Cone beam computed tomography (CBCT) gives dentists a three-dimensional view of the teeth, jaws and surrounding structures. Once found mainly in specialist and radiology practices, CBCT units are increasingly common in general practices, especially those placing implants, doing complex endodontics or extracting third molars.
But CBCT isn't a simple equipment purchase. It comes with radiation licensing, training, reporting responsibilities and real costs. This guide covers what practice owners in Australia need to consider before buying a CBCT unit.
This article is general information, not clinical, regulatory or legal advice. Radiation rules differ between states and territories. Always check with your state radiation regulator.
Key takeaways
- CBCT provides 3D imaging that can help with implant planning, endodontics, impacted teeth and pathology.
- It delivers a higher radiation dose than standard 2D dental X-rays, so every scan must be clinically justified.
- Radiation licensing is state-based. CBCT often needs additional licensing or training beyond standard dental X-ray licences.
- The dentist who takes a scan is generally responsible for interpreting the whole image volume, not just the area of interest.
- The business case depends on referral volume, procedure mix and how many scans you'd otherwise refer out.
What CBCT is used for in general practice
- Implant planning: bone volume, nerve and sinus position, and guided surgery planning
- Endodontics: complex root anatomy, missed canals, resorption and periapical lesions
- Impacted teeth: third molars near the inferior alveolar nerve, and impacted canines
- Pathology and trauma: cysts, fractures and other findings
- Airway and TMJ assessment, within appropriate scope and training
Radiation safety: justification and optimisation
Two principles underpin dental radiography in Australia:
- Justification: each exposure must have a clear clinical benefit that outweighs the risk. CBCT shouldn't be used routinely where 2D imaging is enough.
- Optimisation: keep doses as low as reasonably achievable by choosing the smallest suitable field of view, the right resolution and appropriate settings for the patient, particularly children.
ARPANSA, the national radiation protection agency, publishes codes and guidance relevant to dental radiology, and state regulators set the licensing requirements.
Licensing in Australia
Radiation licensing is managed by each state and territory, and the details differ. Common requirements include:
- A licence for the premises or practice that owns and operates the equipment, sometimes called a management or possession licence
- A use licence for each person who operates the equipment
- Additional training or licence conditions for CBCT, which several jurisdictions treat differently from intraoral and panoramic units
- Compliance testing of the unit by an accredited tester at installation and at regular intervals
- A radiation management plan and appropriate shielding, signage and monitoring
Some examples:
- The ACT distinguishes general dental X-ray equipment from 3D volumetric and CBCT units, and requires relevant training for the latter.
- Victoria covers dental 3D volumetric imaging under the dentist's use licence, and operating without the required licence is an offence.
- The Northern Territory asks for evidence of appropriate training to operate OPG and CBCT equipment.
- NSW requires a radiation management licence for premises, and equipment must be tested at installation and periodically after that.
- Western Australia has historically had stricter requirements for CBCT than other states.
Rules change, so contact your state or territory regulator early in the buying process, before you order equipment or start building works.
Interpreting and reporting scans
A CBCT scan captures much more than the area you're interested in. The generally accepted standard is that the whole volume should be reviewed and reported, including incidental findings in the sinuses, airway or bone.
Practices typically choose between:
- Reporting in-house, if the dentist has appropriate training and competence
- Referring scans to an oral and maxillofacial radiologist for a formal report, either for every scan or for larger fields of view
Using a smaller field of view reduces both the dose and the amount of anatomy to review.
The business case
Volume
Count how many patients you currently refer for CBCT each month, and how many cases you refer out or decline because you don't have it.
Costs
- Equipment, often combined with panoramic imaging
- Installation, including room design, shielding assessment and any building works
- Licensing, compliance testing and monitoring
- Training for dentists and operators
- Software for viewing and implant planning
- Radiology reporting fees, if you refer scans for reports
- Service contracts
Benefits
- Convenience for patients, who avoid a separate radiology appointment
- Faster treatment planning for implants and complex cases
- Better patient communication with 3D visuals
- Potential to offer, or keep in-house, more complex treatment
Questions to ask before you buy
- What are my state's licensing and training requirements for CBCT?
- Which fields of view and resolutions does the unit offer, and what are the doses?
- Does the room need shielding or building works?
- How does the software integrate with my imaging and practice management systems?
- Who will report scans, and at what cost?
- What do service, warranty and compliance testing cost over five years?
Frequently asked questions
Can general dentists use CBCT in Australia?
Yes, generally, provided they meet their state's licensing, training and registration requirements. Check with your regulator.
Is CBCT safe for children?
CBCT should be used for children only when clearly justified, with the smallest suitable field of view and settings optimised for their size.
Can AI help interpret CBCT scans?
Some AI tools support 3D imaging. Check their regulatory status and intended use. See AI dental X-ray analysis.
Next steps
Contact your state radiation regulator about CBCT requirements, and count your current CBCT referrals. For other technology decisions, read our guides to intraoral scanners and what's worth adopting in 2027. To free up front desk time while you invest in clinical technology, see IntelliDent's AI agents.