306 - safe use of ionising radiation.

Question 1

Current ionising radiation regulations (IRR)

Answer 1

deals with exposure to employees and public

Question 2

who does IRR apply to?

Answer 2

workplaces that use radioactive substances and electrical equipment
every employer must comply with IRR

Question 3

what should employers do with ionising radiation?

Answer 3

keep exposure as low as possible
justify why using ionising radiation on patient

Question 4

ionising radiation (medical exposure) Regulations (IR(ME)R)

Answer 4

deals with exposure on patients for medical and non-medical procedures

Question 5

what does (IR(ME)R) include?

Answer 5

clincial justifcation for x-ray exposures
dose kept low as reasonably possible
clinical audits
only trained staff use equipment
accidental/unintended exposure records

Question 6

local rules for ionising radiation

Answer 6

every unit must have local rules displayed next to them, they include:
name of appointed radiation protection advisor
identification of controlled area
appropriate summary of working instructions e.g. 1.5m away
dose investigation level to see if personal monitoring is needed

Question 7

how often are radiation protection files reviewed?

Answer 7

regular basis to see if relevant and if need to make changes

Question 8

why do radiation protection files need a log?

Answer 8

to show it has been reviewed and if changes were made

Question 9

what should the radiation protection file include?

Answer 9

local rules and written procedures made by the legal person

Question 10

what hazard does the primary beam have?

Answer 10

it is ionising radiation and can cause severe burns even from short exposure

Question 11

what hazard does scatter radiation have?

Answer 11

it is secondary radiation when the beam crosses the object and causes radiation to scatter
therefore only the patient is in the room
risks skin damage and burns

Question 12

what hazard results from absorption by the patient?

Answer 12

patient can absorb energy when exposed, frequent exposure linked to development of cancer

Question 13

what is the hazard of equipment failure?

Answer 13

over-exposure

Question 14

what to do with x-ray equipment that isn’t used?

Answer 14

turn off to avoid accidental exposure

Question 15

what is the hazard of accidental exposure?

Answer 15

can cause damage like burns, damaged eye vision if direct exposure
must report and note it

Question 16

what is a bitewing?

Answer 16

images of posterior teeth when in occlusion

Question 17

what does a dentist see from a bitewing?

Answer 17

crowns of upper and lower molars/premolars

Question 18

what do bitewings help diagnose?

Answer 18

interproximal caries
overhanging restorations
poor fitting crowns
occlusal caries
recurrent caries under existing restorations

Question 19

what is the frequency of taking bitewings?

Answer 19

every two years if higher risk ever year

Question 20

what must be done with every radiograph?

Answer 20

must be justified

Question 21

what is a periapical radiograph?

Answer 21

allow dentist to see whole tooth, includes crown, root and bone

Question 22

why is a periapical radiograph used?

Answer 22

to diagnose problems that cause the pt pain e.g. abscess

Question 23

what radiograph is used to support pre-operative assessments e.g. xla and rct

Answer 23

periapical radiograph

Question 24

what is a dental pantomograph/orthopantomography/panoral

Answer 24

radiograph that allows dentist to see every tooth along jaw, alveolar process and TMJ and maxillary antrum

Question 25

what is a DPT useful for?

Answer 25

unerupted and impacted teeth like third molars
bone structure for ortho and implants

Question 26

what is the radiographic grading process?

Answer 26

graded 1-3 with letter A- acceptable or N- not acceptable

Question 27

why are radiographs graded?

Answer 27

to show we are taking radiographs correctly

Question 28

how often do radiographs need to be audited?

Answer 28

every 3-6months

Question 29

how are radiographs audited?

Answer 29

100 patients picked from last 6 months
must have good amount of acceptable and minimum of non-acceptable

Question 30

what happens if the audit finds a lot of non-acceptable radiographs?

Answer 30

dentist must get further training as they aren’t being taken correctly

Question 31

what is a step-wedge test?

Answer 31

way of testing equipment, process and software equipment

Question 32

what does a step-wedge test help assess?

Answer 32

impact that exposure changes have on radiographic images

Question 33

what to do when the solution has been changed?

Answer 33

use a test object and expose radiation then process to check there are no faults