California Dental 2027 Ebook Continuing Education

_______________________________ DCA05DR Dental Radiation Health, Safety, and Protection, 3rd Edition

For nonoccupationally exposed individuals, the DLs have been established at one tenth of the DL for radiation workers. This category includes individuals in the general population, such as personnel who are not radiation workers but who work in areas adjacent to imaging facilities or persons accompanying patients who are in an adjacent waiting or reception area within the facility. Healthcare workers and those who have occupational exposure to radiation must follow the ALARA principle to decrease their exposure to radiation to as far below the dose limits as possible (Frane & Bitterman, 2023). It is essential that students in dental, dental hygiene, and dental assisting programs and dental staff members receive initial and ongoing training that minimizes radiation exposure to their patients and themselves (Hariry et al., 2024). The cur- rent recommendations for annual DLs are listed in Table 4 . RADIOGRAPHER PROTECTION Individuals operating dental radiographic machines should take steps to protect themselves from occupational radiation exposure. Excess radiation exposure to the dental radiographer can result from improper safety habits and exposure from the primary beam, secondary radiation, and leakage radiation. To avoid these sources of radiation, the radiographer should stand behind a protective barrier during radiographic expo- sures. The radiology operatory must be constructed from mate- rials that shield surrounding areas from primary and secondary radiation. Many materials used in construction, such as drywall and sheetrock, provide the thickness necessary for protective shielding. For most dental x-ray installations, lead lining of the operatory walls is unnecessary. If no barrier is present, the clinician should stand at least 6 feet (2 meters) away and at a 90° to 135° angle to the primary beam. This practice is known as the distance and position rule (Benavides et al., 2024). Location of the exposure control panel and exposure switch outside of the dental operatory facilitates operator protection.

RADIATION SAFETY AND PROTECTION Radiation safety and protection are based on the ALARA principle. ALARA is an acronym for “as low as reasonably achievable.” This principle maintains that exposures to ion- izing radiation should be kept as low as possible (Price, 2023). It means that every effort should be made to reduce unnecessary radiation exposure for patients and dental professionals alike. DOSE LIMITS For many years, the concept of maximum permissible dose ( MPD ) defined occupational exposure DLs. This approach is now considered obsolete, and MPD has been replaced with effective whole-body DLs, which have separate classifications of radia- tion exposure limits for occupationally exposed workers and the general public (Kock, 2024). The DLs recommended by the International Commission on Radiological Protection (ICRP) are a fundamental for radiation protection for occupationally exposed workers and for the general public (Kock, 2024). The DLs are based on an LNT dose-response relationship that expects that unnecessary radiation exposure will be avoided and that any dental or medical procedure that requires any form of ionizing radiation is justified (International Commis- sion on Radiological Protection, 2019). Current DLs not only address whole-body exposures but also establish DLs for various organs. The DLs account only for occupational exposure and do not include exposures received as a patient. In fact, there are currently no DLs established for patient exposures received from diagnostic or therapeutic radiation sources.

RECOMMENDED ANNUAL DOSE LIMITS