Take it right the first time

Tips and tricks for safer dental radiographs

As dental hygienists, we want to capture quality diagnostic radiographs on the first exposure and avoid having to retake images to protect our patients and ourselves. Technology continues to emerge in favor of the clinician, leading to less room for operator error and overexposure to the patient. Our goal when taking radiographs is to maintain the ALARA principle (As Low As Reasonably Achievable). We do not want to expose our patients to any excess radiation, so following this rule is critical. This article will review the basics of exposing radiographs, as well as tips and tricks for taking a better image.

Radiation shielding

The apron for patient shielding should be utilized any time radiographs are exposed (figure 1). Not only do the American Dental Association and Food and Drug Administration recommend appropriate patient shielding, but there are also rules and regulations specific to each state.1 Lead-free and standard lead-lined protective aprons are available. Compared to lead, lead-free options provide equal patient protection, but the aprons are much lighter. Effective patient shielding requires a minimum of 0.25 mm of lead or lead equivalent.2

Figure 1: Use an apron any time radiographs are taken.

You may wonder, “When do I use a protective apron with a thyroid collar?” The National Council on Radiation Protection and Measurements requires thyroid shielding for all children and highly recommends the same for adults for any intraoral radiographs. This recommendation is based on the radiosensitive nature of the thyroid gland.3 Studies show that protective collars reduce radiation dosage to the thyroid by 26% to 33%.4 When taking a panoramic image, an apron that protects the front and back of the patient, such as a cape or vest style, should be used. A thyroid collar is not needed when taking a panoramic image as it may obscure desired anatomical structures. With the many apron choices available, make sure you choose the style appropriate to the type of radiographic exposure.