Updated: Aug 4, 2020
Reduce Radiation Exposure In Your Practice
Many people who visit the dentist are concerned about having dental images exposed. Most patients will swear they have images exposed “every time” they visit the office. As a mother of two teens, I have always called ahead to any imaging center to ensure the clinic is digital rather than analog (film) based before taking my children in for images. This is true for dental images when we switched dentists or for other images (arm, leg, finger) due to sport injuries . These are small steps I can take to keep the radiation level as low as I can during their growing years.
Here are some considerations for a practice to minimize radiation which will comfort patients and ensure diagnostic images are exposed.
Digital radiography uses 50-80% less radiation than conventional film. The range is affected by various factors. One should keep in mind that there less decrease in radiation with the use of PSP (indirect digital) receptors compared to sensor (direct digital) receptors. Another benefit of digital radiography is that software can assist the clinician with diagnosis and interpretation by using various aspects of the imaging software and accentuating apicies better using digital subtraction. Images that are too light or too dark can be adjusted using the software rather than exposing the patient again for a retake image.
While dentists may be frustrated with their staff’s ability (or inability) to expose images, one has to ask if the staff members were properly trained on the use of the sensors. Many of us started in dentistry using film based imaging. Techniques are similar but not the same as we transition from film to sensors. Practicing your film techniques with sensors will guarantee overlap with bite wings and often prevent an apex from appearing on the required periapical. Small, but necessary, modifications must be made to eliminate the issues. Training from experienced clinicians makes the difference between diagnostic and non-diagnostic images.
This is multifactorial. It involves proper training and quality assurance. All equipment should be checked using a reproducible method at the start of each day PRIOR to patient exposure. A step wedge is an easy and inexpensive mechanism for performing the morning QA. We do not want that first image of the day to be on a patient without confirming that all the equipment is functioning. Staff members should never decide to expose a retake prior to a dentist diagnosing the image. Only a dentist can decide, with a prescription, that a retake is necessary. It is not within the scope of practice for a dental hygienists or assistants to prescribe radiographs, including retakes.
Lead aprons must be used appropriately for all dental images. Extra-oral images should NOT use a thyroid collar as it increases the chance for a retake. Staff members must be confident in explaining to patients that the lead apron can impede information on a dental image which may at times require a retake. Lead aprons should never be folded. Proper hanging of the apron will increase the life of the apron and protect the patients without breaks in the protective material.
Rectangular collimation is not used as often as it should be in the dental field. It can reduce radiation to your patients by an additional 50-60%. If used incorrectly there is a greater chance of retakes which defeats the purpose of using the mechanisms. Some generator manufacturers include the rectangular collimator with purchase of your generator.