Legal Issues Concerning Cone Beam Computed Tomography
Standard of Care
Standard of care is the base level at which a dentist must perform specific duties, including but limited to endodontic procedures, restorative procedures and diagnosis and treatment planning. If a health care professional performs below this level, it is considered malpractice and negligence. Violations of the standard of care can result in a loss of licensure and monetary repercussions for the dental professional.
There are two primary legal cases involving technology and standard of care: Frye v. United States (1923) and Daubert v. Merrell Dow (1993). In 1993 the United States Supreme Court dismissed the Frye mandate that technology is admissible in court as long as it has “general acceptance” in the scientific community. Even though this ruling rejected the Frye mandate on a federal level, there are still several states that continue to follow Frye’s test for admission of technology as standard of care. For those states following Frye’s standard, an expert in the field is tapped to determine if the technology has become “general acceptance” for the field in question. The ruling of Daubert determined that “scientific knowledge must be derived from the scientific method supported by good grounds in validating the expert’s testimony, establishing a standard of evidentiary reliability” (Stevens).
American Academy of Oral and Maxillofacial Radiology and American Dental Association Recommendations
The American Academy of Oral and Maxillofacial Radiology (AAOMR) came out with recommendation in 2008 about the use of cone beam computed tomography (CBCT). Since then, they have come out with more recommendations in specific areas such as implants and endodontics. This chapter will cover only the original basic recommendations, as the others are noted in Chapters 1 (introduction) and 9 (implants). The American Dental Association (ADA) came out with several recommendations about CBCT in 2012. These recommendations apply to those offices that have a CBCT unit as well as those offices that refer out for this procedure. Because there is overlap of the recommendations, I have combined them as recommendations made for the United States of America.
Prescribing a Cone Beam Computed Tomography Scan
There are several things a referring practitioner must perform and consider prior to prescribing a CBCT scan.
Use of Cone Beam Computed Tomography Scan
These recommendations apply to offices and/or imaging centers that have a CBCT unit or are planning to purchase one.