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Radiology > Lecture 13 > Flashcards

Lecture 13 Flashcards

1
Q

Dental image

A

A two dimensional representation of a three dimensional object by the passing of xrays through the teeth and supporting structures.

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2
Q

Dental images are essential for:

A

Diagnostic purposes
Patient education
Patient record: Baseline info about patient, Document patient’s condition at a specific time, Comparative purposes

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3
Q

Why are xrays important for diagnostic purposes?

A

Images enable the dental professional to identify many conditions that may otherwise go undetected and to see many conditions that are not apparent clinically, helps DP gain a great deal of information about teeth and supporting bone structure.

An oral examination without dental images limits the dental practitioners knowledge to what is seen clinically, that is teeth and soft tissue.

Some diseases, lesions, and conditions of the teeth and bones cannot be identified by clinical exam alone.

Many diseases and conditions produce no clinical signs or symptoms and are typically discovered only through the use of dental images.

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4
Q

How are dental images an important component of a patients records?

A

Give the DP baseline information about the patient

Each image documents the patient’s condition at a specific time

Any subsequent images can be used for comparative purposes. Followup images can be compared with initial images and examined for changes resulting from treatment, trauma or disease.

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5
Q

How does this picture show the importance of dental images?

A

From a clinical exam the mandible looks normal but only the dental image shows a dentigerous cyst present proximal to #18 and the presence of #19 in the bone.

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6
Q

When weighing the risks of dental imaging with the benefits, what is there to know?

A

When dental images are properly prescribed, the benefits of disease detection outweigh the risk associated with dental exposure.

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7
Q

What conditions do dental images show?

A

Missing teeth, extra teeth, impacted teeth, dental caries, periodontal disease, tooth abnormalities, retained roots, cysts and tumors

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8
Q

How can dental images be used in patient education?

A

Images can be used to educate the dental patient about some of the common conditions that are only detected through the use of dental images.

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9
Q

Who is the dental radiographer?

A

Any person who positions, exposes, and processes dental Xray image receptors. In the dental practice this is the hygienist or the dental assistant

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10
Q

Tasks of a dental radiographer

A

• Positioning and exposure of dental x-ray imaging receptors
• Processing of dental x-ray films
• Data retrieval of digital images
• Mounting and identification of dental images
• Education of patients about dental imaging
• Maintenance of darkroom and processing equipment
• Implementation and monitoring of quality control tests
• Ordering of dental x-ray equipment and related supplies

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11
Q

What should the professional goals of the dental radiographer be?

A

• patient and operator protection
• patient education
• operator competence and efficiency
• production of quality images

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12
Q

How should the dental radiographer protect the patient?

A

• Patient protection must be a top priority
• Lowest possible level of x-radiation must be used
*Patient protection techniques
• Limit patient exposure: Lead apron,
Thyroid collar, Beam alignment device
• Properly prescribing of dental imaging
• Correct use of equipment
• Avoid re-takes

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13
Q

How should the dental radiographer protect themselves?

A

• Minimize occupational exposure to x-radiation
• always avoid the primary beam
• Do not hold the receptor for the patient
• maintain an adequate distance
• proper position
• proper shielding from x-rays during the procedure
• Get behind the lead wall
• A radiation-monitoring badge can be used to measure the amount of x-radiation received by the dental radiographer and to identify any excessive occupational exposure.

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14
Q

How can the DR have competence and efficiency?

A

Minimizing time between positioning and exposing the receptor

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15
Q

The dental radiographer must be committed to producing _____dental images.

A

High quality, diagnostic

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16
Q

Why are relations between the patient and the dental radiographer important?

A

Technical skills are not sufficient for providing optimal patient care, radiographer must build trust and communicate well

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17
Q

What are interpersonal skills?

A

Skills that promote good relationships between individuals are termed interpersonal skills. (The term interpersonal is defined as
“between persons.”

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18
Q

What are the components to interpersonal skills?

A

• Communication skills
• Facilitation skills

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19
Q

What are the components of communication skills?

A

Verbal
Nonverbal
Listening

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20
Q

What are facilitation skills?

A

are interpersonal skills used to ease communication and develop a trusting relationship between the dental professional and the patient.

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21
Q

Facilitation skills that enhance patient trust include

A

encouraging questions, answering questions, responding with action, and expressing warmth.

Whenever a patient asks a question, the dental radiographer should respond with accurate information in a direct manner and use language that the patient can easily understand.

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22
Q

What is chairside manner?

A

Chairside manner refers to the way a dental professional conducts himself or herself at the patient’s chairside.

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23
Q

What is good chairside manner?

A

• confident
• avoid comments such as “Oops!” or “Uh oh”: mistake or a lack of control
• explain to the patient exactly which procedures are about to be performed and then answer any questions the patient may have about the procedures.
• The dentist may then reinforce such information and reassure the patient before the dental auxiliary performs the radiographic procedures.

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24
Q

What counts towards the patient’s first impression of DR?

A

• Appearance
- personal hygiene
- clothing
- shoes
• Hygiene
• Greeting

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25
Q

What attitude should the DR have towards the patient?

A

Professional
Courteous
Patient
Honest

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26
Q

The dental radiographer must be able to educate patients about the importance of dental images and also be prepared to answer common questions because

A

Many patients do not understand the value of dental images.

• Patient education concerning dental imaging is likely to result in decreased fears of x-ray exposure.

• A knowledgeable patient is more likely to accept prescribed treatment.

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27
Q

• Modes of education

A

oral presentation, a video, printed literature, or a combination of these methods

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28
Q

Many patients ask the ___rather than the dentist, questions about x-radiation.

A

dental auxiliary

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29
Q

Only the___ may answer questions about any diagnosis related to a dental image.

A

dentist

30
Q

Question: Are dental x-ray images really necessary?

A

• Many diseases and conditions cannot be detected simply by looking into your mouth.
• Dental images are always prescribed to benefit the patient; the primary benefit is disease detection. Through the use of dental images, conditions and diseases that cannot be detected in any other way can be identified early. Early identification and treatment minimize and prevent problems, such as pain and the need for surgical procedures.
• The treatment plan outlined by the dentist will be primarily based on the information we retrieve from your dental images. Dental images allow us to determine which teeth, if any, need restorative care. Therefore the images are necessary to correctly plan your treatment.

31
Q

“How often do I need dental xrays?”

A

The frequency of a dental imaging examination is based on the patient’s individual needs.

32
Q

Q) How often do children need dental x-ray images?

A

Based on the individual needs of the child

33
Q

Q) Can I refuse x-ray images and be treated without them?

A

• The standard of care requires that the dentist decline to treat a patient who refuses necessary x-ray images
• Treatment without necessary images is considered negligent.
• No document can be signed to release the dentist from liability.
• E.g.) if you were to sign a paper stating refusal of dental x-ray images but releasing the dentist from any and all liability, you would be consenting to negligent care. Legally, patients cannot consent to negligent care.

34
Q

Q) Instead of exposing additional images, can you use the dental images from my previous dentist?

A

• Yes. Previous dental images can be used, provided the images are recent and of acceptable diagnostic quality.

35
Q

Q) How is patient exposure to x-rays limited?

A

• Because no amount of radiation is considered safe, strict guidelines are followed to limit the amount of x-radiation.
• The dentist custom-orders patient x-ray images on the basis of individual needs.
• During exposure, a thyroid collar and lead apron, fast film or a digital sensor
• Beam alignment device will be used to protect the patient from excess radiation.
• Good exposure technique is also used to limit exposure to x-radiation.

36
Q

Q) Should dental x-ray exposure be avoided during pregnancy?

A

• Ch14 pg 135
• “When a lead apron is used during dental imaging procedures, the amount of radiation received in the gonadal region is nearly zero. No detectable exposure to the embryo or fetus occurs with the use of the lead apron. The American Dental Association, together with the Food and Drug Administration, has stated in the most recent Guidelines for Prescribing Dental Radiographs that the recommended guidelines “do not need to be altered because of pregnancy.” “
• Evaluate Risk v. Benefits
• Elective procedure v. urgent need that may affect the systemic health

37
Q

Q) Why does the radiographer leave the room when x-rays are produced?

A

• Radiographer does not receive any benefit.
• Must comply with OSHA rules
• Radiographer must use proper protection measures. One of the most effective ways to limit x-ray exposure is to maintain adequate distance and shielding

38
Q

Are dental x-rays safe?

A

The amount of x-radiation used in dental imaging is small, but biologic damage does occur. No amount of radiation is considered safe. As a result, dental x-rays must be prescribed only when the benefit of disease detection outweighs this risk of harm.

39
Q

Will dental x-rays cause cancer?

A

“The radiation exposure that occurs during a dental x-ray examination is very small, and the chance that it will contribute to or cause cancer is exceedingly small. For example, the potential risk of dental imaging inducing a fatal cancer has been estimated to be 3 in 1 million. The risk of a person developing cancer spontaneously is much higher, or 3300 in 1 million. When these two numbers are compared, it is evident that when cancer occurs, it is over 1000 times more likely to be unrelated to radiation exposure.”
• Ch 14 Pg 136

40
Q

The dental auxiliary must be knowledgeable about, and comply with, laws that govern the use of ionizing radiation in dentistry. The possibility of negligent care exists when___

A

dental images are not properly exposed or used.

41
Q

The Consumer-Patient Radiation Health and Safety Act

A

• Outlines requirements for the safe use of dental x-ray equipment.
• This federal law also establishes guidelines for the proper maintenance of x-ray equipment and requires persons who perform dental imaging procedures to be properly trained and certified.
• In addition to federal laws, state, county, and city laws may affect the use of dental x-ray equipment.
• Most states have laws that require regular inspection of dental x-ray equipment, for example, every 5 years.
• Some state laws also require that the dental radiographer be trained and certified or licensed to expose dental images.

42
Q

Risk management

A

refers to the policies and procedures that should be followed by the dental radiographer to reduce the chances of a patient taking legal action against the dental radiographer or the supervising dentist.

43
Q

Disclosure

A

This process of informing the patient about the particulars of dental imaging is termed disclosure.

44
Q

Patients must also be given the opportunity to ask questions and have their questions answered___ the procedure.

A

before

45
Q

Informed Consent Components

A

Components
1. Purpose of the procedure and who will perform it
• Number and type of images used
2. Potential benefits of receiving the procedure

  1. possible risks involved in having the procedure performed, as well as not having it performed
    • Alternative diagnostic aids that may serve the same purpose as dental images
  2. Opportunity for the patient to ask questions and obtain complete information
46
Q

• Informed consent must be obtained from___.

A

all patients

47
Q

In the case if a minor( those under 18) or those declared legally incompetent informed consent must be obtained from

A

A legal guardian

48
Q

It is important that the person who provides the disclosure not___

A

misrepresent any of the information disclosed or threaten the patient into giving consent. The person disclosing information should use language that the patient can understand easily.

49
Q

Liability of dental auxiliaries

A

Even though dental auxiliaries work under the supervision of a licensed dentist, dental auxiliaries are also legally liable for their own actions

50
Q

negligence may result from

A

the action or inaction of the dental radiographer.

• E.g.) If informed consent is not obtained from a patient before the dental imaging procedure, a patient may legally claim malpractice or negligence.

51
Q

Dental malpractice results when the dental practitioner is

A

negligent in the delivery of dental care.

52
Q

Negligence in dental treatment occurs when

A

the diagnosis made or the dental treatment delivered falls below the standard of care.

53
Q

The standard of care can be defined as

A

the quality of care that is provided by dental practitioners in a similar situation under the same or similar conditions.

54
Q

Statute of limitations

A

State laws govern the duration of time within which a patient may bring a malpractice action against the dentist or the auxiliary.

55
Q

In many states, the statue of limitations begins when

A

The patient discovers (or should have discovered) that an injury has occured as a result of dental negligence. In such cases, the statute of limitations may not begin until years after the dental negligence occurred. Frequently, it is not until a patient seeks care from another dental professional that he or she becomes aware that previous dental treatment may have been negligent.

56
Q

Examples of negligence

A

• For example,
• If dental images are not exposed properly, or used
• If all of the information presented on the images is not interpreted or recorded accurately
Dental disease may go undiagnosed and untreated. Years later, the patient may be informed that he or she has an irreversible condition( advanced periodontal disease, root fracture, change
in size of a tumor or other growth), which might have been prevented or more successfully treated with early detection.

57
Q

Documentation
• It is essential that the dental record include the following:

A

• 1. Informed consent
• 2. Number and type of dental images exposed (including retakes)
• 3. Rationale for these dental images
• 4. An imaging report of including diagnostic information obtained from the interpretation of the images

58
Q

Patient record confidentiality

A

• All the information contained in the dental record, including information found on dental images, is confidential, or private.
• Patients do have the right of reasonable access to their records.
• Patients must request in writing to have copies of the record forwarded.
• Dental records and dental images should be retained indefinitely.

59
Q

The dental record is a___ document.

A

legal

60
Q

Dental images are the property of the

A

Dentist

61
Q

Patients Who Refuse Exposure of Dental
Images

A

• The dentist must then decide whether an accurate diagnosis can be made and treatment provided without a dental image.
• In most cases, patient refusal of dental images compromises the patient’s diagnosis and treatment, and the dentist may not be able to provide treatment for the patient.

62
Q

Quality Assurance

A

Specific procedures that are used to ensure the production of high quality diagnostic images

63
Q

A quality assurance plan includes both

A

• quality control tests
• quality administration procedures

64
Q

Quality control tests for dental imaging are used to

A

monitor dental x-ray units, supplies, film processing, and digital imaging equipment.

65
Q

For quality assurance Dental X-Ray Machines should be

A

• Monitored periodically
• Calibrated at regular intervals
• Annual test

66
Q

Reference radiograph

A

A reference radiograph is one that is processed under ideal conditions and then used to compare the film densities of radiographs that are processed daily.

67
Q

Give some examples of quality control tests for DI

A

Stepwedge radiographs
Reference radiographs
Coin test

68
Q

Stepwedge radiographs

A

stepwedge is a device constructed of layered aluminum steps

69
Q

Quality control on digital imaging

A

Dental x-ray machines must be inspected and monitored on a periodic basis. Images exposed annually with fix settings on a phantom head may be reviewed in a side-by-side comparison.

The receptor is also require periodic examination for scratching, bending or general wear and tear . Check for artifacts on images and dental professionals who use direct digital imaging must inspect the wire connection for any signs of separation from the sensor or deterioration, as well as bending of the wire.

It is recommended for me back up of the digital data on the computer on a daily basis, especially in offices with high patient volume

70
Q

Quality Administration Procedures

A

• Description of the quality assurance plan
• Assignment of duties
• Monitoring schedule
• Maintenance schedule
• Record-keeping log
• Plan for evaluation and revision
• In-service training

Radiology (12 decks)

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