The Necessity of CBCT & MRI Imaging in Today’s Orthodontic Diagnosis & Treatment Planning

Episode #403 with Dr. Drew McDonald

Without imaging, you're basically guessing treatment plans — and that’s never a good thing! To know the best possible treatment for your patients, you need MRIs and CBCT. And to help you get started, Kirk Behrendt brings back Dr. Drew McDonald to talk about the pushback with imaging as well as the benefits and value they have for you and your patients. Don't go into treatment blindly! You can have clear images that present the truth. To be a better clinician that changes patients’ lives, listen to Episode 403 of The Best Practices Show!

Main Takeaways:

A clear image will help you see under the surface.

MRIs can show the severity of joint instability.

CBCTs and MRIs are safer than ever before.

Having images can increase case acceptance.

Imaging will lead the way to being better clinicians.

Quotes:

“The biggest thing of why [it’s important], for me, on what we’re talking about with imaging is that it’s the truth. You can't fake that. It’s right there in front of you in the cold, black mirror that you're looking at on that X-ray or that MRI. And ultimately, it tells your patients the truth. But for me, whenever I started going down the road of, ‘Okay, let's see what's under the surface. Let's see why this patient isn't responding the way that I anticipated,’ that really shed a lot of light on what are the true problems here.” (12:07—12:37)

“The other unpleasant conversation that you get to have with patients when [relapse] happens is, ‘Well, I thought this was going to stay. Why didn’t it?’ And it starts to look like you, as the doctor, didn't do your job. Well, no. If you did your job at the front end and diagnosed and said, ‘Hey, we need to take care of not just the teeth but these issues to keep this stable,’ then you really did your job and you're in the clear as a doctor.” (13:09—13:33)

“Right now, in dentistry, the biggest evolving part of this profession is on the imaging side. I think we’re in a huge revolution of how we’re going to do dentistry, where everything is going to be in 3D and people are going to routinely do MRIs, not just TMJ specialists. In my world, I think I'm one of the few orthodontists that do it. But it’s going to be widespread. And honestly, it gives so much value to the patient. We treat them to the highest standard of care possible instead of limiting what we could do.” (15:02—15:35)

“I started looking at my 2D X-rays and then looking at the 3D and saying, ‘Well, I can kind of see this on the 2D.’ On a lateral ceph, you can see adenoids. It’s clear as day. You can see tonsils clear as day. So, you don't necessarily have to be totally in the 3D world, at this moment, to be able to start looking for the things that we should be looking for. I mean, on a pano, you can see turbinates clear as day on a lot of patients and see noses really well. And also, the biggest thing, you can see joints. So, just in our every day, what you take as a general dentist, what you take as an orthodontist, those images are still very valuable if you know where to look besides just the pearly white things in this little area right here.” (17:24—18:09)

“I started saying, ‘Okay, maybe I should be doing [imaging] on a few more patients,’ because I'm starting to see maybe this is part of their problem. But I was recognizing surface issues like narrow palates and things that then I go, ‘Well, maybe I should see if there's something causing this under the surface.’ And then, at that point, you show the patient, and they go, ‘Yeah, let's follow up on that ENT referral.’ I never thought, as a dentist, I'd be writing as many ENT referrals and chiropractic referrals and TMJ stuff that's never thought of as part of your...