Prescribing diagnnostic imaging

Types of radiographs and use

• Intraoral: Periapical, bite wings and occlusal

  • Best Spatial Resolution

  • Can reveal details

• Extraoral: Panoramic, Cephalometric

  • Larger field of view but lower resolution

  • Distortion, superimposition and motion

• Advanced

  • CBCT

  • MDCT

  • MRI

  • Nuclear Medicine

  • Ultrasound (soft tissues)

Positive Historical Findings and Positive Clinical signs or symptoms that you may need a radiograph

Initial Visit Pt

Comprehensive valuation o limited evaluation for specific problem

Recall Pt

Had a recent comprehensive evaluation and return as a pt of record for a periodic evaluation

Pt age Categories

• Child with primary dentition prior to eruption of the first permanent tooth

• Child with transitional dentition

• Adolescent with permanent dentition

• Dentate or Partially edentulous Adult

• Edentulous Adult

Recommendation for Child with primary dentition prior to eruption of the first permanent tooth

• Usually don’t need radiographs if no contact but if there is contact, use bitewings or periapical

• Periapical and occlusal helps evaluate dental development

Recommendation for Child with transitional dentition

• Periapical or panoramic to evaluate dental development

Recommendation for Adolescents with permanent dentition

Panoramic radiography recommended due to high prevalence of periodontal disease and decay in this population

Recommendation for Dentate or Partially edentulous Adult

Posterior bitewings and panoramic bc periodontal disease incidence increases with age

Recommendation for Edentulous Adult

Only performed when assessing for prothesis

Recall interval for Children and adolescents

• High Risk

• Low Risk

• High Risk: 6-12 months

• Low Risk: 12-24 for children and 18-36 months for adolescents

Recall Interval for Dentate and Partially dentate adults

• High Risk

• Low Risk

• High Risk: 6-18 months

• Low Risk: 24-36 months

Recommendation for Edentulous Pt

• High Risk

• Low Risk

no radiographs unless prothesis needed

Recall for Periodontitis Pt

Guidelines for ordering CBCT

• Only when needed

• Smallest Field of View

• Highest radiation exposure