CBCT – the key to success in 2021
Christopher Lehr and Artur Silva explore the idea that the easiest and most effective way to enter the world of digital dentistry is via in-practice CBCT.
What is the thought process behind the idea that 2021 is the ideal time to introduce a CBCT unit to a practice?
Artur: If there’s one thing we can learn from 2020, it is that life takes unexpected turns!
To mitigate the impact of the unknowns, introducing new diagnostic tools reduces the impact partner businesses might have on your practice if they ceased to trade for whatever reason.
For example, having in-house tools like a CBCT provides you with freedom and peace of mind. Knowing that you are able to proceed with treatment without having to factor in a few uncertain hurdles ahead. Hurdles such as where to get a scan, how long it will all take, etc.
Next year, dentists and their teams will see patients return for regular appointments, rather than just emergencies. Practices that are reliant on referrals will have to delay treatment due to the inevitable influx post COVID-19.
Christopher: Picking up on Artur’s points, the COVID-19 pandemic has shown that the digital world is paramount in our modern society. It reduces physical contact while encouraging interaction.
We can never know what the future holds, but we can prepare.
There is the possibility of vaccines kick-starting the economy once again and a massive backlog of patients crying out for treatment from private practices rather than NHS.
Increasing services and offering ‘all under one roof’ solutions is an excellent investment strategy for the coming year. If a practice is already semi digital, but still outsourcing 3D scans, it makes sense to retain and gain more patients by offering in-house scans. Become a referral practice for other local practices that aren’t as affluent.
How do you start in terms of decision making when it comes to getting the right CBCT?
Christopher: The right CBCT and, indeed, manufacturer will depend on what you want to use it for.
All CBCTs have different benefits, ranging from cost-effective scans and ultra-low dose (ULD) to marketing add-ons.
Artur: That’s so true, and there’s a right CBCT for every type of dentistry.
You need to think about what your practice specialises in. There will be machines better suited for implants as opposed to endodontics, for example.
It’s important to choose a suitable tool for the type of work you do. Software demos are a good way to assess machine-dependent image quality.
Essentially, it’s important you feel happy with your future equipment’s capabilities when choosing between several options. So it’s a good idea to get expert advice.
What do you need to have in place from a practice perspective?
Artur: Firstly, you will need some space. At least 1.5m2. And usually a ceiling height of around 2.3m. Although you can take scans with patients sitting down, which allows you to install a CBCT in a room with lower ceilings.
However, ideally you would have a slightly bigger room in order to fit a small computer and monitor inside. Rather than having the control unit outside the CBCT room.
Then, in most cases, the walls will need shielding either with lead or lead equivalent Knauf plasterboards. This is something an RPA can offer advice about.
It’s also important to have network facilities in place. Although a good installation company can provide that, along with meeting all the requirements provisioned by your RPA.
Christopher: Artur has said it all, really.
Fundamentally, all you need is the space and funding to add a CBCT to the practice.
From my perspective as an engineer, it’s also good to know that we can carry out a free site survey to help you assess the costs and space.
When it comes to cost savings, what opportunities does CBCT offer?
Christopher: Of course, running your own CBCT doesn’t come without costs. But the savings and fast turnaround times for patients means just two to three scans a week will pay for the monthly instalments.
Artur: Also, aside from the costs, there is added value that is important to factor in.
Having a CBCT gives you the in-house diagnostic tools that most practices outsource. Instead of referring a patient, completing online referral forms, waiting for the referral site to contact your patient and book a scan, and then finally knowing the patient had the scan but you still need to download it from a cloud service or wait for a USB stick to arrive, you could simply have a short conversation with your patient and walk them to your X-ray room and complete a scan with immediate access to the results.
This not only speeds up treatment tremendously but also reduces the chances of cancelled treatments due to missed appointments at referral sites. Or patients changing their mind after spending a couple of days away from the practice.
You have both referred to improved efficiency. How exactly does that work in reality for practices?
Artur: If we take implants as an example, CBCTs are nowadays a vital tool for implant placement.
The third dimension a cone beam shows is essential for tracing the ID canal precisely. It ensures safe treatment and zero headaches.
Then, the ability to check bone density with a couple of clicks lets you know if you require grafting.
Having the ability to traverse through patient anatomy spatially will enable findings that would otherwise be missed with standard 2D imaging. Plus, in endo cases you can easily have a full view of complex canal anatomy, to ensure treatment effectiveness.
Christopher: We also live in a world where things are expected to happen in an instant.
It makes sense, then, that offering a patient a scan and consultation in a single day goes beyond need to want and expectation. If they have to wait weeks, they might choose to go to a practice where they can see in-depth possibilities the same day.
Marketing is something that practices are embracing more and more. How does CBCT fit in with that?
Artur: As I touched upon earlier, with a CBCT you could become a referral site for outside patients.
Many of our customers do this with their machines, which, of course, helps reduce machine costs. You’d provide full in-house treatment, which improves patient comfort, eliminating unnecessary travel to other sites. Shouting about that in marketing materials is a big draw.
Christopher: Some CBCT models also let patients see what their actual face will look like after corrective surgery. This is a significant promotable service not all practices have.
What training do principals and the team require with an investment in CBCT?
Christopher: A good installation company will offer comprehensive training on all CBCTs upon installation. Along with refresher courses available for any staff taken on in the future.
Certainly, we offer that, and it is really important in order to get the most from the CBCT.
There’s no point investing in that kind of equipment and then not making full use of it.
Artur: I also tell prospective purchasers that dentists taking CBCT scans will need to enrol and complete a CT interpretation course.
There are several providers around the UK, and most offer distance learning, which is especially useful nowadays.
Clearly this is a significant piece of equipment. What after sales service and support would you recommend?
Artur: With CBCTs, as with any other X-ray devices, there is a requirement for testing within certain intervals.
For CBCTs this needs doing early, to ensure image quality is kept at its highest and dose rates are within NDRLs. Dentists can carry out and log their own quality assurance tests, which allows a longer interval between critical examinations, to a minimum of once every three years.
Christopher: You also want to ensure you are looked after all the way through your investment by a team of engineers available to assist with any teething issues, if required. Along with additional support from the manufacturer.
What is the one piece of advice you could give to a practice that is looking at this as a new investment and for those who, perhaps, are not using their CBCT to its full potential?
Artur: This isn’t something you should have as a second thought.
CBCTs are becoming essential tools and are now more accessible and easier to use than ever. Software has come a long way in the past decade and these things are so much easier to use than the first units.
Don’t be afraid of technology.
If you already have a CBCT scanner, then look for opportunities to become a referral site. Manufacturers will usually help with setting things up, and we can help connect the dots.
If your machine is only taking a couple of scans a week, then this is something you should definitely consider.
Christopher: Artur is absolutely right. Don’t stop with in-house scans, market yourself as a referral point and assist the less-equipped practices with their scans.
I’d also suggest that the more highly trained your staff are at taking scans, the better image quality you can achieve. This makes treatment decisions and recommendations and the treatment itself much easier all round.
Christopher Lehr is one of the product specialists within the sales team at Hague Dental Supplies.
Artur Silva is head of digital at Hague Dental Supplies, as well as a Senior Engineer with a vast knowledge of digital radiography, high-end dental chairs, compressors, and suction.