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Here’s a tough question: What would you say was the biggest mistake you’ve made in your dental career?
For Dr. Lenny Hess, Clinical Director at The Dawson Academy, his answer is clear: waiting too long to invest in CBCT technology.
In a recent webinar from The Dawson Academy, Dr. Hess admitted, “I could have afforded one five or six years before I purchased one…It’s probably the number one mistake that I made in my career.”
Those are some strong words from a clinician who lectures 100-120 days per year! But according to Dr. Hess, when dental professionals truly understand what CBCT reveals – and what traditional 2D imaging misses – the urgency becomes crystal clear.
CBCT stands for Cone Beam Computed Tomography. This specialized type of X-ray technology creates three-dimensional images of a patient’s head – including the teeth, jaw, sinuses, airways, and all the surrounding structures.
The main difference? While traditional dental X-rays act as photographs (capturing flat, two-dimensional images), CBCT creates more of a virtual sculpture.
The machine rotates around the patient’s head in a single scan, quickly capturing hundreds of images from different angles. CBCT then uses advanced software to turn those images into a complete 3D model that clinicians can examine from any direction.
By capturing data in three planes (coronal, sagittal, and axial), dentists can see beyond what’s visible on the surface. They can use the images to gain insight into what’s happening inside the bone, around nerve canals, within sinuses, and throughout the joint structures.
Every time a dental professional encounters a clinical problem, it likely stems from an incomplete diagnosis. That failure may not be due to the specialist’s skills, but rather to conclusions drawn from incomplete data.
When we miss critical information, patients struggle to adapt. They experience post-operative sensitivity, discomfort, bite issues – and often that leads to blame on the dental professional.
Because an incomplete diagnosis means we own the problem, even when we didn’t create it.
Traditional dental education may have taught most dentists to hunt for bacterial problems. But what about the patient whose airway is compromised? Or the one with unstable TMJs?
These problems often go undetected on 2D radiographs. A periapical or bitewing is a two-dimensional picture of a three-dimensional object, which means you have a 33% chance that critical issues will simply disappear.
The good news? They can’t hide in 3D.
In the webinar, Dr. Hess reflects on a major realization: “For about the first 15 years of my career, it’s like our profession didn’t realize that people actually need to breathe!”.
By adding CBCT to the diagnostic workflow, you may discover realities that traditional imaging never reveals. Dr. Hess shared the case of a 5-foot-tall, 95-pound female patient whose airway volume measured 3.9 cc’s. The average adult should have approximately 20 cc’s.
Patients with undiagnosed sleep apnea are incredibly hard on their teeth – and even harder on restorations. They clench and grind reflexively to maintain airway patency.
And if you place a traditional night guard on someone with a compromised airway? You’ll exacerbate their problem 65-70% of the time.
The temporomandibular joint is the most complicated joint in the human body. And dental professionals are the ones responsible for treating it, despite receiving almost no dental school training on TMJ health.
CBCT imaging reveals patients with severe degenerative joint disease who never complained about pain. They’ve adapted their entire lifestyle around their dysfunction—avoiding apples, bagels, chewy steaks. They’re hiding in plain sight.
If a dental professional starts making occlusal changes on someone with unstable joints, they could be taking on an enormous risk.
CBCT allows you to visualize condylar health, disc position,
cortical bone integrity, and active remodeling before you ever pick up a handpiece.
Dr. Hess shared another sobering example in his webinar: a patient with less than five cc’s of airway volume.
Using CBCT, he found that the cause was a completely asymptomatic malignant tumor growing in her neck, a life-changing diagnosis that traditional imaging may have never revealed.
CBCT routinely reveals massive infections that are barely visible on PA radiographs. It can also show sinus disease compromising airways, as well as periapical pathology that’s simply invisible in 2D.
The caveat: always use an oral and maxillofacial radiologist to evaluate large field-of-view scans. Professional interpretation protects both you and your patients.
Is CBCT worth the investment for your dental practice? According to Dr. Hess, it’s well worth it – both in how you treat patients, as well as in how you expand your diagnosing and treatment capabilities.
When it comes to radiation concerns, CBCT delivers without the risk. Modern CBCT machines expose patients to approximately 78 microsieverts, which is similar to a cross-country flight and is dramatically lower than that of medical CTs (2,000-30,000 microsieverts).
Plus, Dr. Hess says that practices won’t struggle to achieve return on investment. CBCT identifies treatable conditions you’d otherwise miss, improves treatment acceptance through 3D patient education, and increases case predictability – directly impacting profitability.
Here’s the reality that too many practices realize too late: When dentistry isn’t predictable, it isn’t profitable.
And when professionals can’t diagnose thoroughly, they can’t deliver predictable outcomes.
CBCT technology allows dental professionals to enhance their abilities to become true physicians of the masticatory system. Suddenly, they can see what traditional imaging can’t and deliver care that actually lasts.
Dr. Hess’s regret about waiting isn’t really about the CBCT machine. It’s about all the patients he could have helped sooner, all the problems he could have prevented, and all the incidental findings that could have changed lives.
Don’t make the same mistake – invest in the right technology and techniques today, and treat patients better tomorrow.
Want to learn more tips and insights from the team of experts at The Dawson Academy? Find more great webinars and training sessions online, and learn more at The Dawson Academy’s first course, Core 1.
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Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at ADA.org/CERP.
