3️⃣frequency of pts x rays taken

🦷

ALARA Concept

As Low As Reasonably Achievable)

• Meaning: Keep radiation exposure as low as possible while still gaining the necessary diagnostic information.

• Purpose: Benefits of taking radiographs must outweigh the risks to the patient.

According to ALARA, when should dental radiographs be prescribed?

Only when needed, based on the patient’s age and risk for oral diseases.

Should “routine” radiographs be taken for every patient?

No — routine radiographs should not be taken because every patient’s needs are differen

Age

• Risk level for oral disease or decay

• Clinical signs or symptoms the dentist observes

Where should a dosimeter badge be worn?

The waist gives the most accurate measure of the operator’s real exposure level — it’s the area most likely to be hit by scattered radiation

What type of radiographs are recommended for a new patient with primary dentition? BABY TEETH

selected PA

occlusal views

posterior bitewings

back teeth sit closer together, making it harder to see between them — that’s where hidden cavities

Why would u use occlusual for baby teeth?

see the whole upper or lower arch to check tooth development

extra or missing teeth,

jaw problems.

their jaws are small, so a PANO may NOT give a clear, detailed image.

If a new child patient has no signs of disease and open proximal contacts, do they need radiographs?

No, they may not need any radiographs.

➡ Why: When the teeth are spread out (open contacts), the dentist can usually see or probe between them without x-rays

For a new patient with mixed dentition (some baby teeth and some permanent teeth), what radiographs are recommended, and why

Take

posterior bitewings

W a panoramic exam,

posterior bitewings and selected periapicals

1. How the permanent teeth are coming in 🦷

2. If there are any cavities between teeth 🍬

• Posterior bitewings show

• decay between back teeth and check bone levels.

• Periapicals

• show the entire tooth and roots, helping spot eruption patterns, infection, or missing teeth.

• Panoramic radiographs show

• tooth development, jaw growth, and any extra or impacted teeth all at once

Panoramic or periapical x-rays are added to give a fuller picture

show the whole tooth and jaw area, so the dentist can see how the new permanent (wisdom) teeth are growing, if any are missing, or if there are problems under the gums.

For a new adolescent (teenager) patient, what radiographs are recommended (same as mixed dentition)

Take posterior bitewings with a panoramic exam, or posterior bitewings and selected periapicals.

When is a full-mouth intraoral series (FMX) preferred for an adolescent?

When the patient has signs of generalized dental disease or a history of a lot of dental treatment.

➡ (Because an FMX shows every tooth and all surrounding bone, helping detect widespread decay, bone loss, or other issues that smaller x-rays might miss.)

Should recall (check-up) patients get radiographs every 6 months automatically?

No. Radiographs should not be taken every 6 months no matter what.

➡ (Because the dentist must look at the patient’s caries risk first — x-rays are only needed when there’s a chance of new decay or other changes.

When should radiographs be taken for a recall patient?

Only when the interproximal (between teeth) surfaces can’t be seen or checked with a probe.

➡ (Because if the dentist can’t see or reach those areas, x-rays help spot hidden decay

How often should posterior bitewings be taken for patients with high caries risk?

Every 6 to 12 months for children and adults.

How often should posterior bitewings be taken for patients with low caries risk?

12 to 24 months for children, and every 18 to 36 months for adolescents (teens)

How is the need for radiographs determined in cases of periodontal disease or growth and development?

dentist’s clinical judgment

Why might adolescents need a panoramic exam?

developing third molars (wisdom teeth).

➡ (A panoramic x-ray shows the entire jaw, so the dentist can see how the wisdom teeth are forming

Where should the clinician stand during x-ray exposure?

Stand at least 6 feet away from the x-ray source and at a 90–135° angle from the beam.

➡ (This distance and angle reduce scatter radiation — the safest spot is behind or to the side of the patient, not in front.)

Should the clinician ever hold the tubehead or receptor in the patient’s mouth?

No, never.

➡ (Because this would expose the clinician’s hands and body to radiation. If the patient needs help, a parent or guardian can assist — but they must be properly shielded with a lead apron

How often is a dosimeter badge checked or sent for review?

Every 3–4 weeks.

➡ (The badge is analyzed to track how much radiation was received and to confirm that the worker’s exposure is staying safely below the allowed limits.)

Why is digital radiography considered safer than film radiography?

requires a smaller amount of radiation to make an image.

➡ (Digital sensors are more sensitive, so they need less exposure — which reduces the patient’s overall radiation dose.

Radiographs should be taken every 6 months regardless of the patient’s condition. Adolescents developing third molars may need panoramic imaging.

False

Explanation:

Radiographs should not be taken every 6 months automatically.

The frequency of dental radiographs depends on the patient’s caries risk, previous radiographs, and clinical findings:

• High caries risk: every 6–12 months (children and adults)

• Low caries risk: every 12–24 months (children) or 18–36 months (adolescents)

✅ Adolescents often develop third molars, so a panoramic radiograph may be recommended to evaluate their eruption and development.

According to guidelines issued by various dental associations, which statement is true?

Patients without evidence of disease and with open proximal contacts may not require a radiographic exam.

Explanation:

• Radiographs should not be taken routinely or at fixed intervals (like every 6 months).

If partially-formed third molars are noted on a panoramic radiograph but are not erupted, how old is the patient most likely to be?

Between 11 and 15 years old

Explanation:

• The roots of third molars begin developing about 6 years before eruption (which typically occurs between ages 18–21).

Dental radiographs should be prescribed:

Only after evaluating the patient’s individual needs and clinical findings.

A 17-year-old patient is showing pain around the back of the mouth. Which of the following radiographic images could BEST help assess the condition?

Panoramic radiograph

• At 17 years old, third molars (wisdom teeth) are commonly erupting or impacted, which can cause pain in the back of the mouth.

• A panoramic radiograph provides a broad view of the entire dentition, including the third molar region, jaw, and surrounding structures