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Dental nurse exam revision > Unit 306 > Flashcards

Unit 306 Flashcards

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1
Q

Why do we take dental radiographs?

A

To diagnose and detect

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2
Q

Dental caries on a radiograph shows up as…

A

a dark area extending inwards from the enamel.

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3
Q

Periodontal disease shows up as…

A

A loss of the lamina dura (compact bone)
loss of height of the alveolar bone
widening of the periodontal ligament space.

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4
Q

Periodontal and periapical abscesses show up as…

A

A dark circular area at the apex.
Destruction of the apical lamina dura and spongy bone.

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5
Q

Cysts show up as…

A

enlarged darker areas surrounding other structures
Can sometimes push tooth roots out of their normal positions.

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6
Q

Examples of Latrogenic problems caused by the dentist:

A

Overhanging restorations
Root perforations by posts.

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7
Q

If a 14 year old patient had still not recieved their UL3 what would a radiograph detect?

A

Supernumerary and unerupted teeth
To determine the congenital absence of unerupted teeth

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8
Q

What does congenital absence mean?

A

Permanent absence of tooth

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9
Q

If a patient had a large swelling on the jaw what could a radiograph determine?

A

Hard tissue lesions such as bone cysts, tumours

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10
Q

Examples of what treatments radiographs are used in:

A

Endodontics
Extraction
Orthodontics
Implants
Preparations crown/bridge

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11
Q

A type of ionising radiation…

A

X-ray

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12
Q

What type of radiation is an X-ray?

A

Electromagnetic

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13
Q

What does radiopaque mean and examples?

A

Radiation cant pass through
Appear light grey to white
Crowns, restorations

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14
Q

What does radiolucent mean and examples?

A

Radiation can pass through
Appear dark grey to black
Cavities, soft tissues

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15
Q

The outer layer of bone on an xray will appear whiter than the cancellous inner layer.

A
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16
Q

What is the reason behind x-rays hitting the atoms of the tissue cells?

A

Scatter or absorbtion

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17
Q

What can happen if radiation energy is absorbed into our tissue cells?

A

Tissue damage

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18
Q

If the radiation energy hit the chromosomes in our body what could happen?

A

Damage
Undergo change “MUTATION”
Possibly the chromosomes would die.

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19
Q

What does ALARP stand for?

A

As low as reasonably practicable

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20
Q

What does ALARA stand for?

A

As low as reasonably achievable

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21
Q

Where is the controlled zone when an x-ray is being took?

A

Inside the surgery with the patient.

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22
Q

Why should Quality assurance systems be regularly operated (audits)?

A

Ensure the dental images produced are to a consistently high standard.

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23
Q

Is ionising radiation potentially hazardous to health?

A

YES

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24
Q

Is there a safe level of use regarding radiation?

A

NO

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25
Q

What can an overdose of radiation cause?

A

Ranges from a mild burn to leukaemia and potentially death.

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26
Q

Who was the IRR17 enforced by?

A

HSE - Health and safety executive

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27
Q

IR(ME)R 2017 + IR(ME)R (NI) 2017 is enforced by in different areas of the UK:

A

CQC - england
HIW - Wales
IRMER Inspector - scotland
RQIA - northern ireland

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28
Q

Who is the IRR17 concerned with?

A

Staff

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29
Q

Who is the IRMER17 concerned with?

A

Staff and patients

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30
Q

What does scatter radiation do?

A

It bounces of tissue cells during exposure in an uncontrolled manner and can re-expose the patient several times.
Increasing the radiation dose.

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31
Q

What has been put in place to reduce the amount of scatter radiation from taking place?

A
  1. Use of fast films such as F speed intraoral films
  2. Short exposure time - modern x-ray machines, fast films and fast intensifying screens in extraoral cassettes.
  3. Rectangular collimator tubes - provide a parallel x-ray beam.
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32
Q

HSE - graded approach

A

Low risk - notify the HSE
Medium risk - Register with the HSE
High risk - Recieve consent from the HSE

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33
Q

What grade does dental radiography fall into with the HSE?

A

Medium risk

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34
Q

Who is the legal person?

A

Employer - internal
Ensures the workplaces full compliance with both sets of regulations.

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35
Q

Who is the radiation protection Advisor RPA ?

A

Specialist person/organisation - external
Give advice on staff and public safety in relation to both sets of regulations.
Routine radiation surverys

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36
Q

Who is the Medical Physics Expert MPE?

A

Specialist - external (Falls under the IRMER)
Give advice on the matters of radiation protection concerning medical and non-medical exposures, including the measurement and optimisation of patient doses and QA.

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37
Q

Who is the radiation protection supervisor RPS?

A

Senior dentist or DCP (post qaul in radiography)- interal
Assess risks and ensure precautions are taken to minimise them.
IRR17

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38
Q

What is the legal person responsible for?

A

Organising a 3 yearly assessment of radiation safety within the workplace.
Drawing up the local rules - referred to by all staff

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39
Q

Where should the local rules be located?

A

At each X-ray machine
A copy in the radiation protection file

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40
Q

Safety zone - 2m
Controlled area -1.5m

A
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41
Q

What is the usual dose investigation level?

A

Anything above 1 mSv per year

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42
Q

What must the Radiation protection supervisor hold to be a RPS?

A

Certificate of competence
Recognised by the HSE

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43
Q

Who is the referrer of dental radiographs?

A

The dentists

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44
Q

IRMER practitioner…

A

The dentist or radiographer (therapists) who takes responsibility for JUSTIFYING the taking of the radiograph.

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45
Q

Operator…

A

Any member of the dental team who carries out all or part of the practical duties involved with exposure or processing.

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46
Q

Can therapists be an IRMER practitioner in the hospital?

A

NO

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47
Q

What patient should not be exposed to radiation?

A

Pregnant patient

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48
Q

What to do during accidental exposure/machine malfunction?

A

Turn off the main power source.

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49
Q

What must be done if a practice decides not to carry out non-medical imaging exposures?

A

Written protocol

50
Q

Who must be notified in the event of an accidental exposure occurrence?

A

RPA

51
Q

The 2 examples of types equipment testing:

A
  1. Acceptance Testing- new dental imaging
  2. Routine survey - existing equipment
52
Q

What is the radiation protection file?

A

Holds information regarding everything in place to ensure radiation protection within the workplace.

53
Q

What is the time frame for updating the radiation protection file?

A

Yearly

54
Q

What is the purpose of a Quality assurance system?

A

Ensure images are always at a high standard
Reducing exposure time and faults (handling, during exposure, processing)

55
Q

What is the radiography QA scoring system set out in clinical governance guidelines?

A

Grade 1 - Excellent 70%
Grade 2- Diagnostically acceptable 20%
Grade 3- Unacceptable 10%

56
Q

How often should the results of the QA scoring system be recorded and why do they need to be recorded?

A

After each exposure
Analysed on a regular basis and any problems identified ASAP
See if there is a pattern in each surgery or machine malfunctions

57
Q

Who is at high risk of exposure in the dental workplace?

A

The operator

58
Q

If a QA score 3 is a regular occurrence what is the next step?

A

Reject image analysis sheet

59
Q

How often should radiation equipment be checked?

A

3 yearly

60
Q

What is the percentage of reduction in scatter radiation when fast films, shortest exposure and narrowest beam are combined?

A

40%

61
Q

What should a parent wear if the child cannot keep still during an X-RAY?

A

Protective lead apron

62
Q

How can the amount of stray radiation received by staff be checked?

A

Film badge worn for 3 months at waist level
Suppliers + Processors- Radiation protection division (RPD)

63
Q

How often should a low risk patient be radiographed?

A

Every 2 years

64
Q

How often should a Moderate risk patient be radiographed?

A

Every Year

65
Q

How often should a High risk patient be radiographed?

A

Every 6 months - reducing when caries risk is under control

66
Q

What are intra-oral films?

A

Image taken within the oral cavity

67
Q

What are extra-oral films?

A

Image taken outside the oral cavity

68
Q

Contents of an intra-oral film packet….

A

Paper, film, paper, lead foil

69
Q

What does a horizontal bitewing show and what does it detect?

A

The posterior teeth in occlusion - INTRA
Detect CARIES

70
Q

What does a vertical bitewing show and what does it detect?

A

Extended view of the posterior teeth, from mid-root of both upper n lowers. - INTRA
Periodontal bone levels, true periodontal pockets.

71
Q

What does a periapical radiograph show and what does it detect?

A

One or two teeth in full length with surrounding bone. - INTRA
Infection, mobility, fractures

72
Q

What does an anterior occlusal radiograph show and what does it detect?

A

Plane view of the anterior section. - INTRA
To check for un-erupted teeth, supernumerary teeth and cysts.

73
Q

Contents of an extra-oral film cassette….

A

Cassette case
Intensifying screen
coating
film
coating
intensifying screen
cassette case

74
Q

True or False: the packets of extra-oral films can only be opened in a dark room?

A

True

75
Q

What does a Dental Panoramic Tomograph DPT + OPG show and what is the purpose?

A

Shows both jaws and their surrounding bone anatomy. - EXTRA
Ortho, wisdom teeth, helps diagnose pathology, jaw fractures.

76
Q

What does a lateral oblique show and what is it to check?

A

Shows the posterior portion of one side of the mandible including the ramus. - EXTRA
Check the position of un-erupted third molars

77
Q

What does a lateral skull (cephalometric) show and what does it check?

A

View of the side of the head. -EXTRA
Taken in a machine called “Cephalostat”
Monitor Jaw growth, check malocclusion for severe Ortho purposes.

78
Q

Intra oral films are held in place by…

A

Film holders

79
Q

Intra oral digital films are held in place by….

A

Special sensor

80
Q

What are the 2 angulations that intra-oral films can be exposed in?

A

1- paralleling technique - periapical
2. bisecting angle technique - anterior occlusal

81
Q

What does digital radiography avoid the use of?

A

chemically coated plastic film, and the need for processing.

82
Q

The sensor plate on digital radiographs is connected directly to the computer via USB cable. Uses pixels

A
83
Q

Advantages of digital radiography…

A
  • Financial savings
  • Avoids health and safety issues from occurring
  • Helps to achieve ALARP due to low dose
  • Image is produced quickly
  • same sensor can be used repeatedly
84
Q

Disadvantages of digital radiography…

A
  • Inadequate infection control
  • Financial implications
  • Unable to alter image
85
Q

What is a hidden image called?

A

Latent image

86
Q

Intra-oral film packet contains…

A

Celluloid film coated with light sensitive silver bromide salts.

87
Q

Example of an automatic processing machine:

A

Velopex machine

88
Q

Automatic processing machine consists of:

A

Chemical and water tanks, conveyor belt style of rollers that carry the film through.

89
Q

The order of automatic processing:

A

Developer, fixer, water, dry

90
Q

How many tanks does an automatic processing machine use?

A

3 tanks

91
Q

What is developer?

A

Alkaline - hazardous chemical waste

92
Q

What is fixer?

A

Acid - hazardous chemical waste

93
Q

Manual processing is carried out by hand in a dark room: True or False?

A

True

94
Q

The water tank in manual processing is heated what is the temperature range?

A

18-22C 20c is the ideal temperature

95
Q

What colour is the manual processing safety light?

A

Red

96
Q

The order of manual processing:

A

developer
wash
fixer
wash

97
Q

What are the deposits found in developing tanks called?

A

Silver bromide

98
Q

What do you use when topping up the chemicals?

A

A Funnel

99
Q

What does lead foil do?

A

Absorb scatters

100
Q

How many tanks are present in manual processing?

A

4 tanks

101
Q

Example of indirect digital..

A

Scanner

102
Q

Example of direct digital…

A

USB port, wireless

103
Q

What does mounting mean?

A

Changing the image to its correct position after processing.

104
Q

what could happen if an image is not mounted correctly?

A

Wrong treatment could be done.

105
Q

poorly maintained equipment will lead to…

A

poor quality radiographs

106
Q

What is a common reason for x-ray films to deteriorate before expiry date?

A

If they are left in hot or damp places or kept too near an x-ray set

107
Q

How should intra oral films be stored?

A

Laying Flat

108
Q

Maintenance of processing machines:

A

cleaned daily

109
Q

What fault is a dark film?

A

Processing fault
Overdeveloped/overexposed

110
Q

What fault is a blank image?

A

Processing fault
Not been exposed to radiation

111
Q

What is the fault of a foggy image?

A

Common fault
Film expired

112
Q

What is the fault of a black film?

A

Processing
exposed to light

113
Q

What is the fault of a light film?

A

processing
underexposed

114
Q

what is the fault of a blurry film?

A

exposure
movement

115
Q

what is the fault of foreshortening and elongation image?

A

exposure
incorrect cone positioning

116
Q

What is the fault of brown and green marks on an image?

A

Handling
split chemicals

117
Q

what is the fault of black lines across the film?

A

handing
bent film

118
Q

Faults are avoidable due to maintenance

A
119
Q

Universal system of quality…

A

scoring and analysing radiographs.

120
Q
A
121
Q

What test is preformed for x-ray machines?

A

Step wedge test

122
Q

What does the step wedge test do?

A

Determine the strength of the solution ( developer)

Dental nurse exam revision (13 decks)

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