306 - safe use of ionising radiation. Flashcards
Current ionising radiation regulations (IRR)
deals with exposure to employees and public
who does IRR apply to?
workplaces that use radioactive substances and electrical equipment
every employer must comply with IRR
what should employers do with ionising radiation?
keep exposure as low as possible
justify why using ionising radiation on patient
ionising radiation (medical exposure) Regulations (IR(ME)R)
deals with exposure on patients for medical and non-medical procedures
what does (IR(ME)R) include?
clincial justifcation for x-ray exposures
dose kept low as reasonably possible
clinical audits
only trained staff use equipment
accidental/unintended exposure records
local rules for ionising radiation
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
how often are radiation protection files reviewed?
regular basis to see if relevant and if need to make changes
why do radiation protection files need a log?
to show it has been reviewed and if changes were made
what should the radiation protection file include?
local rules and written procedures made by the legal person
what hazard does the primary beam have?
it is ionising radiation and can cause severe burns even from short exposure
what hazard does scatter radiation have?
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
what hazard results from absorption by the patient?
patient can absorb energy when exposed, frequent exposure linked to development of cancer
what is the hazard of equipment failure?
over-exposure
what to do with x-ray equipment that isn’t used?
turn off to avoid accidental exposure
what is the hazard of accidental exposure?
can cause damage like burns, damaged eye vision if direct exposure
must report and note it
what is a bitewing?
images of posterior teeth when in occlusion
what does a dentist see from a bitewing?
crowns of upper and lower molars/premolars
what do bitewings help diagnose?
interproximal caries
overhanging restorations
poor fitting crowns
occlusal caries
recurrent caries under existing restorations
what is the frequency of taking bitewings?
every two years if higher risk ever year
what must be done with every radiograph?
must be justified
what is a periapical radiograph?
allow dentist to see whole tooth, includes crown, root and bone
why is a periapical radiograph used?
to diagnose problems that cause the pt pain e.g. abscess
what radiograph is used to support pre-operative assessments e.g. xla and rct
periapical radiograph
what is a dental pantomograph/orthopantomography/panoral
radiograph that allows dentist to see every tooth along jaw, alveolar process and TMJ and maxillary antrum
what is a DPT useful for?
unerupted and impacted teeth like third molars
bone structure for ortho and implants
what is the radiographic grading process?
graded 1-3 with letter A- acceptable or N- not acceptable
why are radiographs graded?
to show we are taking radiographs correctly
how often do radiographs need to be audited?
every 3-6months
how are radiographs audited?
100 patients picked from last 6 months
must have good amount of acceptable and minimum of non-acceptable
what happens if the audit finds a lot of non-acceptable radiographs?
dentist must get further training as they aren’t being taken correctly
what is a step-wedge test?
way of testing equipment, process and software equipment
what does a step-wedge test help assess?
impact that exposure changes have on radiographic images
what to do when the solution has been changed?
use a test object and expose radiation then process to check there are no faults
