_______________________________ DCA05DR Dental Radiation Health, Safety, and Protection, 3rd Edition
Image Receptors D-speed film, E-speed film, and F-speed film are currently avail- able. F-speed film provides the lowest radiation exposure to the patient and should be utilized in offices where film-based imaging is used as it requires substantially less radiation than D-speed film (Benavides et al., 2024). The use of F-speed film or digital image receptors significantly reduces patient exposure and is recommended for intraoral radiography. Digital image receptors include rigid solid-state wired or wireless detectors, such as a charge-coupled device (CCD) and the complemen- tary metal oxide semiconductor, and a flexible wireless sensor, such as the photostimulable phosphor plate (PSP) or storage phosphor plate. Forming a digital image on the receptor requires less radiation because the sensor is more sensitive to radiation than traditional film and can produce an image that is comparable to the diagnostic quality of an F-speed film (Benavides et al., 2024). Examples of acceptable intraoral image receptors include PSPs, rigid solid-state sensors, and F-speed film. The radiation exposure from a digital panoramic radiograph is less than that of a digital full-mouth series of radiographs (Kiser, 2020). Current intensifying screens utilize rare earth elements, such as lanthanum and gadolinium, which significantly decrease patient exposure when compared to the calcium tungstate screens used in the past. Receptor Instruments Beam alignment devices center the receptor and primary beam of radiation and are recommended for all intraoral exposures. The paralleling technique aligns the long axis of the tooth and receptor parallel to each other, giving the most accurate representation of the teeth and surrounding structures without dimensional distortion. The paralleling technique is easier to use than the bisecting angle technique and eliminates the need for the operator to estimate the correct angulations of the beam. Receptor instruments are recommended for intraoral imaging because they produce quality images and reduce the need for retakes. Retakes Retakes are one of the most common causes of unnecessary patient radiation exposure (Monnin, 2021; Bhatti & Shaikh, 2020). They frequently result from improper patient position- ing and processing technique (Hariry et al.; Monnin, 2021; Bhatti & Shaikh,2020. With dental radiographs in particular the most common causes were positioning errors, improper angulation, improper alignment, and incorrect film placement (Monnin, 2021). The transition from standard dental radio- graphic films to digital sensors requires staff training as the size and the placement of the digital sensors differs from that of traditional dental radiographic films, which have been used for decades. Every radiograph that is diagnostically unaccept- able must be retaken. The retake may be necessitated either by poor radiographic exposure technique or by processing errors. To produce quality diagnostic images, the radiographer must have a thorough knowledge of the imaging methods used in dentistry, including paralleling, bisecting the angle, and
bitewing and panoramic techniques. It is the responsibility of the radiographer to reduce patient exposure to radiation by maintaining high standards and being aware of the details required in the imaging chain. Receptor handling, placement, processing, and scanning must be meticulous and thorough for the production of quality radiographs.
Self-Assessment Question
3. One of the most common causes of unnecessary dental patient radiation exposure is: A) The need for retakes. B) The use of F-speed films for dental x-rays. C) The use of digital x-ray systems. D) The use of the bisecting angle technique for dental x-rays. Machine and Facility Inspection All dental radiographic equipment, regardless of date of purchase or manufacturer, is subject to state and federal x-ray equipment inspections. States have various safety regulations and perform inspections on the basis of the type and use of radiation-generating equipment in the dental office, from intraoral machines to panoramic and other extraoral imaging equipment. Radiation inspectors evaluate the facility to ensure that proper warning signs are posted, correct safety procedures are in place, and all operating controls are placed outside of, or at an acceptable distance from, the patient area. Dental offices must pass compliance tests that include exposure and timer reproducibility; safety checks for the level of scatter radiation for patients, operators, and other staff members; reading of the dosimetry reports of radiographers; inspection of the machine output; and a check of the construction materials in the general work area. All individuals who work with radiation should be required to review safety procedures on a routine basis, have thorough in-service trainings, and be required to take continu- ing education programs or courses (Lee & Choi, 2021). Quality Assurance Quality assurance programs have been established for dental radiography procedures. The term quality assurance refers to a plan of action to ensure that a dental office and its workers will produce consistent, high-quality images with minimal exposure risk to patients and dental professionals with training in compliance with state dental practice acts and regulations (Benavides et al., 2024). Staff members who have not utilized digital radiography for dental x-rays must receive training that is specific for this treatment modality as the radiographic tech- nique differs from that of conventional radiography. Quality assurance protocols for dental radiography should be developed and implemented for: • X-ray machines maintenance and compliance with state regulations.
• Image receptors. • Film processing.
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