American Dental Association and American Academy of Oral and Maxillofacial Radiology patient selection for dental radiography and cone-beam computed tomography

BACKGROUND: As an update to the 2012 American Dental Association and US Food and Drug Administration "Dental Radiographic Examinations: Recommendations for Patient Selection and Limiting Radiation Exposure," this resource provides decision-making guidance on the use of various imaging modalities for general and pediatric dental care practitioners. TYPES OF STUDIES REVIEWED: The American Dental Association Council on Scientific Affairs convened an expert panel of 6 members along with an expert consultant group of 18 members to develop evidence-based guidance on dental imaging. A systematic review of the literature was conducted to identify relevant systematic reviews and organizational guidelines addressing 9 clinical questions. The recommendations presented were developed by means of a non-Delphi process (ie, reaching consensus through a structured process). RESULTS: Due to limitations in the available evidence, consensus recommendations rather than formal guidelines were developed. A thorough evaluation of the patient history and clinical findings should precede radiographic examinations. Previously obtained images should be reviewed, and all imaging modalities, especially cone-beam computed tomography, should be used judiciously to minimize cumulative radiation exposure to the patient. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Clinicians should base imaging decisions on the patient's medical and dental histories, clinical examination findings, disease risk assessment, and the presence of specific clinical conditions. When used appropriately, radiographic imaging contributes to dental treatment decisions and results in optimal patient care.