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chapter 11 Dental Radiographs and the Dental RadiographerOUTLINEDENTAL RADIOGRAPHS THE DENTAL RADIOGRAPHER Importance of Dental Radiographs Knowledge and Skill Requirements Uses of Dental Radiographs Duties and Responsibilities Beneﬁts of Dental Radiographs Professional Goals Information Found on Dental RadiographsLEARNING OBJECTIVESAfter completion of this chapter, the student will be able to do the following:• Deﬁne the key words • Discuss the knowledge and skill requirements of the dental• Discuss the importance of dental radiographs radiographer• List the uses of dental radiographs • List the responsibilities that may be assigned to the dental• Discuss the beneﬁts of dental radiographs radiographer• List examples of common dental conditions that may be • Discuss the professional goals of the dental radiographer evident on a dental radiographKEY TERMSRadiograph, dentalRadiographer, dentalThe dental radiographer must understand the importance of through teeth and supporting structures. The dental radiog-dental radiographs and the reasons why dental radiographs rapher must have a thorough understanding of the value andare a necessary component of comprehensive patient care. As importance of dental radiographs. In addition, the dentaldiscussed throughout this text, the dental radiographer must radiographer must be familiar with the uses of dental radio-have both sufﬁcient knowledge and technical skills to perform graphs, the beneﬁts of dental radiographs, and the informa-dental radiographic procedures. In addition to background tion that can be found on dental radiographs.knowledge and technical skills, an understanding of theresponsibilities and professional goals of the dental radiogra- Importance of Dental Radiographspher is necessary. Dental radiographs are a necessary component of compre- The purpose of this chapter is to review the importance hensive patient care. In dentistry, a radiographic examina-and beneﬁts of dental radiographs and the knowledge and tion is essential for diagnostic purposes. Radiographs enableskill requirements of the dental radiographer. The role of the the dental professional to identify many conditions thatdental radiographer is deﬁned, and his or her duties and may otherwise go undetected; dental radiographs allow theresponsibilities are described. In addition, the professional dental practitioner to see many conditions that are notgoals of the dental radiographer are outlined. apparent clinically. An oral examination without dental radiographs limits the dental practitioner’s knowledge to what is seen only clinically, that is, teeth and soft tissues.DENTAL RADIOGRAPHS With the use of dental radiographs, the dental professionalA dental radiograph is a two-dimensional representation of gains a great deal of information about teeth and supportinga three-dimensional object produced by the passage of x-rays bone structures. 121
122 PART III Dental Radiographer Basics Radiographs can be used to educate the dental patientUses of Dental Radiographs about some of these common conditions that are onlyDental radiographs have many and varied uses. One of the detected through the use of dental radiographs.most important uses of dental radiographs is for detection ofdiseases, lesions, and conditions of the teeth and bones that THE DENTAL RADIOGRAPHERcannot be identiﬁed by clinical examination alone. Manydiseases and conditions produce no clinical signs or symp- The dental radiographer is any person who positions,toms and are typically discovered only through the use of exposes, and processes dental x-ray image receptors. In thedental radiographs. typical dental practice, the dental radiographer is a dental Dental radiographs are also used for conﬁrming suspected auxiliary, either a dental hygienist or a dental assistant. Thediseases and for assisting in the localization of lesions and dental radiographer must have sufﬁcient knowledge as wellforeign objects. Radiographs provide essential information as technical skills to perform dental radiographic proceduresduring routine dental treatment; for example, the dentist and have a thorough understanding of his or her responsibili-relies on radiographs during root canal procedures. Dental ties and professional goals.radiographs can be used to examine the status of teeth andbone during growth and development. Dental radiographs Knowledge and Skill Requirementsare indispensable for showing changes secondary to trauma, To be a competent dental radiographer, background knowl-caries, and periodontal disease. edge of dental radiography is essential. The purpose of the Dental radiographs are an essential component of the ﬁrst 10 chapters of this text has been to provide the dentalpatient record. A radiograph contains a vast amount of infor- radiographer with adequate background information tomation, much more than a written record does. An initial perform dental radiographic procedures. The dental radiog-radiographic examination provides baseline information rapher must have a basic understanding of radiation historyabout the patient. Each radiograph serves to document the (Chapter 1) and a working knowledge of radiation physicspatient’s condition at a speciﬁc time. Any subsequent radio- (Chapter 2), radiation characteristics (Chapter 3), radiationgraphs can be used for comparative purposes. Follow-up biology (Chapter 4), and radiation protection (Chapter 5). Inradiographs can be compared with initial radiographs and addition, the dental radiographer must be familiar withexamined for changes resulting from treatment, trauma, or dental x-ray equipment (Chapter 6), dental x-ray ﬁlmdisease. (Chapter 7), dental x-ray image characteristics (Chapter 8), dental x-ray ﬁlm processing (Chapter 9), and quality assur-Beneﬁts of Dental Radiographs ance in the dental ofﬁce (Chapter 10).The primary beneﬁt of dental radiographs to the patient is In addition to background information, the dental radiog-detection of disease, as mentioned earlier. When radiographs rapher must master the knowledge of patient managementare properly prescribed (see Chapter 5), exposed, processed, basics (Chapters 12 to 15). Most important, the dentaland scanned, their beneﬁt far outweighs the risk of small radiographer must be proﬁcient in technique concepts anddoses of x-radiation (see Chapter 4). the technical skills used in dental radiography (Chapters 16 Through the proper use of dental radiographs, the to 24).dental professional can minimize and prevent problems,such as tooth-related pain or the need for surgical proce- Duties and Responsibilitiesdures. Thus, the dental professional can save the patient The dental auxiliary is a member of the dental team and hastime and money while maintaining the patient’s oral an important role in the practice. Each auxiliary employedhealth. in the dental ofﬁce is assigned speciﬁc duties and responsi- bilities. The assigned duties and responsibilities vary, depend-Information Found on Dental Radiographs ing on the size and nature of the dental practice and theA number of conditions related to teeth and jaws produce no individual qualiﬁcations of the auxiliary. Assigned respon-clinical signs or symptoms and can only be detected on dental sibilities in regard to dental radiography may include theradiographs. Some of the more common diseases, lesions, following:and conditions found on dental radiographs include the • Positioning and exposure of dental x-ray imagingfollowing: receptors • Missing teeth • Processing of dental x-ray ﬁlms • Extra teeth • Data retrieval of digital images • Impacted teeth • Mounting and identiﬁcation of dental radiographs • Dental caries • Education of patients about dental radiography • Periodontal disease • Maintenance of darkroom facilities and processing • Tooth abnormalities equipment • Retained roots • Implementation and monitoring of quality control • Cysts and tumors procedures
CHAPTER 11 Dental Radiographs and the Dental Radiographer 123 • Ordering of dental x-ray equipment and related Operator Efﬁciency supplies The dental radiographer must be committed to performing his or her assigned duties in a time-efﬁcient manner. He or she must always work carefully but quickly when positioningProfessional Goals and exposing dental x-ray image receptors. Patients alwaysThe dental radiographer must have pride in his or her work, appreciate the auxiliary who does not waste time and whoalways strive for professional improvement, have deﬁned works in a competent and efﬁcient manner.professional goals, and be committed to achieving thosegoals. Priority goals for the dental radiographer include Production of Quality Radiographspatient and operator protection, patient education, operator The dental radiographer must be committed to producingcompetence and efﬁciency, and production of quality high-quality diagnostic radiographs and must constantlyradiographs. strive to achieve perfection with each dental radiograph. To produce the perfect dental radiograph, the radiographer mustPatient Protection carefully position and expose the image receptor, correctlyPatient protection must be a top priority and a primary process it, and properly mount and identify the ﬁnishedconcern of the dental radiographer. Whenever the dental radiograph. The dental radiographer can take great profes-radiographer performs radiographic procedures on patients, sional pride in producing perfect dental radiographs.the lowest possible level of x-radiation must be used.Retakes resulting in unnecessary patient exposure to Quality Carex-radiation must be avoided at all times. Patient protection When the dental radiographer attains professional goals suchtechniques used before exposure include the proper pre- as those outlined earlier, the patient receives the highestscription of dental radiographs and the use of proper quality of care possible. Quality care beneﬁts not only theequipment. During exposure, use of the thyroid collar, the patient but also the profession of dentistry.lead apron, a fast ﬁlm, and beam alignment devices canprotect the patient from excessive exposure to radiation. In SUMMARYaddition, proper selection of exposure factors and good • The dental radiographer must understand the importancetechnique protect the patient. After the ﬁlms are exposed of dental radiographs and why dental radiographsto x-rays, meticulous handling and processing techniques are a necessary component of comprehensive patientare critical for the production of diagnostic radiographs. care.Speciﬁc patient protection techniques are discussed in • Dental radiographs are essential for diagnostic purposesChapter 5. and enable the dental professional to identify many condi- tions that may otherwise go undetected.Operator Protection • Although dental radiographs have many uses, the primaryOperator protection must also be a primary concern for the use is detection of diseases, lesions, and conditions of thedental radiographer. To avoid occupational exposure to teeth and bones.x-radiation, the dental radiographer must always avoid the • Dental radiographs are obtained to beneﬁt the patient.primary beam and maintain an adequate distance, proper The primary beneﬁt is disease detection; the beneﬁt ofposition, and proper shielding from x-rays during the proce- disease detection far outweighs the risk of small doses ofdure. Radiation monitoring also protects the dental radiog- radiation.rapher. Speciﬁc operator protection recommendations are • Much information can be obtained from a radiographicdiscussed in Chapter 5. examination. Numerous conditions related to teeth and jaws produce no clinical signs or symptoms and can onlyPatient Education be detected on dental radiographs.Patient education is another priority for the dental radio- • The dental radiographer is any person who positions,grapher. The dental radiographer must play an active role in exposes, and processes dental x-ray image receptors. Thethe education of patients concerning radiation exposure, dental radiographer must have both sufﬁcient knowledgepatient protection, and the value and uses of dental radio- and technical skills to perform dental radiographicgraphs (see Chapter 13). procedures. • Responsibilities of the dental radiographer include posi-Operator Competence tioning, exposure, and processing of ﬁlms; mounting andOperator competence must always be a concern of the identiﬁcation of radiographs; education of patients; main-dental radiographer, who must strive to maintain or tenance of darkroom facilities and equipment; implemen-improve professional competence by attending continuing tation and monitoring of quality control procedures; andeducation courses and lectures, studying professional books ordering of equipment and supplies.and journals, and reviewing and updating radiographic • Priority goals for the dental radiographer includetechniques. patient protection, operator protection, patient education,
124 PART III Dental Radiographer Basics operator competence, operator efﬁciency, and production Haring JI, Lind LJ: The importance of dental radiographs and inter- of high-quality radiographs. pretation. In Radiographic interpretation for the dental hygienist, Philadelphia, 1993, Saunders.BIBLIOGRAPHY Johnson ON, Thomson EM: Patient relations and education. InFrommer HH, Savage-Stabulas JJ: Patient management and special Essentials of dental radiography for dental assistants and hygienists, problems. In Radiology for the dental professional, ed 8, St. Louis, ed 8, Upper Saddle River, NJ, 2007, Pearson. 2005, Mosby. QUIZ QUESTIONSTRUE OR FALSE 6. The dental radiographer is any person who 1. Localization of foreign objects is the most positions, exposes, and processes dental x-ray important use of dental radiographs. receptors. 2. The beneﬁt of disease detection does not outweigh 7. The dental radiographer is assigned only to the risk of small doses of x-radiation. position and expose dental x-ray imaging 3. Through the use of dental radiographs, the dental receptors. professional can detect diseases, lesions, and 8. The dental radiographer may be assigned to conditions of the jaws that cannot be identiﬁed monitor quality control procedures. clinically. 9. Patient and operator protection must be primary 4. A radiograph contains less information than a concerns of the dental radiographer. written record. 10. Operator competence is maintained by performing 5. Missing, extra, and impacted teeth can be dental radiography duties. identiﬁed on a dental radiograph.