Module 1

Question 1

What are the basics for patient protection when you consider x-ray exposure?

Answer 1

Guidelines for the prescription of appropriate radiographs
Proper equipment
Protocol set forth by WSU
Know what type of x-rays you’re taking before you seat the pt

Question 2

What are the guidelines for the prescription of appropriate radiographs?

Answer 2

New pt = individualized radiographic exam consisting of PA/occlusal view, bite-wings, and pano depending on age

High risk recall pt = bite-wings every 6-12 months

Recall pt = bite-wings every 12-24 months, 18-36 months, or 24-36 months depending on age

Recall pt with perio = clinical judgment required for need and type of x-ray (bite-wings and/or PA’s) of areas where perio can be identified

Recall pt growth/development = clinical judgment required for need and type of x-ray (pano for child/teen)

Other = clinical judgement required for need and type of x-ray

Question 3

Give example of proper equipment for protecting pt’s during x-rays

Answer 3

Lead apron
Thyroid collar
Barrier walls

Question 4

What is the protocol for x-rays at WSU?

Answer 4

Annually, but exceptions can be made with rationale

Question 5

Describe filtration

Answer 5

Filters out low-energy, longer wavelength x-rays within the tubehead (inherent filtration) or aided by aluminum disks placed between the collimator and the tubehead (added filtration)

Question 6

What is the role of filtration in limiting the amount of x-rays to the pt?

Answer 6

Filters out wavelengths so the shorter wavelengths come through which are less harmful and more diagnostic because they penetrate

Question 7

Describe collimation

Answer 7

Restricts the size and shape of the x-ray beam that exits the tubehead

Question 8

What is the role of collimation in limiting the amount of x-rays to the pt?

Answer 8

Determines how much of the x-ray is being exposed to the pt

Question 9

What are the two types of collimation?

Answer 9

Retangular and Circular

Question 10

List 6 ways to protect the pt from excess radiation during x-ray exposure

Answer 10

Maintenance of equipment
Use of digital sensors
High film speeds (F)
Pt records-date of films
Proper barriers
Reduce scatter radiation

Question 11

Why is film handling and processing after film/image production important?

Answer 11

The images taken are part of the pt record and the processing and storage of quality images are important for quality pt care and for legal purposes

Question 12

What factor or form of protection provides the most reduction of radiation to the pt during x-ray exposure?

Answer 12

Rectangular collimation

Question 13

Identify protection procedures for operators of x-rays

Answer 13

Maintenance of dental x-ray equipment
Exposure technique
Radiation monitoring/film badges
Protective barriers/shielding
Distance/position recommendations
Film/film holding devices,
Digital sensors

Question 14

Discuss maintenance of dental x-ray equipment

Answer 14

Have equipment checked regularly by state officials and make sure to put all equipment away properly (returning control arm to position), and cleaning processors

Question 15

Discuss exposure technique

Answer 15

Never be in the direct path for the primary x-ray beam

Question 16

Discuss radiation monitoring/film badges

Answer 16

Use individual or room film badges for verification

Question 17

Discuss protective barriers

Answer 17

Protective barriers include lead aprons, thyroid collars, and office design of walls; if you are pregnant wear a protective apron

Question 18

Discuss distance/position recommendations

Answer 18

You should be at least 6 ft away at 90-135 degrees or behind a barrier

Question 19

Discuss film/film holding devices

Answer 19

Never hold a film

Question 20

Discuss digital sensors

Answer 20

Digital sensors produce less radiation and are less harmful to the pt

Question 21

Define maximum permissible dose (MPD)

Answer 21

Maximum dose equivalent that a body should be exposed to in a given period of time

Question 22

What is the MPD for an occupationally exposed individual?

Answer 22

5 rems (.05 sv) per year
Younger than 18 or pregnant then it is .1 rem (.001 sv) per year

Question 23

What is the maximum accumulated dose for a lifetime for an occupationally exposed individual?

Answer 23

(N-18) x 5 rem/year or .05 sv/year; N = operators age

Question 24

What is the MDP for the general public?

Answer 24

.1 rem (.001 sv) per year

Question 25

Define the ALARA principle

Answer 25

“As low as reasonably achievable”; use the least amount of radiation to achieve the maximum diagnostic results (protect the pt and yourself from excessive/unnecessary primary or secondary radiation)

Question 26

How can you address pt concerns regarding dental x-rays?

Answer 26

Discuss with the pt to gain their trust
Be knowledgeable
Explain reasons for taking x-rays like: undetected disease and pathologies, prevent small problem from becoming bigger, less time for tx = less cost to pt, unnecessary pain be avoided, explain precautions, and be patient