Dental CT Scans: Why You Might Need One

Your dentist recommends a dental CT (computerized tomography) for your oral cavity — and you keep wondering, "Why a CT? Why not an X-ray?" Now, that's a confusing situation to be in. Reasons, why you might need a dental CT, are many. Making the right decision is easier if you are aware of what conditions can call for a dental CT, how they work, and how to prepare for one. We bring to you everything you need to know about dental CTs.

What is a dental CT?

A CT is a short form for computed tomography. You probably have heard of a CT scan for other areas of the body, such as the abdomen, knee, or brain. Similarly, there are CTs specific for oral health — dental CTs. More precisely, dental CTs are three-dimensional imaging techniques, unlike conventional dental X-rays, which only provide two-dimensional images of teeth and oral structures.

First developed in the late 1980s, dental CTs are now a part of standard setups across dental clinics and hospitals. As a result, they are used in day-to-day treatments, especially when dealing with complex cases or advanced dental technologies. The important structures that a dental CT covers include teeth, roots, soft tissues (tongue), upper and lower jaw bones, temporomandibular joints, maxillary sinus, nerves in and around the oral cavity, and parts of the pharynx and airway.

Conditions that may require a dental CT

Your dentist can advise for a dental CT if they need to see more than a dental X-ray can provide. While CTs might not be needed for every regular dental checkup, be assured that your dentist has reasons to ask you for one. Here are some conditions where you may need a dental CT.

• Failed root canal therapy. Extra canals that go undetected are a major cause of a failed RCT. Dental X-rays can show only a single angle of the teeth and are unable to detect overlapped or narrow canals. That's when dental CTs are very helpful. They can detect overlapped, narrow, and missed canals raising re-RCT success rates to over 90%.
• Jaw joint assessments. Dental CTs are one of the best tools for checking the joint's position, alignment, and any potential abnormalities. Moreover, dentists can look at the bones, cartilage, and muscles around the joint to get a complete picture of what's happening. If you're dealing with jaw pain, swelling, or jaw locks, a dental CT scan can be super helpful.
• Evaluating impacted teeth. Impacted teeth, especially wisdom teeth, can be difficult to evaluate in routine X-rays. A dental CT aids dentists in determining the location and angulation of wisdom teeth and helps plan an extraction accordingly.
• Detecting trauma. Dental CTs give doctors detailed images making it much easier to spot fractures, assess the damage, and plan surgeries. As oral and facial fractures often occur together, CTs are helpful because they provide a detailed, comprehensive template of the surrounding facial structures. It is a great tool for helping a team of dentists, head-neck trauma specialists, and cosmetic surgeons communicate and work together on a case.
• Implant positions. The success of dental implants relies heavily on a thorough pre-operative evaluation of the area, including the nearby structures and how the implants will be positioned in the bone. In addition, your dentist must navigate around vital nerves and arteries during the placement. This is where dental CT scans come in. Dental CT scans provide high-resolution images with great clarity that showcase the bone structure, texture, and quality. These scans also serve as a powerful tool for determining whether you are a suitable candidate for dental implants in the first place.
• The extent of cysts and tumors. Dental CT scans provide exact measurements, location, and extent of growth for dental cysts and tumors. Furthermore, CT scans' 3D pictures provide crucial information about a cyst's shape, boundaries, and possible encroachment on adjacent structures.
• Orthodontic treatment assessment. Planning is a key step in orthodontics. Therefore, orthodontists rely on CT scans to help devise personalized treatment plans, determine the need for tooth extractions, and evaluate whether braces or aligners suit the case.

Your dental CT is like a 3D virtual model of your mouth. It helps dentists to diagnose, detect, treat, and monitor progress. And the best part is it's digital. It can be stored, retrieved, and transferred across systems. So, if you are moving or on vacation, visiting a new dentist, or continuing your therapy after a time gap, your dentist can always look back at a previous CT or forward the same to your new dentist.

How dental CT scanners work

Understanding how machines work can be a bit boring, so let us break it down for you:

1. Next, these images are stacked (like a stack of coins) and processed to produce 3D images of your mouth. All this happens in less than a minute before you can see them on the monitor.
2. These X-rays are captured onto a detector opposite the source. As the scanner spins, it takes snapshots from various angles. These high-resolution images capture the tiniest of details.
3. It releases a narrow X-ray beam — in the form of a cone or a fan. These X-rays are invisible and can penetrate teeth and bones.
4. Dental CT scanners have a large circular C-arm that spins around your head, similar to a spinning top.

While all of this may sound simple, millions of technical instruments within the scanners are working in synchrony to get a perfect scan.

CT scans in dentistry: pros and cons

Dental CTs have their own benefits and limitations. However, the benefits definitely outweigh the drawbacks.

Dental CT scan risks

Dental CTs emit less radiation than a standard CT machine. However, repeated CTs have been linked to the risk of heart and cancer diseases. The advent of cone beam CTs (CBCTs) which emit only 2–30% of the radiation compared to traditional dental CTs, has drastically cut the risk of radiation exposure while enhancing safety standards.

A pediatric CT should be done only when absolutely needed.

Does insurance cover dental CT scans?

A dental CT scan might cost between $200 and $1,000, depending on where you live and the type of equipment utilized. Unfortunately, insurance coverage for dental CT scans varies depending on your specific dental insurance plan.

Some plans include coverage for CT scans as part of their benefits, while others might consider it an additional procedure requiring separate coverage. Therefore, it's important to check the details of your dental insurance plan or reach out to your insurance provider to find out if dental CT scans are covered and to learn their terms and conditions.

Preparing for a dental CT: a takeaway guide

Getting a dental CT done is simple and easy.

• Start with clear communication. Inform your dentist if you are pregnant, have had a dental CT within the last year, or have any health issues that prevent you from sitting still. Your dentist can come up with an alternative option accordingly. Also, if you are concerned with safety and radiation, talk with your dentist.
• Prepare yourself. There is nothing to worry about if you are getting a dental CT. Just prepare yourself for the procedure. You will be asked to remove any metal jewelry, glasses, hairpins, clips, or piercings before you enter the CT scan area. Metals can scatter the rays from the CT and block out the oral structures.
• Follow instructions. The assistant will ask you to stand in front of the machine, place your head on a holder and stay still while the scanner does its work.
• Sit back and relax. Once the images are captured, the monitor can take up to one minute to show the model on the screen — that's about it. Your dentist will now interpret the results from the image and discuss your treatment options.

Dental CT scans are a revolutionary imaging tool in the world of dentistry. They give dentists the power to see things clearly and make the right decisions for your treatment. By using these advanced scans, dentists can plan your care with precision, ensuring the best outcomes. So, trust in the magic of dental CT scans and let them work their wonders.