Hello.

We appreciate your trust and that you refer patients to us for CBCT examinations.

In accordance with the Swedish Radiation Safety Authority’s regulations on medical exposures (SSMFS 2018:5), Chapter 2, Section 1 states that referral guidelines must be available to those who issue referrals for diagnostic examinations within the practice.

This information is therefore intended to serve as guidance for referrals for diagnostic imaging, with a particular focus on CBCT, where the justification assessment is of great importance.

Important information for the referring clinician

A CBCT examination must always be justified according to current radiation safety regulations. This means that the examination must be clinically motivated and only performed when the clinical question cannot be answered with conventional diagnostic imaging (intraoral radiography or OPG).

As the referring clinician, you are responsible for:

  • justifying the indication,
  • attaching relevant 2D images,
  • and providing the information required for the radiologist to make a correct and safe assessment.

CBCT must not be used for screening or when the clinical question can be answered with intraoral imaging or OPG. The examination should not be ordered for an unclear clinical question or lack of indication. If the referral is incomplete, we may request supplementary information or reject the referral.

The checklists and guidelines included in this guide aim to assist you as the referring clinician and ensure that the radiologist receives complete documentation. A well-prepared case reduces processing time, improves the quality of the report, and contributes to an optimal and low-radiation examination for the patient.

The referring clinician is responsible for ensuring that the referral is clinically motivated and complete. The radiologist is responsible for the performance of the examination, radiation dose optimization, and diagnostic interpretation.

Please note that additional information may be required depending on the clinical question. We may therefore request supplementary material when necessary for diagnosis. Referrals lacking a clinical question or relevant 2D images may need to be supplemented before CBCT is performed.

A complete referral should include:

  • Patient information
  • Clinical question
  • Date of previous X-ray
  • Relevant 2D images (digital)
  • Relevant medical history
  • Referring clinician’s contact details
  • Any special requests (implant planning, slice orientation, etc.)

CBCT examinations are performed according to the ALADA principle (As Low As Diagnostically Acceptable), meaning that the radiation dose is kept as low as possible based on the clinical question. Therefore, it is important that CBCT is only referred when the diagnosis cannot be made with 2D radiography, and that relevant images and information are attached to avoid retakes or supplementary examinations.

For questions, additional information, or advice regarding referrals, you are always welcome to contact us.

Thank you for your cooperation – we look forward to continuing to work together.

Sincerely,
Swedish Dental