Radiograph

• 3 points that must be contained in the Local Rules for radiography


  • Named RPS (Radiation Protection Supervisor)/RPA
  • Summary of contingency plan arrangements
  • Description of designated controlled area (1.5-2Metres)
• Where a set of local rules should be available

  • Practices where ionising radiation is used
• IR(ME)R 17


  Ionising Radiation Medical Exposure Regulations
• IRR 17


  Ionising Radiation Regulations
• ALARP


  As Low As Reasonably Practicable
• 2 ways to implement ALARP in the dental practice


  • Only take films that are clinically necessary
  • Clinical audit
• 2 ways of ensuring the safe use of any x-ray equipment in a dental practice


  • Turn off x-ray machine after each exposure
  • Stand 1.5m-2m behind primary beam -use a collimator
• 2 procedures that can be undertaken to ensure the radiographs taken in the practice are of good quality


  • Carry out clinical audit
  • Step wedge test/ Use film holders
• Main role of the RPS in the practice


  • Carry out risk assessment of radiography equipment
  • Ensure compliance with IRR/IRMER/Local Rules
• 2 pieces of information you would expect to find in a Radiation Protection file


  • Copy of radiography risk assessment
  • Copy of staff qualifications
  • Copy of local rules
• 2 reasons why it is important to have a Quality Assurance programme in relation to dental radiography

  • To ensure high quality films/images
  • To prevent the need to retake film/image
  • To ensure consistent diagnostic Information & keeping radiation doses as low as reasonably practicable
• Radiation monitoring badges must be worn when more than 100 intra-oral films are taken weekly
• Radiation monitoring badges must be worn when more than 50 extra-oral films are taken weekly
• 2 adverse risks to health that dental radiography can have on the human body


  • Damage sensitive tissue
  • Damage to reproductive tissue
  • Cumulative/Damage to foetus
  • Cancer causing
• 2 reasons why it is important to maintain accurate and up-to-date records of x-ray film expiry dates


  • To avoid using out of date film
  • To use oldest stock first
• 2 things an OPG radiograph would usually be taken to show


  • Impacted third molar
  • Unerupted teeth for orthodontic assessment
• Precautions that could be taken to ensure radiation is used safely in a dental practice


  • Use a collimator
  • The machine should be switched on at the start and off at the end of the day
  • When x-rays are taken stand at least 1.5-2m away
  • All staff are qualified to take x-ray's
  • Use the slowest speed film available
• Guidance notes for dental radiography

  • Films must be held for small children
  • X-rays should only be taken if clinically necessary
• Radiation machines should be switched off between the patients
• A fast film will mean a reduced exposure time
• Dental radiation machines should be certified for radiation safety reasons every 3 years
• Radiation Risk/Warning sign


  Indicates radiation risk
• Main role of the RPS


  • Carry out risk assessment of radiography equipment
  • Ensure compliance with IRR/IRMER/Local Rules
• Bitewing radiograph


  Shows crowns of upper & lower posterior (pre-molars & molars) teeth on one side
• 3 things a bitewing radiograph would usually be taken to show


  • Caries
  • Early bone loss
  • Overhanging restoration
• 2 things a periapical radiograph should be taken to show


  • Caries
  • Bone loss/Working root length in endo
• Radiograph


  An x-ray film after it has been exposed and processed
• Digital radiography


  Uses a direct digital sensor or phosphor storage plate instead of a film
• Bitewing radiograph is the most appropriate to detect interproximal caries
• 2 examples of extra-oral films


  • OPG
  • Cephalometric
• Periapical radiograph is the most appropriate during endodontic treatment
• 2 types of radiographs that would be most appropriate to show supernumerary teeth


  • OPG
  • Occlusal
• Intra oral radiograph


  • Bitewing
  • Use: Detect Caries
• 3 reasons why a radiograph may need to be taken

  • Detect caries
  • Detect bone loss
  • Detect abscess
  • Working root length
  • Detect cyst
  • Locate unerupted tooth
  • Tooth fracture
• Radiographs used for different procedures


  • Periapical for diagnostic endodontic
  • Occlusal for unerupted canine
  • Bitewing for interdental cavity
• Film holders


  Used when taking intra-oral views to reduce risk of error and no radiation of patient's hand fingers
• Step wedge


  Used to test film to check density & contrast
• Step wedge should be used once per day
• There are 2 intensifying screens in an extra-oral cassette
• Intensifying screen in an extra-oral cassette


  Helps to focus the image on to the film and reduces the x-ray dose to the patient