Do I need a CT scan for my dental implant surgery

I've been using CT scans to diagnose and treatment plan for dental implant patients since the mid 90's. The detailed information provided by CT scans have made diagnosis more accurate and the placement of the implants more precise and safe. Naturally, there is concern about safety of x-rays and whether we really need such detail imaging for dental implants. I'll talk about the benefits of using CT scans another time but today  I want to share some information on x-ray safety.

First, we need to understand that even if we do not take an x-ray, our bodies are subjected to radiation all the time. So, let's put x-rays in the context of background radiation. The miniSeivert is the unit of measurement of the radiation absorbed by the body, taking into account that different tissues and organs have different levels of sensitivity to radiation. The slide above shows the typical dose caused by different types of dental x-rays. BERT is Background Equivalent Radiation Time. So, as you can see, taking a cone beam CT of one jaw roughly equates to the amount of background radiation we get when we take a six hour flight.

While there are risks involved in exposure to x-rays, the increased level of risk over the baseline risk is insignificant. One can look at it in another way by comparing risk of other activities that we do without thinking of the risks. This may be comparing apples with oranges but you get the idea. 

Most important of all, the risk of not having the detail images provided by a CT scan prior to dental implant surgery include injury to adjacent nerves and blood vessels, perforation through sinuses, etc, which outweight the fraction of a percentage increase in lifetime risk of developing cancer.