In June of 2016, Michigan's Certificate of Need Commission voted to remove dental cone-beam CT scanners (CBCT) from their list of regulated items in accordance with Michigan Senate bill 741. The commission found, in agreement with bill sponsor, Senator Rick Jones and petitioning dental professional organizations, that the regulation was hindering practices in effectively diagnosing and treating their patients at a reasonable cost.
What CON Removal Means for Dental CT in Michigan
The removal of CBCT equipment from the list of items requiring a Certificate of Need (CON) in Michigan means that application fees (approximately $3000), legal fees, and the extensive paperwork associated with certification will be eliminated.
Even under CON regulations, CBCT has become an increasingly popular modality in Michigan. According to a statement by the Michigan Department of Health and Human Services, “dental cone beam CT scanners have increased 429 percent in Michigan to 74 in 2014 from 17 in 2010, and patient scans have increased 423 percent to more than 25,990 from 5,900 during that same period” (crainsdetroit.com). Prevalence of the modality is expected to grow even further in light of the commission's move.
Why Dental CT?
Cone-beam CT scanners provide clearer and more accurate scans than the standard 2D bite-wing X-rays more commonly used for dental imaging. Dr. Samuel Bander DDS, a private practice doctor of 36 years, recently spoke with Block Imaging on the benefits of cone-beam technology saying, "There are many uses for cone beams in the dental office. They can be used for implant placement, orthodontics, and endodontics (root canal therapy)... to name a few.”
Additionally, detection of issues such as impacted teeth, un-erupted teeth, cleft palates, crowding, and a slew of other issues can be detected with the level of accuracy that only a 3D image can provide. The use of 3D imaging technology also allows for greater precision when measuring bone dimensions for mini-implant placement and correction of maxillary transverse deficiency issues in adolescents.
Presently, traditional bite-wing X-rays are mainly used for detection of tooth decay and gum disease. Their basic format and scanning abilities do not support a wide enough variety of scans to accurately detect the issues that, left unattended, become much more costly for patients and practices.
In support of the motion to eliminate cone-beam CT scanners from the CON list, Bill Sullivan, Vice President of Advocacy and Professional Relations for the Michigan Dental Association, had this to say,
The Michigan Dental Association is very happy with what the commission did. This will help because [CBCT] is a technology that is used virtually all around the country. The clarity of the picture helps diagnosis and treatment and will greatly enhance care. Michigan dentists should have the same access to this technology, and now they do.
Now that the cost and effort associated with CON have been eliminated, Michigan dentists who have considered introducing dental CT systems at their practices will, perhaps, find the decision a little easier to make. Add to that the fact that 2017 offers the best outlook for the Section 179 tax deduction, and this year shapes up to be the most cost-effective time yet to take the CBCT plunge.