Dental Radiology EXAM 1

Flashcards covering key terms, historical pioneers, equipment, imaging examinations, patient and operator protection rules, and infection prevention principles in dental radiography.

What is radiation?

Energy carried by waves or streams of particles

What is x-radiation?

High energy radiation produced by the collision of a beam of electrons with a metal target in an x-ray tube

What is an x-ray?

A beam of energy that has the power to penetrate substances and record image shadows on photographic film

How is radiology defined?

Science or study of radiation as used in medicine; a branch of medical science that deals with the use of x-rays, radioactive substances, and other forms of radiant energy in the diagnosis and treatment of disease

What is a radiograph?

A picture (visible photographic record) on film produced by the passage of x-rays through an object or body - also called x-ray film

What is a dental radiograph?

A photographic image produced on film by the passage of x-rays through teeth and related structures

What is radiography?

Art and science of making radiographs by the exposure of film to x-rays

How is dental radiography defined?

The production of radiographs of the teeth and adjacent structures by the exposure of film to x-rays

Who is a dental radiographer?

Any person who positions, exposes, and processes x-ray film

What is an image receptor?

A recording medium, examples include x-ray film, phosphor plate, or digital sensor

What is dental imaging?

The creation of digital, print, or film representations of anatomic structures for the purpose of diagnosis

Why are dental images important?

Dental images enable the dental professional to identify many conditions that may otherwise go undetected and to see conditions that cannot be identified clinically.

The discovery of x-radiation

Wilhelm Conrad Roentgen (1985) took the first radiograph of a human body, which was of the hand of his wife; x-rays were shortly thereafter called Roentgen rays in honor of him.

When was the first intraoral imaging sensor introduced?

1987.

When was Cone beam computerized tomography (CBCT) introduced in dentistry?

1999.

What are examples of common dental conditions that may be evident on a dental image?

Missing teeth, extra teeth, impacted teeth, dental caries, periodontal disease, tooth abnormalities, retained roots, cysts and tumors, and foreign objects.

What is an intraoral radiographic examination?

An inspection of teeth and intraoral adjacent structures.

What is an extraoral radiographic examination?

An inspection of large areas of the skull or jaws (panoramic).

What are the 3 types of intraoral imaging examinations?

Periapical examination, interproximal examination, and occlusal examination.

What is the purpose of a periapical examination, and what receptor and techniques are used?

Used to examine the entire tooth and supporting bone using a periapical receptor with paralleling and bisecting techniques.

What is the purpose of an interproximal (bitewings) examination?

To examine the crowns of both maxillary and mandibular teeth on a single image using a bite-wing receptor and bite-wing technique.

What is the purpose of an occlusal examination?

Used to examine large areas of the maxilla or the mandible on one image using an occlusal receptor and occlusal technique.

What projections constitute a complete mouth series (CMS)?

Periapicals and bitewings.

What are the general diagnostic criteria for intraoral images?

Images must have optimum density, contrast, definition, and detail, and must have the least amount of distortion possible.

When is prescribing a CMS for a new patient warranted?

When the patient presents with clinical evidence of generalized dental disease or a history of extensive dental treatment.

What is the function of the tubehead in a dental x-ray unit?

Contains the x-ray tube that produces dental x-rays.

What is the function of the extension arm in dental x-ray equipment?

Suspends the x-ray tubehead, houses the electrical wires, and allows for movement and positioning of the tubehead.

What components consist within the control panel of a dental x-ray unit?

An on-off switch and indicator light, exposure button, exposure light, control device for time, and control devices for kilovoltage and milliamperage.

What is a beam alignment device?

Used to help the dental radiographer position the PID in relation to the tooth and the receptor.

How do regulatory responsibilities for dental x-ray equipment differ between federal and state/local levels?

Federal government regulates manufacture and installation; state and local governments regulate how equipment is used and dictate codes pertaining to x-radiation.

What is inherent filtration in dental x-ray tubeheads?

Takes place when the primary beam passes through the glass window of the x-ray tube, insulating oil, and tubehead seal, equivalent to 0.5-1.0 mm of aluminum.

What is added filtration in dental x-ray equipment?

Aluminum disks (each 0.5 mm) placed between the collimator and tubehead seal to filter out longer wavelength, lower energy x-rays.

What minimum total aluminum filtration is required for machines operating BELOW 70 kVp?

Minimum of 1.5 mm aluminum filtration.

What minimum total aluminum filtration is required for machines operating ABOVE 70 kVp?

Minimum of 2.5 mm aluminum filtration.

What is collimation and what is the recommended diameter of the useful beam at the patient's skin?

restricting the size and shape of the x-ray beam and reduces patient exposure; recommended diameter is 2.75 inches.

What are 6 ways to protect the patient from excessive radiation during x-ray exposure?

Thyroid collar, lead apron, fast film (F-speed), beam alignment devices, exposure factor selection, and proper technique.

What is the #1 rule of operator radiation protection?

The radiographer must avoid the primary beam.

What distance and position guidelines must the operator follow during an exposure?

Remain at least 6 feet from tubehead (or use a barrier wall/door) and stand perpendicular or at a 90-135 degree angle to the primary beam.

What is the Maximum Permissible Dose (MPD) for occupationally exposed persons?

50 mSv/year.

What is the Maximum Permissible Dose (MPD) for occupationally exposed pregnant women?

0.5 mSv/month during pregnancy.

What is the Maximum Permissible Dose (MPD) for non-occupationally exposed persons (patients)?

1 mSv/year.

What does the ALARA concept state?

As low as reasonably achievable: every possible method of reducing exposure to radiation should be employed.

What is the definition of an antiseptic?

A substance that inhibits the growth of bacteria, describing handwashing or wound-cleansing procedures.

What is asepsis?

The absence of pathogens, or disease-causing microorganisms.

How does sterilization differ from disinfection?

Sterilization destroys all pathogens including highly resistant bacteria and mycotic spores, whereas disinfection inhibits or destroys pathogens but does not kill highly resistant spores.

What is parenteral exposure?

Exposure to blood or other infectious materials that results from piercing or puncturing the skin.

What are standard precautions?

Measures that include a standard of care designed to protect health care personnel and patients from pathogens spread by blood or any other body fluid, excretion, or secretion.

What three conditions must be present for disease transmission to occur?

Susceptible host, pathogen with sufficient infectivity and numbers to cause infection, and portal through which the pathogen may enter the host.

How are instruments classified for sterilization/disinfection in dental radiography?

Critical (penetrate soft tissue and bone, NOT used in radiography), Semicritical (contact mucous membranes, e.g. beam alignment devices), and Noncritical (do not contact mucous membranes, e.g. PID, tubehead, lead apron, control panel).

What type of disinfectant is required for cleaning and disinfection of environmental surfaces?

Intermediate level disinfectants that are EPA-registered chemical germicides labeled as BOTH hospital disinfectants and tuberculocidals.

What are the infection control guidelines for digital wired and PSP sensors?

Neither can be sterilized in an autoclave or submerged in a disinfection solution.

infection prevention procedures that are necessary before x-ray exposure

preparation of treatment area (x-ray machine, dental chair, work area), preparation of supplies and equipment (film, PSP sensors, digital sensors, beam alignment devices), preparation of the patient (chair adjustment, headrest adjustment, lead apron, miscellaneous objects like eyeglasses, dentures, chewing gum), and preparation of the dental radiographer (hand hygiene, PPE, and beam alignment devices)

infection prevention procedures that are necessary during x-ray exposure

drying of exposed receptors, collection, of exposed receptors, beam alignment devices, interruptions during exposure

infection prevention procedures that are necessary for digital imaging

disposal of contaminated items, beam alignment devices, handwashing, lead apron removal, surface disinfection

importance of dental images

necessary component of comprehensive care, essential for diagnostic purposes, important documentation record

discuss the benefits of dental images

disease detection —> identifying problems and need for dental intervention

prescribing of dental images

based on the INDIVIDUAL needs of the patient

receptor holder

device used to hold and align intraoral dental x-ray receptors in the mouth

patient protection before x-ray exposure

prescribing dental radiographic, proper treatment, and proper equipment

importance of receptor handling and processing after patient exposure to x-radiation

• artifacts caused by improper film/sensor handling result in non-diagnostic films

• improper film processing and digital image retrieval may require retakes, needlessly exposing the patient to excess radiation

personnel monitoring

dental x-ray machines must be monitored for leakage radiation

equipment monitoring

montiroing badge can be worn at wait level when taking radiographs

Discuss with the dental patient radiation protection steps used before, during, and after exposure to x-radiation

educate patients on importance of diagnostic radiographs, discuss measures we take to ensure safety, and point out using digital sensors

pathogen

a microorganism capable of causing disease

bloodborne pathogen

pathogens present in blood that cause diseases in humans

exposure incident

a specific incident that involves contact with blood or other potentially infectious materials and that results from procedures performed by the dental professional

infectious waste

waste that consists of blood, blood products, contaminated sharps, or other microbiologic products

occupational exposure

contact with blood or other infectious materials that involves he skin, eye, or mucous membranes and that results from procedures performed by the dental professional

PPE

protective attire, gloves, mask, and eyewear

sharps

any objects that can penetrate the skin, including, but not limited to, needles and scalpels

describe the rationale for infection prevention

to prevent the transmission of infectious diseases

describe the 3 possible routes of disease transmission

direct contact with pathogens, indirect contact with contaminated objects or instruments, or direct contact with airborne contaminations

radiolucent

appears dark, sign of disease

radiopaque

appears white/light, enamel & restoration

dentulous areas

with teeth

edentulous areas

without teeth

how many images taken for CMS

14-20

open contacts

space between teeth to determine if there is decay

what type of Rinn do we use

XCP universal

negative angulation

tube head is positioned UP

positive angulation

tube head is positioned DOWN

what degree tube head for bite tabs

positive 10 — tube head will be pointed DOWN