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5th Yr - CP5- IRMER > Selection criteria > Flashcards

Selection criteria Flashcards

1
Q

What principle do we follow in radiography

A

ALARP

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2
Q

What does the principle ALARP stand for

A

As
Low
As
Reasonably
Possible

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3
Q

How do we follow the ALARP principle

A
  1. Dose optimisation by choice of technique
  2. Use of selection criteria to justify all exposures
  3. Production of optimal quality images
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3
Q

How do we follow the ALARP principle

A
  1. Dose optimisation by choice of technique
  2. Use of selection criteria to justify all exposures
  3. Production of optimal quality images
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4
Q

Prior to undertaking a radiographic investigation what questions should you ask

A
  1. Has to been done already
  2. Do I need it now
  3. Is It the best investigation
  4. Are they all needed
  5. Have I explained the problem
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5
Q

What does a radiographic justification require

A

That the patients receive a NET BENEFIT from the exposure

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6
Q

What factos can affect decision making

A
  1. Litigation
  2. patient expectations
  3. Peer pressure
  4. Fixed practices
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7
Q

Which selection criteria do we use

A
  1. Radiate protection
  2. Selection criteria for dental radiographs by FGDP
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8
Q

What does the FGDP selection criteria for dental radiograph include

A
  1. Developing dentition
  2. Dental caries diagnosis
  3. Periodontal assessment
  4. Endodontics
  5. Implantology
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9
Q

How are the grades of recommendations given for evidence based guidelines

A

Grade A B or C

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10
Q

What is a grade A of recommendation

A

When the evidence given has gone through at least one randomised clinical trial

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11
Q

What is a grade B of recommendation

A

Where the evidence has been collected from well conducted clinical studies bu no studies at randomised clinical trials

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12
Q

What is a grade C of recommendation

A

When evidence comes from expert repots or options and or clinical experiences of respected authorities

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13
Q

What grade of recommendation do most dental selection criteria have

A

Grade C
Apart from I the diagnosis of caries where the evidence is ranked an A grade

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14
Q

What are some problems with caries diagnosis from a radiograph

A
  1. Overlapping contacts
  2. Cervical burn out
  3. The mach effect
  4. Corrosion products from liners and amalgams
  5. Heavily restored dentition
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15
Q

Why do we get cervical burn out

A

Due to x rays over penetrating or burning out the thinner tooth edge reducing in this area appearing like a radiolucent band around the necks of teeth

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16
Q

What is the Mach Effect

A

A visual effect when uniformly dark area meets uniformly light areas making the dark shade appear darker and the lighter shade appear lighter

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17
Q

What is the frequency of taking x rays in a child or adult dependent on

A

Dental caries risk

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18
Q

How often should a high dental caries risk child have their x rays taken

A

6 month bitewings until no new or active lesions arise or until patient changes into a different risk category

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19
Q

How often should a moderate dental caries risk child have their x rays taken

A

Annual bitewings

20
Q

How often should a low dental caries risk child have their x rays taken

A

12-18 months bitewings in the primary dentition
2 Yeats bitewings in the permanent dentition

21
Q

Describe a child of high caries risk

A
  1. No fluoride in their water
  2. Don’t use fluoridated toothpaste
  3. Have a high sugar diet or sugary medication
22
Q

How often should a high dental caries risk adult have their x rays taken

A

6 monthly bitewings

23
Q

How often should a moderate dental caries risk adult have their x rays taken

A

Annual bitewings

24
Q

How often should a low dental caries risk adult have their x rays taken

A

2 yearly bitewings

25
Q

What information does a panoramic radiograph show you

A

Entire dentition on one film

26
Q

What are the benefits of a panoramic radiograph

A
  1. Time efficiency
  2. Lower patient dose compared to full mouth PAs
  3. patients tolerate it better
27
Q

What are some of the disadvantages of a panoramic radiograph

A
  1. May have soem overlapping teeth in some areas
  2. Careful patient positioning required
28
Q

Do we take bitewings to aid with a diagnosis of periodontal disease

A

no

29
Q

When should we take radiographs in regards to periodontal disease

A

If a stage 3/4 BPE is obtained
Code 3 use existing bitewings or take OPT/ PAs as indicated
Code 4 take OPT or full mouth PAs as indicated

30
Q

What are radiographs used to do in periodontal disease diagnosis

A

Stage and grade

31
Q

When do we need to take radiographs in Endodontics

A
  1. Pre op
  2. Working length
  3. Mod fill in difficult cases
  4. Post obturation radiographs
  5. Follow up radiographs
32
Q

When do take a follow up radiograph following Endodontics treatmetn

A

1 year unless you have a large periapical lesion

33
Q

When might we take a cone beam CT in Endodontics

A

Indicated when:
1. planning for surgical procedure
2. Resorption cases
3. In cases Complicated by concurrent factors

34
Q

When must we take a CBCT

A

In implant planning

35
Q

Should panoramic be taken routinely to screen fro disease

A

no

36
Q

List the referral criteria for panoramic radiography

A
  1. Bony lesion no completely demonstrated on intra orals
  2. Grossly neglected dentition
  3. Wisdom teeth assessment prior to surgical intervention
  4. Jaw trauma
  5. As part of an orthodontic assessment
  6. For periodontal disease
37
Q

For 3rd molar assessments which radiograph should we take

A

Panoramic

38
Q

Why do we take panoramic when carrying out a third molar assessment

A

It shows us:
1. presence of caries/ resorption
2. Type and degree of impaction
3. Course and relationship of ID canal

39
Q

When should third molar assessment be carried out

A
  1. If patient is in pain
  2. If clinical indication of disease or pathology
40
Q

Why do we take panoramics following jaw trauma

A

Panoramics show fractures really well in the mandible

41
Q

Which type of jaw fractures are not shown well on a panoramic

A

High condylar fractures

42
Q

Other than clinical indication what is another key factor we must consider to assess if a panoramic is justified

A

Age

43
Q

Why is age an important factor to consider justification of a panoramic

A

If you take a panoramic on a too young child you may get:
1. Movement artefacts
2. They may not fit the focal trough
3. They may have to stand on a stool if they are too small (Health and safety risks)
4. Doesn’t tend to change the management

44
Q

What is THE youngest age of a child we would take a panoramic on

A

5 years

45
Q

What do we take prior to panoramic radiography

A

Clinical history

46
Q

Give some selection criterias for intramural radiogrpahy

A
  1. Caries
  2. Periodontal disease
  3. Endodontics
  4. Pre extraction ?
47
Q

Do we always need to take a radiogrpah prior to extraction

A

no not always

48
Q

When is a pre extraction radiograph indicated

A
  1. A history of previous difficult extraction
  2. A clinical suspicion of unusual anatomy
  3. A medical history placing the patient at special risk of complications were encountered prior to orthodontics
  4. Impacted teeth or have a close relationship to anatomical structures

5th Yr - CP5- IRMER (6 decks)

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