists using or planning to install CBCT equipment aware of the most important issues, as soon as possible. The aim of this article is to explain what these issues are and how to deal with them, in advance of the formal guidance. Briefly, the issues of greatest importance from a radiation safety perspective are as follows:

•  the selection of equipment
•  establishment of a suitable QA programme
•  consultation with a Radiation Protection Adviser (RPA) and Medical Physics Expert (MPE) for the necessary advice on radiation protection
•  training requirements
•  referrals