What Script Do I Need To Order an MRI for a Patient?

By: Dr. Leonard A. Hess, DDS
Clinical Director, The Dawson Academy
Article Originally Appeared on TheDawsonAcademy.com

So what script do we need if we order an MRI on our patient?

Now, it used to be, several years ago, that MRI was kind of the gold standard for us to look inside the joint.

That is not the really case anymore.

CBCT Gives Us Great Information, But Sometimes It Is Not Enough

CBCT is so common now; that many dental offices have it. And it can give us great information.

We cannot see the soft tissue. We are seeing mostly hard tissue. Well, you can get great information on the joint space from it.

It gives us information on whether we think the disc is there or not. What is the bone like the condyle, the eminence? Are we having changes?

So it gives us great, great information and gives us a good idea of whether the disc is there or not.

Use Your CBCT Scan to Determine if an MRI is Necessary

We start to get into an MRI now if we think there is some type of soft tissue issue.

Now maybe results from a CBCT might show us that an MRI would help, as well. But when we start worrying about soft tissue, we need to know where the disc is.

Maybe there is a pain pattern that we can’t explain, so we want to rule out other things, growths, tumors, things like that, or if there is an inflammatory response.

All those are going to show up on our MRI, so it gives us great information.

Add a Radiologist to Your Interdisciplinary Team

Now, to order an MRI, it is really not that complicated. I think one of the things I would recommend for you is to add to your interdisciplinary team a radiology center in your area.

So talk to the radiologist. Tell them what you are doing and what it is that we need. An MRI of the TMJ, we do not need contrast.

So number one, no contrast makes things a lot easier.

Ensure They Have a TMJ Coil and Are Using No Contrast

The second thing is the MRI center, they have to have a TMJ coil. The joints are very small, so they have to have the coil so they can actually get an accurate and precise read of the joint.

If they do not have that, the MRI is not going to help you. So make sure they have that.

And then simply that we do not need contrast. We will need imaging of the mouth closed and open.

Closed, they are going show us then the slices so we can see from lateral to medial and open, the same thing.

And that is really all the information that we need. You can talk to the radiology center about how they read it and what we are looking for.

Use Beam Reader, as Well

Obviously, we want them to give us all the info on the medical side to make sure there is nothing that we are missing there, but then we want the information on our side so we can get a great idea of where is the disc, closed and open, lateral pole, medial pole, and then we can make our joint diagnosis.

We use BeamReaders a lot. And we use BeamReaders because as a radiology center, their dentist is making these reads, but they give us the information that we need so we can make the proper diagnosis.

That has really been a great addition to our team as well.

Keep Reading: Vertical Dimension Confusion

Dr. Leonard Hess, DDS

Dr. Leonard Hess, DDS

Dr. Leonard Hess began teaching continuing education courses in 2005, and the topics include occlusion, smile design, treatment planning, preparation design, and practice integration of complete dentistry. He’s taught full-day continuing education courses at the American Academy of Cosmetic Dentistry’s national meeting, The Greater New York Dental Meeting, AACD National Meeting, Pacific Dental Conference, Ontario Dental Association meeting, and The Yankee Dental Conference. Dr. Hess also has taught courses in Japan, Germany, Poland, China, and Canada. Dr. Hess is currently serving as the Senior Clinical Director at The Dawson Academy. He also owns Union County Center for Comprehensive Dentistry in Charlotte, North Carolina.