Faculty Profile: Dr. Erika Benavides

Dr. Erika Benavides: Looking closely to find what radiology reveals

For Erika Benavides, her career in radiology has always been fascinating, challenging and rewarding.

When she adds in the fulfillment of sharing her knowledge with students as a Clinical Professor at the University of Michigan School of Dentistry, the career satisfaction can’t get much higher.

“I have always been fascinated by diagnostic sciences and by the ability to see beyond what you can see with the naked eye to get to the root cause of diseases and abnormalities,” she said.

Her interest in radiology developed during dental school in her hometown of Cali, Colombia. After she finished her dental degree program at the University of Valle, there were no radiology residency programs in Colombia so she decided to pursue educational opportunities in the U.S. She was accepted by the Medical University of South Carolina in Charleston for a six-month externship in craniofacial genetics under the mentorship of Dr. Carlos Salinas. Working with an oral and maxillofacial radiologist on a research project, she confirmed that radiology was the career she wanted to pursue.

Benavides then joined the University of Missouri at Kansas City in 2000 for a one-year General Practice Residency that provided more hands-on dentistry exposure in a hospital setting and experience treating medically-compromised patients and complex cases. She stayed on at UMKC as an oral and maxillofacial radiology resident and then completed an interdisciplinary PhD program that allowed her to combine research in oral biology and biomedical engineering. “Drs. Jerry Katz and Paulette Spencer were my greatest mentors at UMKC,” Benavides said. She gained greater appreciation for working with various specialties.

“Engineers have such a different perspective than someone in the healthcare field,” she said. “It’s very enriching to look at clinical questions from different lenses.”

The advantages of a multidisciplinary approach reinforced what Benavides had already come to understand about the value of oral and maxillofacial radiology as a core specialty. “Imaging is key to most dental specialties and being a radiologist I have the privilege to collaborate and contribute in multi-specialty teams, which is very rewarding,” she said.

With her PhD in hand, Benavides came to the University of Michigan School of Dentistry in 2006 as a clinical lecturer in the Department of Periodontics and Oral Medicine, which oversees radiology. She already knew she enjoyed the teaching side of radiology because she had been a clinical teaching assistant at UMKC. At U-M, she steadily moved up the faculty ranks after three years as a lecturer, becoming a full professor in 2019.

Benavides says she had the good fortune to join the radiology division at U-M four years before the retirement of Professor Sharon Brooks, the world-class radiology expert who was a faculty member from 1973 until 2010. Brooks, who edited and contributed to top radiology journals and lectured at conferences around the world, shared her knowledge and teaching experience. “I was so fortunate to work with Dr. Brooks,” Benavides said. “She was an outstanding mentor –so inspiring, generous, and knowledgeable.”

That spirit of camaraderie and sharing is what Benavides tries to pass along to students learning about radiology in the DDS, graduate specialty and dental hygiene programs. She and Dr. Fabiana Soki are the lead faculty for the school’s series of didactic and clinical radiology courses from first-year students up through graduate level. Some are large lectures, some are small group seminars, some are hands-on radiographic technique and interpretation sessions.

“I love asking questions to students to help them reinforce their knowledge,” Benavides said. “I give them plenty of time to think about what I’m asking, but I push them to think. When the lightbulb goes on and they say, ‘Oh, yes, now I see, that makes sense’ – it is very satisfying. I love that aspect of teaching and transferring knowledge.”

Radiology, like all the aspects of dentistry, evolves constantly. The days of the examining x-ray film on a lightbox are over for the most part. Instead, digital imaging and Cone Beam Computed Tomography (CBCT), which provides striking and accurate 3-dimensional images, help dentists and doctors diagnose many types of conditions and provide patients with the best treatment options.

“We have to keep up with how rapidly radiology is growing as far as technological advances,” Benavides said. “For example, when I started my radiology residency program, Cone Beam CT was not that popular. We were using conventional tomography, which was much more time consuming. Now, Cone Beam CT is pretty much the standard of care for many dental applications. Artificial intelligence, dental magnetic resonance imaging (MRI), and stationary intraoral tomosynthesis are part of the near future in dental imaging.”

In the process of staying at the forefront of her profession, Benavides has taken on several national leadership roles. She is a Diplomate and Past-President of the American Board of Oral and Maxillofacial Radiology (ABOMR) and has served as Councilor for Communications and Chair of the Research and Technology Committee of the American Academy of Oral and Maxillofacial Radiology (AAOMR).

Benavides also played a key role in a new recommendation announced by the American Dental Association earlier this year regarding the long-standing practice of using lead aprons and thyroid collars to shield patients during dental x-rays. She was chair of an expert panel established by the ADA’s Council on Scientific Affairs to take a fresh look at data related to radiation exposure. Working with ADA staff for three years, Benavides and other radiology experts from around the country reviewed the latest published research, documents and regulations. The review determined that lead aprons and thyroid collars are no longer necessary, leading the ADA to recommend the end of that practice. Benavides said the review was also important in providing up-to-date information on radiation safety protocols and best dose reduction methods to minimize radiation risks for patients and dental office staff.

The importance of her work in radiology is never lost on Benavides. She said one of the most important messages she delivers to students is the need to examine the entire radiograph or CBCT scan, not just the region of interest related to the reason for taking it. A scan may have been ordered to examine the bone prior to a dental implant, but the images could reveal even more important information about, for example, soft tissue calcifications and benign and malignant lesions in the head and neck area.

She often shares the story of a particular patient she examined. She noticed asymmetry of the airway on his CBCT scan and recommended referral to an otorhinolaryngologist. The specialist discovered a tumor pressing against the airway and that the patient was suffering from Stage 2 papillary thyroid carcinoma. “The patient was able to receive treatment, but if it weren’t for the scan, it would have been too late by the time they discovered the tumor,” Benavides said. “That is why we teach students a very systematic approach to reviewing not only Cone Beam CT scans, but also intraoral and panoramic radiographs. We want them to have a mental checklist so that they always look at everything.”

“Your interpretation can be so impactful on a patient’s life. That patient with the carcinoma later sent me a thank-you card that I still have. It is a reminder of why I do what I do. It is so rewarding.”