After completion of this chapter, the student will be able to do the following:
• Discuss the importance of dental radiographs
• List the uses of dental radiographs
• Discuss the benefits of dental radiographs
• List examples of common dental conditions that may be evident on a dental radiograph
• Discuss the knowledge and skill requirements of the dental radiographer
• List the responsibilities that may be assigned to the dental radiographer
The dental radiographer must understand the importance of dental radiographs and the reasons why dental radiographs are a necessary component of comprehensive patient care. As discussed throughout this text, the dental radiographer must have both sufficient knowledge and technical skills to perform dental radiographic procedures. In addition to background knowledge and technical skills, an understanding of the responsibilities and professional goals of the dental radiographer is necessary.
The purpose of this chapter is to review the importance and benefits of dental radiographs and the knowledge and skill requirements of the dental radiographer. The role of the dental radiographer is defined, and his or her duties and responsibilities are described. In addition, the professional goals of the dental radiographer are outlined.
A dental radiograph is a two-dimensional representation of a three-dimensional object produced by the passage of x-rays through teeth and supporting structures. The dental radiographer must have a thorough understanding of the value and importance of dental radiographs. In addition, the dental radiographer must be familiar with the uses of dental radiographs, the benefits of dental radiographs, and the information that can be found on dental radiographs.
Dental radiographs are a necessary component of comprehensive patient care. In dentistry, a radiographic examination is essential for diagnostic purposes. Radiographs enable the dental professional to identify many conditions that may otherwise go undetected; dental radiographs allow the dental practitioner to see many conditions that are not 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. With the use of dental radiographs, the dental professional gains a great deal of information about teeth and supporting bone structures.
Dental radiographs have many and varied uses. One of the most important uses of dental radiographs is for detection of diseases, lesions, and conditions of the teeth and bones that cannot be identified by clinical examination alone. Many diseases and conditions produce no clinical signs or symptoms and are typically discovered only through the use of dental radiographs.
Dental radiographs are also used for confirming suspected diseases and for assisting in the localization of lesions and foreign objects. Radiographs provide essential information during routine dental treatment; for example, the dentist relies on radiographs during root canal procedures. Dental radiographs can be used to examine the status of teeth and bone during growth and development. Dental radiographs are indispensable for showing changes secondary to trauma, caries, and periodontal disease.
Dental radiographs are an essential component of the patient record. A radiograph contains a vast amount of information, much more than a written record does. An initial radiographic examination provides baseline information about the patient. Each radiograph serves to document the patient’s condition at a specific time. Any subsequent radiographs can be used for comparative purposes. Follow-up radiographs can be compared with initial radiographs and examined for changes resulting from treatment, trauma, or disease.
The primary benefit of dental radiographs to the patient is detection of disease, as mentioned earlier. When radiographs are properly prescribed (see Chapter 5), exposed, processed, and scanned, their benefit far outweighs the risk of small doses of x-radiation (see Chapter 4).
Through the proper use of dental radiographs, the dental professional can minimize and prevent problems, such as tooth-related pain or the need for surgical procedures. Thus, the dental professional can save the patient time and money while maintaining the patient’s oral health.
A number of conditions related to teeth and jaws produce no clinical signs or symptoms and can only be detected on dental radiographs. Some of the more common diseases, lesions, and conditions found on dental radiographs include the following:
Radiographs can be used to educate the dental patient about some of these common conditions that are only detected through the use of dental radiographs.
The dental radiographer is any person who positions, exposes, and processes dental x-ray image receptors. In the typical dental practice, the dental radiographer is a dental auxiliary, either a dental hygienist or a dental assistant. The dental radiographer must have sufficient knowledge as well as technical skills to perform dental radiographic procedures and have a thorough understanding of his or her responsibilities and professional goals.
To be a competent dental radiographer, background knowledge of dental radiography is essential. The purpose of the first 10 chapters of this text has been to provide the dental radiographer with adequate background information to perform dental radiographic procedures. The dental radiographer must have a basic understanding of radiation history (Chapter 1) and a working knowledge of radiation physics (Chapter 2), radiation characteristics (Chapter 3), radiation biology (Chapter 4), and radiation protection (Chapter 5). In addition, the dental radiographer must be familiar with dental x-ray equipment (Chapter 6), dental x-ray film (Chapter 7), dental x-ray image characteristics (Chapter 8), dental x-ray film processing (Chapter 9), and quality assurance in the dental office (Chapter 10).
In addition to background information, the dental radiographer must master the knowledge of patient management basics (Chapters 12 to 15). Most important, the dental radiographer must be proficient in technique concepts and the technical skills used in dental radiography ( Chapters 16 to 24 ).
The dental auxiliary is a member of the dental team and has an important role in the practice. Each auxiliary employed in the dental office is assigned specific duties and responsibilities. The assigned duties and responsibilities vary, depending on the size and nature of the dental practice and the individual qualifications of the auxiliary. Assigned responsibilities in regard to dental radiography may include the following:
• Positioning and exposure of dental x-ray imaging receptors
• Processing of dental x-ray films
• Data retrieval of digital images
• Mounting and identification of dental radiographs
• Education of patients about dental radiography
• Maintenance of darkroom facilities and processing equipment
• Implementation and monitoring of quality control procedures
The dental radiographer must have pride in his or her work, always strive for professional improvement, have defined professional goals, and be committed to achieving those goals. Priority goals for the dental radiographer include patient and operator protection, patient education, operator competence and efficiency, and production of quality radiographs.
Patient protection must be a top priority and a primary concern of the dental radiographer. Whenever the dental radiographer performs radiographic procedures on patients, the lowest possible level of x-radiation must be used. Retakes resulting in unnecessary patient exposure to x-radiation must be avoided at all times. Patient protection techniques used before exposure include the proper prescription of dental radiographs and the use of proper equipment. During exposure, use of the thyroid collar, the lead apron, a fast film, and beam alignment devices can protect the patient from excessive exposure to radiation. In addition, proper selection of exposure factors and good technique protect the patient. After the films are exposed to x-rays, meticulous handling and processing techniques are critical for the production of diagnostic radiographs. Specific patient protection techniques are discussed in Chapter 5.
Operator protection must also be a primary concern for the dental radiographer. To avoid occupational exposure to x-radiation, the dental radiographer must always avoid the primary beam and maintain an adequate distance, proper position, and proper shielding from x-rays during the procedure. Radiation monitoring also protects the dental radiographer. Specific operator protection recommendations are discussed in Chapter 5.
Patient education is another priority for the dental radiographer. The dental radiographer must play an active role in the education of patients concerning radiation exposure, patient protection, and the value and uses of dental radiographs (see Chapter 13).
Operator competence must always be a concern of the dental radiographer, who must strive to maintain or improve professional competence by attending continuing education courses and lectures, studying professional books and journals, and reviewing and updating radiographic techniques.
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 positioning and exposing dental x-ray image receptors. Patients always appreciate the auxiliary who does not waste time and who works in a competent and efficient manner.
The dental radiographer must be committed to producing high-quality diagnostic radiographs and must constantly strive to achieve perfection with each dental radiograph. To produce the perfect dental radiograph, the radiographer must carefully position and expose the image receptor, correctly process it, and properly mount and identify the finished radiograph. The dental radiographer can take great professional pride in producing perfect dental radiographs.
• The dental radiographer must understand the importance of dental radiographs and why dental radiographs are a necessary component of comprehensive patient care.
• Dental radiographs are essential for diagnostic purposes and enable the dental professional to identify many conditions that may otherwise go undetected.
• Although dental radiographs have many uses, the primary use is detection of diseases, lesions, and conditions of the teeth and bones.
• Dental radiographs are obtained to benefit the patient. The primary benefit is disease detection; the benefit of disease detection far outweighs the risk of small doses of radiation.
• Much information can be obtained from a radiographic examination. Numerous conditions related to teeth and jaws produce no clinical signs or symptoms and can only be detected on dental radiographs.
• The dental radiographer is any person who positions, exposes, and processes dental x-ray image receptors. The dental radiographer must have both sufficient knowledge and technical skills to perform dental radiographic procedures.
• Responsibilities of the dental radiographer include positioning, exposure, and processing of films; mounting and identification of radiographs; education of patients; maintenance of darkroom facilities and equipment; implementation and monitoring of quality control procedures; and ordering of equipment and supplies.
• Priority goals for the dental radiographer include patient protection, operator protection, patient education, operator competence, operator efficiency, and production of high-quality radiographs.
Frommer, HH, Savage-Stabulas, JJ, Patient management and special problems. Radiology for the dental professional, ed 8, St. Louis, Mosby, 2005.
Haring, JI, Lind, LJ. The importance of dental radiographs and interpretation. In: Radiographic interpretation for the dental hygienist. Philadelphia: Saunders; 1993.
Johnson, ON, Thomson, EM, Patient relations and education. Essentials of dental radiography for dental assistants and hygienists, ed 8, Upper Saddle River, NJ, Pearson, 2007.
________ 1. Localization of foreign objects is the most important use of dental radiographs.
________ 2. The benefit of disease detection does not outweigh the risk of small doses of x-radiation.
________ 3. Through the use of dental radiographs, the dental professional can detect diseases, lesions, and conditions of the jaws that cannot be identified clinically.
________ 4. A radiograph contains less information than a written record.
________ 5. Missing, extra, and impacted teeth can be identified on a dental radiograph.
________ 6. The dental radiographer is any person who positions, exposes, and processes dental x-ray receptors.
________ 7. The dental radiographer is assigned only to position and expose dental x-ray imaging receptors.
________ 8. The dental radiographer may be assigned to monitor quality control procedures.
________ 9. Patient and operator protection must be primary concerns of the dental radiographer.
________ 10. Operator competence is maintained by performing dental radiography duties.