Proactively Uncovering Harmful Health Conditions with 3D Technology

3D dental technology is essential for baseline dental treatment planning and communication, while also flagging harmful health conditions that may lurk just below the surface.

The advancement of technology in the dental industry, dubbed the “technical revolution in dental care” by Forbes, has significantly increased the potential for better quality of oral health care. As a patient, if you go to a dental office that has invested in advanced technology, you may be told you need a 3D x-ray or digital scan taken of your mouth. You may wonder how this technology is different than a traditional dental x-ray and if it’s truly needed. Although not every dentist office invests in this cutting-edge technology, our office at Alpers Family and Cosmetic Dentistry believes that it is essential to the care of our patients’ total health and wellbeing. In fact, we believe it is the most valuable dental x-ray you can ever have!

"We perform the intraoral scan and dental cone beam scan on all of our new patients," said Rylie, Registered Dental Hygienist at Alpers Family and Cosmetic Dentistry. "It's not just about your teeth - it's about your total, overall health. This technology allows us to assess the whole person and can really make an impact on the patient's quality of life."

Our doctor and team members have seen harmful health concerns hiding just under the surface that would have otherwise remained undetected and untreated, if not for our digital 3D equipment. Let’s unpack some of these findings – but first, we need to break down the types of digital technology out there.

What Are The Types of Dental 3D Technology?

The latest 3D dental technology that may be used in dental practices today includes the intraoral scanner, like the iTero™, and the dental cone beam CT digital x-ray.

Registered Dental Hygienist performing intraoral scan on patient and CBCT scanner
Left: Intraoral scanner | Right: CBCT

Intraoral Scanning

Unlike traditional impression materials, intraoral scanning involves moving a small wand around your mouth to capture highly accurate, three-dimensional images of your teeth and gums. Not only do patients appreciate foregoing the mess and gagging that comes with traditional impressions, but they also are amazed at how easy and efficient the scanning process is.

Along with its ability to replace the traditional impression method, other benefits of using this scanner include capturing changes in bite, tooth chipping and wear, as well as efficiently creating Invisalign aligners and easily showing patients simulations of their smile.

Dental Cone Beam CT X-Ray

Dental cone beam computed tomography (CBCT) is a special type of digital x-ray equipment that involves remaining still while the x-ray source and detector revolves around you for a 360-degree rotation. Just a single cone beam scan produces three-dimensional images of your teeth, soft tissues, nerve pathways and bone.

Patients are often already aware of MRI and CAT scanning technology for other areas of the body; the dental cone beam CT scan is essentially a CAT scan of your teeth and mouth, jaw, bony structures of the face, nasal cavity and sinuses. According to an article published in The Journal of International Oral Health, “Greater accuracy of CBCT in measurements at lower radiation doses has made it a preferred option in implant dentistry.” This is because it allows the dentist to know precisely how to place the dental implant for optimal recovery and function.

But the dental cone beam digital x-ray's use goes beyond just dental implants. This advanced technology also allows us to identify the issues that may be concealed under the surface in order to not only evaluate and plan dental treatment, but also catch other red flags in a patient’s health and total well-being.

When the iTero intraoral scanner and dental cone beam CT x-ray are both used, that’s when the magic happens!

“I use both the intraoral 3D scan and the dental cone beam CT digital x-ray to plan all of my patient cases,” said Dr. Alpers. “When I’m able to show a patient their different treatment options in 3D and talk through their wants and needs real-time, that’s when I see their eyes light up. I see how they begin to get excited about what’s possible.”

Identifying Health Concerns Early

We believe that investing in 3D dental technology – which at our office means using both the iTero™ and dental cone beam CT – is in the best interest of the patient, as we are often able to identify major health concerns before the patient is actually feeling physical pain or seeing the repercussions from leaving an issue untreated.

Here are some of the findings we’ve seen with our patients by using this technology:


With our 3D equipment, patients have discovered unknown infections that were hiding beneath the surface. Many dental offices only take traditional x-rays, but since some infections are not detected on this type of x-ray, the cone beam 3D x-rays are essential in identifying the root cause of symptoms.

The two most common types of hidden infections we see through our CBCT are tooth infections and sinus infections. If we identify a tooth infection, the patient is able to be treated immediately in our office. In the cases where patients have a sinus infection, we are able to give them the information they need to go directly to a specialist, like an ENT. These infections may be causing symptoms, like pain, for the patient, so they are able to get the treatment they need by identifying the root cause of the issue. At other times, we catch it early enough before the patient is even experiencing pain.

CBCT scan shows severely infected tooth
3D x-ray reveals a severely infected tooth with bone loss

Patients are often surprised to discover these findings at their routine dental visit! Often, we hear about patients who have visited their primary care provider, but they were simply told to take an antibiotic. This only temporarily helped their symptoms, and the root cause of the issue was never investigated further.

One patient in particular said she had been experiencing chronic sinus issues for 15 years! After our office flagged an infection draining into her sinus and referred her to see an ENT, she was able to get the treatment she needed and says she’s never felt better.

3D scan showing sinus infection and deviated septum
3D x-ray reveals sinus infection (A) and deviated septum (B)

Identifying the root cause of symptoms is key to not only prevent further pain, swelling and continual infection, but also to prevent further destruction that may limit treatment options. For example, some patients are unable to do a necessary dental implant because an infection completely destroyed the bone that the implant would have otherwise been placed on. Identifying an infection early opens up the patient's available treatment options in the future.


Unlike traditional x-rays, digital 3D x-rays are able to pick up cysts and benign or malignant tumors.

One patient, who was a young, otherwise healthy individual, was experiencing pain and did not know what was causing it. Our CBCT identified a cyst that he likely has had his entire life, but would have never known about if he had not had the 3D x-ray performed. Now he’s able to take this information to his medical provider to assess treatment options.

CBCT scan shows large benign cyst causing patient pain
3D x-ray uncovers that a large benign cyst is the cause of patient's pain, requiring removal

Typically a patient visiting the dental office does not expect to find out that they have a cyst or tumor, and in many cases, these pathologies would have otherwise continued to grow and remain undetected for years. By catching them as early as possible, these patients are often in a position to have better outcomes with treatment.

Impending Loss and Destruction of Teeth

Digital dental scanners are able to highlight areas where a patient’s bite is putting too much force on their teeth. If left unidentified and untreated, these patients are highly susceptible to losing teeth in the short- or long-term future. By catching these issues early, they are able to receive treatment, such as Invisalign, that ultimately saves their teeth and improves functionality.

3D scan showing patient's bite contributing to tooth loss
Intraoral scan revealed patient's bite, with its excessive force, played a role in tooth loss

If these bite issues are not detected and treated early, patients will inevitably need to do more complex, invasive treatment later, which is ultimately more costly. But by intervening early, they are more likely to need less treatment, have more minimally invasive options available to them, and pay less overall.

iTero scan of patient's bite and Invisalign treatment
A: Intraoral scan shows that this patient's bite was contributing to significant wear | B: Timelapse of the patient's Invisalign treatment in two different views; this treatment corrected their bite by moving the lower front teeth, which prevented further damage and loss of teeth
Concealed Teeth Length

We’ve seen patients who have been unhappy with their gummy smiles and have asked about cosmetic treatments like veneers. However, our innovative technology has shown us what is hiding beneath the surface, and in some cases, we’ve seen patients who actually have teeth of significant size hidden beneath their gum tissue.

3D scans showing tooth length underneath gum tissue
Left: CBCT x-ray, overlayed with intraoral scan, shows longer teeth beneath patient's gum tissue | Right: Patient can see what's possible with a minimally invasive gummy smile correction

By performing a quick, simple gummy smile correction procedure (also referred to as dental crown lengthening), these patients have been able to leverage a more conservative treatment option and get the smile they always dreamed of – one that may also be better for long-term functionality. If they had not had a proper 3D assessment, they may have chosen a more invasive, expensive treatment option than they truly needed, potentially with less ideal outcomes.

Hyperdontia / Supernumerary Teeth (i.e. Extra Teeth)

Although we typically have two sets of teeth, in some cases a person may have hyperdontia, which is the medical term for supernumerary teeth or extra teeth. In this situation, the extra tooth is usually hidden in an unexpected place – like behind other teeth or in the person's arch. What’s even more surprising is when a patient has an extra tooth that’s completely hidden from view, such as deep within their jaw.

CBCT scan reveals extra tooth in base of nose
3D x-ray shows the patient has an extra tooth in the base of their nose

In fact, in one of our patients, we found a tooth buried within their nose! In this case, the patient had no adverse symptoms and could leave the tooth alone, but in s cases, these hidden teeth can cause issues and pain for the patient. Because of a simple 3D x-ray, our patients have an understanding of their medical condition far sooner and can get the care ineed.

Are these 3D technologies safe?

Radiation safety is always a concern. However, advances in digital technology have allowed for significant reductions in exposure. A dental CBCT scan’s radiation is less than half of the radiation exposure from a single mammogram, and roughly 33 times less exposure than a chest CT scan you’d get at the hospital.

Here’s some additional comparisons to put it all in perspective:

Activity Approximate Effective Radiation Dose (mSv)
Eating a banana 0.0001
Dental bitewing x-ray 0.005
Dental panoramic x-ray 0.025
Dental Cone Beam CT 0.18
Flight from New York to Tokyo, round trip 0.20
Ingesting food (per year) 0.29
Mammogram 0.4
Living in Australia (per year) 1.5
Chest CT 6.1
Spine CT 8.8

Additionally, the digital intraoral scan does not expose the patient to any radiation at all.

Our belief is that the benefit of the dental cone beam CT imaging, which is the early detection of hidden health conditions and ultimately accurate diagnoses and treatment, is greater than the small risk that comes with using it.

A Thorough, 3D Assessment Is Essential

As these cases show, 3D dental technology has become a necessary and useful tool in order to identify and treat underlying dental and health conditions. Since our office owns this equipment, we are able to offer 3D assessments to our patients at a low cost, as part of their new patient package. It's important to note that we make zero profit off of using this equipment; we believe it's simply the right thing to do for our patients.

"Once we invested in this technology and began using it on our patients, it became clear that we need to use it on all of our patients without exception," said Dr. Alpers. "It's in the best interest of the patient's overall health. Once you see what it's capable of finding, you can't un-see it. There's no way that I, in good conscience, can let my patients visit my office without having a thorough assessment performed. We ensure everyone has one - otherwise, we're letting these issues go undetected and undiagnosed."

At Alpers Family and Cosmetic Dentistry, leveraging this technology allows us to assess our patients' total health and well being - not just their oral health - and it allows them to take a proactive role in their health, often leading to more minimally invasive and less costly treatment options. We are fortunate to have invested in this innovative technology so that we can make it available to all of our patients, and we believe both of these 3D technologies are absolutely essential to our mission of providing unparalleled quality and patient care.

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