Sir, we read with interest your recent publication on the current practice in the use of cone beam CT in UK dental practices.1

Although it is difficult to generalise based on the limited sample of respondents in this study, we share the concerns of the authors regarding the interpretation and reporting of CBCT scans. We would like to share our experience of referrals and associated imaging received in secondary care.

As a regional oral and maxillofacial unit, we often receive referrals from colleagues in primary care sending patient referrals in with radiographs (OPT) with incidental findings. We do in these cases provide a second opinion to the patient and the practitioner regarding further management and, where appropriate, provide the necessary care.

Our response to CBCT imaging received for the same reason with incidental findings and normal anatomical structures is different. The practitioners are advised to have the images reported by an appropriate radiologist. This is purely because we should all work within our scope of practice and competence and we do not have access to CBCT scans within the hospital trust yet.

In these situations, there is clearly a need for practitioners to be aware of their responsibilities and to keep up to date with skills in radiographic interpretation. In addition, they should have a robust clinical governance process in place for this sophisticated imaging modality.

We have also in recent months received referrals from colleagues in primary care accompanied by a CBCT including a report from an imaging centre.

However, the report was from a radiologist with no GDC/GMC registration credentials. Teleradiology and outsourcing of reporting is increasingly common, but all who report on patients in the UK, wherever in the world, should be registered with a UK healthcare regulator.

The Royal College of Radiologists has published a comprehensive document2 in its Standards for interpretation and reporting of imaging investigations which defines the standards and best practice which our patients should expect and is aimed at radiologists and other reporters.

We would strongly recommend this guidance to clinicians and imaging centres with cone beam CT scans, to allow them to provide high quality, safe care for our patients.