The use of cone-beam computed tomography (CBCT) by dentists for diagnostic purposes in South Africa. Ethical and legal issues

For centuries, dental practitioners have used radiographs as their primary diagnostic tools. (Lorenzoni et al., 2012: 1-10). Cone-beam Computed Tomography (CBCT) was introduced to the dental profession in early 2000’s and represented a convenient alternative to the higher radiation dose Medical Computed Tomography (CT) to be used as a dental radiological diagnostic tool (Friedland, 2009: 58). The dental profession accepted this new technology, however the criteria for using CBCT technology is far more complex than that for conventional radiographs (Noffke et al., 2011: 262-266). According to Noffke et al., this complexity is in terms of radiation dosage requirements, clinical indications, and radiological interpretation of the images (2011:263). Dental practitioners are currently faced with a predicament; guiding principles and safety precautions that were once applicable to conventional radiographic imaging techniques are no longer adequate or sufficient in regards this new technology (Holroyd & Gulson, 2009: 1-10). Currently in South Africa, limited guidance and training is available for the dental practitioner regarding CBCT (Noffke et al., 2011: 263). Dental practitioners, who may not have received adequate training regarding the safe and effective use of this innovative technology, are presently making use of this diagnostic modality in South Africa (op cit). The only training currently available locally is limited to the procedural aspects of CBCT technology offered by the businesses which market the equipment (op cit). This research report explores the multitude of ethical and legal issues concerning the use of CBCT technology by South African dental practitioners as a diagnostic tool.
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirement for the degree of Master of Science in Medicine in the branch of Bioethics and Health Law, Steve Biko Centre for Bioethics. Johannesburg 2014