Periodontist Dr. Antoine Clarke is taking his view of dentistry to a whole new level with the addition of a cone-beam computed tomography (CBCT) digital imaging that is increasingly being used by dental professionals for various clinical applications, including dental implant planning, visualization of abnormal teeth, evaluation of the jaws and face, cleft palate assessment, diagnosis of dental caries (cavities), endodontic (root canal) diagnosis and diagnosis of dental trauma.
The CBCT allows dentists to reconstruct a three-dimensional (3D) image of a patient's dental, oral and maxillofacial region (that is, the mouth, jaw and neck), as well as the ear, nose and throat (ENT) area.
"I decided to bring this technology because it's the best standard of care anywhere in the world," said Dr. Clarke, who practices out of 122 Rose North House on Collins Avenue.
The digital imaging system provides images that are detailed, and offers significant and precise information, compared to a traditional X-ray film, according to the dentist. Dr. Clarke's specialty deals with teeth, gums and bones, and his goal is to prevent bone loss in patients and avoid them having tissue loss and losing teeth.
"Computerized technology produces clear and extremely detailed three-dimensional pictures of the jaw, demonstrating the actual makeup of the teeth, sinuses and jaw bone. The CBCT, besides being the standard of care, is 100 percent accurate. It's the most accurate form of an x-ray you could ever receive concerning bone tissue. And when I do procedures, I want to be 100 percent -- providing patients with 100 percent surety, 100 percent diagnosis and 100 percent treatment plan," said Dr. Clarke.
With at least 90 percent of Bahamians having periodontal disease and temporomandibular joint (TMJ) disorders (a group of conditions that causes pain and dysfunction in the jaw joint and the muscles that control jaw movement), Dr. Clarke said equipment such as the CBCT is necessary in the practice of dentistry.
"It is used to assess orthodontic, periodontics oral and maxillofacial surgery; assess the maxillary sinus, endodontics, pathology; and general dentistry. It is excellent for patients with a gag reflex.
The CBCT is done on the patient in an open environment in a seated position with scanning times of less than 30 seconds. This, he said, makes it great for handicapped patients as well as children. Dr. Clarke said it offers significantly lower radiation compared to traditional CT scans -- up to 95 percent less radiation.
In comparison to conventional x-rays, Dr. Clarke said the CBCT's three-dimensional view gives dentists height, width and shows them the true picture of a tooth or bone, and anything going on inside a patient's mouth.
"With this age of dentistry, where patients are going from office to office trying to find a resolution for certain things, it gives you 100 percent resolution."
Dental CBCT systems have been sold in the United States since the early 2000s.
The technology has been available at Dr. Clarke's office for a few months. He said he's used it a number of times for many different applications.
The ideal candidate for a CBCT, he said, is any patient requiring dental care -- numerous fillings, unresolved pain, sinus problems or TMJ.
CBCTs range anywhere from $150 to $400 in the United States, according to Dr. Clarke. While he did not care to discuss cost, he said he is offering the scan at a reasonable price in comparison. He said most insurance companies also cover the cost of the scan.
"Dentistry and medicine is going up, and a lot of times it's going up because of the advances in technology. Rather than guessing what a problem is or trying to figure it out, we can figure it out with 100 percent accuracy. And I want to provide the most predictable and most acceptable standard of care throughout my profession. Hopefully it improves the quality and standard of care in this country. As a specialist, I tend to look at things three dimensionally in any event, but this allows me to see things I may not have picked up on, like a cyst, where it's located, and the size of it."
Dr. Clarke said he always wants to offer patients the best form of treatment.
"I decided to go to 3D technology because I got tired of the rumors about teeth in a day. That does not exist. You don't get teeth in a day. There are so many processes that you have to go through to get to that stage, and some of these individuals that are flying all over the place for these advertisements use this same type of technology, and I figured I would keep it home. If you can get teeth in a day, it will be done right here," he said.

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