If you provide orthodontic treatment in your practice, patients may be intrigued by the need for multiple radiographs throughout the process. Because of this, it’s important that each radiograph is justified, in the best interest of the patient, and that you are able to clearly communicate these reasons to them. In doing this, they will feel more comfortable with the process, and will have a better understanding of the treatment they’re receiving – helping to keep them involved in their own oral health journeys.
The number of adult patients seeking orthodontic treatment is constantly on the rise. A survey conducted by the British Orthodontic Society (BOS) in 2021 found that 89% of orthodontists report an increase in its popularity over the previous five years.[i] As such, clinicians must be prepared to answer their patients’ questions to promote engagement and treatment acceptance.
Planning for orthodontics
Radiographs are essential for planning orthodontic treatment, allowing clinicians to assess the position and form of the teeth and jaws, as opposed to assessing individual teeth. In particular, radiographs are used to assess any missing, extra, impacted, or misaligned teeth – in addition to the shape and length of the roots. Clinicians will also assess the jaw, as any issues may impact the success of orthodontic treatment. Radiographs are an effective and reliable way to gain the information needed to make the best possible recommendations to patients. Clinicians can use them to determine any problem areas, and establish the best way to correct them. This includes determining whether procedures such as oral surgery or extraction may be necessary prior to orthodontic treatment.[ii]
As a by-product of this, clinicians are able to regularly monitor for changes to oral health. Radiographs can help to pick up on pathologies which may have otherwise gone unnoticed for some time, or which may pose issues during treatment. These might include abscesses and tumours, for example.[iii] While this may not have been the intended reason for the scan, it is always an opportunity to pick up on such issues, so it is important to be mindful that this may be the outcome in some cases.ii
Monitoring treatment progress
Radiographs are necessary during the course of orthodontic treatment too. They allow dentists to monitor the progress of treatment at various stages. For instance, they will show the presence or absence of any complications during treatment, such as apical root resorption caused by orthodontic forces,[iv] which require a change in the treatment plan. In certain scenarios, additional radiographs may be taken to monitor complications such as this.[v] By taking a radiograph, clinicians are able to determine if there are any issues, or if treatment is on course, to aid in decision making regarding whether or for how long treatment should continue. Images may also indicate further procedures during treatment, such as tooth extraction, for example, if it is found that the jaw cannot accommodate all the existing teeth.ii
The ALARA principle
Post treatment, a radiograph is taken to evaluate the outcome. This can also be used to inform additional procedures, such as wisdom tooth removal, for example. The ALARA (as low as reasonably achievable) principle means that dentists should only conduct a radiograph if its benefits outweigh the risks.[vi] Minimal radiographs should be taken, using as low of a dosage as possible, and in as little time as possible to protect the safety of patients and the dental team. All appropriate measures should be taken to protect health, while using dental imaging to assist in treatment planning, assess progression, and evaluate outcomes.
CBCT scanners are ideal for practices who carry out dental imaging regularly, and are seeking a low-dose system. When investing in a CBCT system, it’s vital to choose a model which is best suited to your practices’ needs, and integrates with your current workflows. By adopting a CBCT system in practice clinicians are able to complete a full assessment in one appointment, helping to save patients time and begin treatment earlier. The ORTHOPHOS S 3D and Axeos 2D & 3D systems, are available from Clark Dental, is a fantastic option. It offers multiple fields of view, and a range of dose options to accommodate a wide variety of needs – allowing you to take 3D low dose and HD images.
Many patients will be aware of the potential effects of radiation on their health, so it is important to be well-equipped to answer any questions they may have about why you would like to carry out dental imaging. Further to this, radiographs must always be justified, and completed quickly using a low dose to best protect your patients and your team. Radiographic images are essential for planning, carrying out, and reviewing orthodontic treatment, and can enable clinicians to identify and treat pathologies simultaneously. As such, using high-quality equipment to carry out dental imaging is key for success.
If you’d like to find out more about Clark Dental’s solutions, call the team on 01268 733 146, email info@clarkdental.co.uk or visit www.clarkdental.co.uk.
[i] Omran, R., Dowie, A. Increased demand for orthodontic treatments during the COVID-19 pandemic: a commentary. Br Dent J 234, 84–87 (2023). https://doi.org/10.1038/s41415-023-5451-3
[ii] Dr. Greg Jorgensen. Why Does the Orthodontist Need Another X-ray? https://www.jorgensenorthodontics.com/blog/why-does-the-orthodontist-need-another-x-ray
[iii] Australian Journal of General Practice. Interpreting an orthopantomogram. Accessed Nov 23. https://www1.racgp.org.au/ajgp/2020/september/interpreting-an-orthopantomogram
[iv] Topkara A, Karaman AI, Kau CH. Apical root resorption caused by orthodontic forces: A brief review and a long-term observation. Eur J Dent. 2012 Oct;6(4):445-53. PMID: 23077427; PMCID: PMC3474562.
[v] British Orthodontic Society. Guidelines for the management of the traumatised tooth. Accessed Nov 23. https://www.bos.org.uk/wp-content/uploads/2022/09/Guidelines-for-the-management-of-Traumatised-Tooth.pdf
[vi] GOV.UK. Radiological protection of people and the environment: generic developed principles. Accessed Nov 23. https://www.gov.uk/government/publications/rsr-generic-developed-principles-regulatory-assessment/radiological-protection-of-people-and-the-environment-generic-developed-principles
