Please find the full publication via ↗︎ https://doi.org/10.1259/dmfr.20130291
Authors: J Brown, R Jacobs, E Levring Jäghagen, C Lindh, G Baksi, D Schulze, R Schulze;
Dentomaxillofacial Radiology, Volume 43, Issue 1, 1 January 2014
Overview
Cone Beam Computed Tomography (CBCT) has become a standard imaging tool in dental and maxillofacial radiology, offering three-dimensional views of hard tissue anatomy and pathology. However, this advanced technology comes with a critical challenge: most dentists receive little to no formal training in interpreting cross-sectional 3D imaging during their undergraduate education.
The European Academy of DentoMaxilloFacial Radiology (EADMFR) has developed this position paper to address this training gap, offering clear guidelines for the safe and effective use of CBCT by general dentists across Europe.
Why CBCT Training Matters
CBCT delivers significantly higher radiation doses than conventional two-dimensional dental X-rays. As CBCT adoption grows rapidly across European dental practices, the collective radiation exposure to patients is increasing — making proper training in justification, image acquisition, and interpretation more important than ever.
Without adequate training, dentists risk:
- Inappropriate justification of CBCT scans
- Missed or misinterpreted pathology
- Unnecessary radiation exposure to patients
- Failure to recognize when referral to a specialist is needed
- Two Recognized Roles in CBCT Imaging
The position paper distinguishes between two key professional roles:
- The Prescriber — refers patients for CBCT examinations and reviews the resulting images and reports for clinical decision-making.
- The Practitioner — takes clinical responsibility for performing the CBCT examination, including justification, image acquisition, and typically the radiological report.
A dentist may act as one or both, depending on their practice setting and national regulations.
Two Levels of Training
Level 1 — Basic Training
Designed for Prescribers with limited radiology background. Covers imaging fundamentals, radiation biology, selection criteria, national regulations, and basic differences between 2D and 3D imaging.
Minimum requirement: 12 hours of combined theoretical and practical training.
Level 2 — Advanced Training
Designed for Practitioners and those reporting on CBCT images. Includes hands-on software training, in-depth interpretation skills, quality assurance, and knowledge of when to refer for a second opinion.
Minimum requirement: 12 hours theoretical + 12 hours practical training, building on completed Level 1 training.
Core Training Content
Both levels address:
- Radiation physics and dose considerations specific to CBCT
- Justification and referral criteria
- Radiation protection principles
- CBCT equipment and technology
- Interpretation of normal anatomy and pathology
- Recognition of imaging artefacts
- Structured radiological reporting
Level 2 additionally covers equipment quality control, advanced software use, and comprehensive interpretation of the full facial skeleton.
Key Takeaways for Dental Professionals
- CBCT training should build on — not replace — existing undergraduate radiology education
- Regular refresher courses are recommended as technology and evidence evolve
- Training requirements vary by country, but EADMFR’s framework offers a common European reference point
- These are recommendations, not legally binding standards — national regulations always take precedence
About This Position Paper
This paper was developed by an EADMFR expert working group over the course of one year, drawing on the SEDENTEXCT project guidelines and the Academy’s 2009 consensus statement. It reflects international expert opinion aimed at improving patient safety and diagnostic accuracy in dental CBCT imaging across Europe. A review and update is planned within five years to reflect ongoing developments in the field.