From Dale Miles:
I’m shocked at how many dentists sometimes order dental X-ray images based on the frequency of the payer or insurance companies’ reimbursement schedules. That is not a reason for prescribing X-ray images in the first place, and second, it would be hard to defend requesting these images for diagnosis if you haven’t even examined the patient
Dale makes a number of good points in this article including comments on a disturbing practice we see a lot in medicine and more and more in dentistry. That is determining clinical procedures based on insurance coverage rather than on what is best for the patient.
The primary focus of the paper is reduced radiation exposure. Dale makes a number of very good suggestions including the use of collimation. What he doesn’t mention, perhaps because it is assumed, is the use of digital systems. Digital radiography in general uses less radiation than film. On the other hand he does point out that new CBCT systems are easy to over use and the dentist needs to consider when to prescribe an image and what clinical value he/she will receive.