Every orthodontist wants to have a crystal ball; a tool for viewing the future so they know what issues might be ahead that would dictate a different approach in orthodontic treatment planning.

I feel like we have a crystal ball right here in our office, although it occupies decidedly more space than the orb Prof. Sybill Trelawney taught Harry Potter and his friends to use.

Our crystal ball actually is an i-CAT 3D cone beam scanner that makes it possible for us to capture 3D views from a single arch to your entire skull, and many variations in between. This technology helps us collect high definition 3D scans while minimizing patient exposure.

It’s Cone Beam, Not Conehead
Before we continue, let’s get you up to speed on some basic definitions (and one more movie reference). We’re not talking about the Coneheads, so erase those pointy-headed alien images from your mind.

The complete name of the technology we’re discussing today is Cone Beam Computed Tomography – commonly referred to simply as “CBCT scans.” They were introduced in the U.S. in 2001. Since then, this technology has gradually earned a reputation for being the go-to diagnostic tool of choice in practically every dental specialty, including orthodontics. An independent study conducted in 2011 showed that four out of five orthodontic residency programs throughout the U.S. used CBCT for specific applications, and one in five programs used them on a routine basis for all patients, according to an article published in the January/February issue of Orthodontic Practice.

The benefits of cone beam 3D imaging are widely recognized for orthodontics and other dental specialties because of the additional vital information they offer regarding bone structure and tooth orientation, the Orthodontic Practice article states.

CBCT scans are drastically different from traditional X-rays. They produce 3D images of the bone and teeth being scanned. Traditional X-rays are 2D images produced by using X-ray radiation. As you might imagine, 3D images are far superior to their 2D counterparts. Think of a grainy black and white photo from your grandparents’ photo album, compared to the rich sharpness of an image you can view on your iPad, thanks to its Retina display technology. The difference is like night and day, right? That’s how we in the orthodontic field feel about viewing a traditional X-ray image, versus a 3D image.

The 3D images of the face, neck and teeth produced by CBCT scans are virtually limitless – and they’re available in full color, which paves the way to more comprehensive treatment planning. Capturing these images also is quick, easy and pain-free for our patients. You simply have a seat in a chair or stand comfortably for a 10-second scan.

Environmental and Health Benefits of 3D Technology
Taking traditional X-rays of patients’ teeth and jaws exposes them to higher radiation levels than with 3D scans. You are exposed to more radiation in a few days of living on Earth than what you’re exposed to during a single 3D scan.

Dentists and orthodontists who phase out their traditional X-ray systems also are being kinder to the environment by doing so. Traditional X-rays require special film and chemicals to develop the images. Once those chemicals have been used, they must be disposed of properly to avoid ultimately making their way into our lakes and waterways. This can be a bit costly, too.

What 3D Means for Patients
The bottom line is every parent wants their child’s orthodontist to have access to CBCT scans because the result will be a better, more well-informed treatment plan. The higher the quality of images and the more detailed information we can capture, the more accurate we are able to be regarding a diagnosis and treatment plan.

There are multiple potential hurdles that we can identify using CBCT scans and better address. Here are a few examples:

Impacted teeth: Your adult teeth will erupt as they’re supposed to most of the time. But if your teeth are severely crowded, a tooth’s eruption path could be obstructed. We need to know if that’s going to be a problem down the road. Once we identify an impacted tooth, we can take measures to work around it. Sometimes those measures include pulling one or more baby teeth to provide room. Other times, we may work in conjunction with an oral surgeon to surgically expose the impacted tooth and bond a bracket to it so we can guide it into proper position.

Cysts and tumors: Because 3D scans give us such a clear picture of the oral cavity, we are able sometimes to identify problems such as cysts and tumors that if undetected, could become serious issues.

Degenerative joint disease: 3D technology has helped us identify degenerative issues with the temporomandibular joint in the past. Degenerative joint disease destroys tissue and frequently is caused by excess stresses on the joint, or a reduced ability for those tissues to adapt to applied stress, according to an article written on the topic.

Shorter tooth roots: Short roots are important to identify prior to beginning treatment because of the risk of root structure loss. Determining the size of roots can’t be done with traditional X-ray technology.

Airway obstructions:  identifying obstructions is important, because they can increase your chances of having sleep apnea.

Having Your Scans Read by an Oral Radiologist
Your health is important to us. That is why we take measures to inform patients and parents of a valuable option available to you through our office: getting your 3D scans read by an oral radiologist. We have an informed consent form on our website that we ask new patients/parents to review and sign at their first appointment. On this form, we explain that having a trained, licensed oral radiologist evaluate and potentially diagnose issues that fall outside the orthodontic treatment realm is recommended.

An oral and maxillofacial radiologist is a dentist who has chosen to specialize in capturing and interpreting radiographic images to identify problems in the jaws and face, according to The American Academy of Oral and Maxillofacial Radiology.

Having these reports read by an oral radiologist costs $120, and that is a small price to pay for peace of mind. Thanks to 3D scans, we can identify potential problems far earlier than we could with traditional X-rays. And we all know the earlier a harmful issue can be diagnosed and treated, the less invasive and less costly the treatment options tend to be. You oral health is worth it.