Using CBCT to Present “Scary” Treatment Plans

Very few people like to visit the dentist. Now, imagine how much less they like visiting an oral surgeon. In the patient’s mind, surgery involves scalpels, anesthesia and recovery time—it’s far more involved than the biannual dental prophy. However, I’ve found when it comes to a “scary” treatment, such as an autogenous bone graft, using cone beam computed tomography (CBCT) helps me calm the fears and address the concerns of my patients. Not only that, CBCT improves patient understanding of their treatment and can increase case acceptance.

Borrowing Bone “in the Neighborhood”

Let’s say that a patient is interested in implants. However, a CBCT scan, which lets me view the oral cavity in 3D from any angle, reveals there isn’t enough bone present. To proceed with treatment, an autogenous bone graft is necessary. When discussing bone grafts with patients, their response is typically: “Gosh, that sounds terrible; taking bone from one part of my body to another?!” However, as I’ve discussed previously, the accuracy of CBCT reveals possible donor sites within the same maxillofacial region. It’s almost like moving a puzzle piece from one area of the puzzle and snapping it in to another area to make it fit. I reassure the patient by explaining: “Actually, we’re going to borrow a little bit of your own bone while I’m ‘in the neighborhood’.” That sounds far better to a patient than informing them we’re going to go to their hip or leg to take bone.

Two Chairs at the Computer

Prior to using a CBCT unit, I would leave the patient and review their CT scans then go back and attempt to explain what I had found. Often, I’d get a glass-eyed look from the patient as they tried to make sense of what I was saying. Now, I have two chairs in front of the computer. I sit with the patient and give a brief overview of how CBCT works, i.e. “imagine cutting an apple in half, then turning to look at the core.” By the time I’m done showing them their own 3D CBCT scan, they better understand the challenges we’re up against, why we might need bone grafting, why we might need to do implants in different areas than originally planned, etc. With this advanced technology in front of them, patients are reassured that they’ve come to the right doctor for treatment.

CBCT is a powerful tool for educating the patient and increasing their understanding of the treatment plan. Not only that, CBCT can simplify what may sound like a complicated treatment to the patient, such as a autogenous bone graft, and put them at ease. With CBCT, patients are more confident in choosing a treatment plan, even if that treatment may sound “scary.”

How do you currently present treatment plans to patients? If you’re using CT, what are some challenges you face? If using CBCT, have you noticed an increase in case acceptance?

Craig Misch, D.D.S., M.D.S., P.A. Contributor


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