Dental Radiography and Safety.

1. A patient who is scheduled for an x-ray expresses concerns about being exposed to radiation because he witnessed the effects of radiation on his father, who died of cancer.

a. How should the dental assistant respond to this patient’s concerns? The dental assistant should empathize with the patient’s concerns and provide reassurance. They can say something like, “I understand your concerns, and it’s completely normal to worry about radiation exposure. However, the radiation doses used in dental X-rays are very low and are considered safe. We take every precaution to minimize your exposure, such as using lead aprons and collimators to focus the X-ray beam. Your well-being is our priority.”

b. What can you tell the patient about x-ray film and other radiation safety measures? The dental assistant can explain that modern X-ray machines use digital sensors or films that reduce radiation exposure significantly compared to older technologies. Additionally, lead aprons and thyroid collars can be used to shield sensitive areas. The dental assistant should also mention that X-rays are only taken when necessary for diagnosis, and the benefits of having the information from the X-ray far outweigh the minimal risk of radiation exposure.

2. As you prepare a young teenager for a cephalometric image, his father, an engineer, asks about the content of the film cassette. As you explain the contents of the cassette to be a large sheet of x-ray film tightly held against an intensifying screen, he interrupts asking, “What? An intensifying screen?”

a. What factors should you consider before responding? Before responding, consider the level of understanding the father has and adjust the explanation accordingly. It’s essential to provide information that is accurate but also understandable to a non-medical audience.

b. How would you explain safety measures used during exposure? You can explain that an intensifying screen is a safety feature used to reduce radiation exposure. It works by amplifying the effect of the X-rays, allowing a shorter exposure time and less radiation to the patient. This technology is commonly used to make the X-ray process safer and more efficient.

3. A new assistant has just been hired and has been instructed to help the dental assistant prepare a full set of x-rays on two new patients. The dental assistant decides to take the x-rays herself and instructs the new assistant to develop the first set of x-rays while the dental assistant continues with the second patient. After developing the x-rays, the new assistant presents the x-rays to the dental assistant. The x-rays are cloudy, chalky, and unreadable.

a. How should this situation be handled? The dental assistant should handle this situation with professionalism and communication. They should first thank the new assistant for their efforts and acknowledge that errors can happen. Then, they should explain the issue with the cloudy X-rays and ask the new assistant to try again while providing guidance or assistance as needed.

b. Should the x-rays be retaken? Yes, the cloudy and unreadable X-rays should be retaken. Radiographs that are not clear and readable are of no diagnostic value and should not be used for patient evaluation. It’s crucial to ensure that the new assistant receives proper training and supervision to improve their skills.

4. Nathan Sawyer, a patient in your office, calls and states that he is moving out of state and needs his dental radiographs before he moves next week.

a. What precautions does the dental radiographer need to take prior to releasing Nathan’s x-rays? Before releasing Nathan’s X-rays, the dental radiographer should confirm the patient’s identity to ensure they are giving the records to the correct person. They should follow any applicable privacy laws and office policies to protect the patient’s sensitive health information.

b. What is the correct protocol to release radiographs to a patient? The dental office should have a written protocol for releasing radiographs to patients. Typically, the patient may need to sign a release form acknowledging their request for the X-rays. The records should be copied and provided to the patient, and the original copies should be retained for the office’s records. It’s essential to maintain patient confidentiality and comply with any legal requirements in your jurisdiction.

5. Discuss the five basic sizes of intraoral dental film. Discuss the difference between periapical, bite-wing, and occlusal film.

a. What are the sizes of intraoral film? Intraoral dental films come in five basic sizes:

1. Size 0: Used for pediatric patients or for narrow anterior regions.
2. Size 1: Used for anterior teeth in adults and adolescents.
3. Size 2: Most commonly used for periapical and bitewing radiographs in adults.
4. Size 3: Rarely used; typically for large adult occlusal radiographs.
5. Size 4: Extraoral film used in panoramic radiography.

b. What are the differences between periapical, bite-wings, and occlusal radiographs?

• Periapical Radiographs: These show the entire tooth from crown to root tip and surrounding bone. They are used to evaluate individual teeth, including root canals, periapical infections, and bone loss.
• Bitewing Radiographs: These capture the crowns of the upper and lower teeth and are primarily used to check for interdental caries (cavities) and assess the contact points between teeth.
• Occlusal Radiographs: Occlusal radiographs are larger and provide a top-down view of the upper or lower arch. They are used to detect large pathologies, foreign objects, and the position of unerupted teeth in the jaws.