After completion of this chapter, the student will be able to do the following:
• Define the key terms associated with interpreting images
• Summarize the importance of the interpretation of images
• Define the roles of the dentist and the dental auxiliary in the interpretation of dental images
• Discuss the difference between interpretation and diagnosis
• Describe who is able to interpret dental images
• Describe when and where dental images are interpreted
• Describe how interpretation can be used to educate the dental patient about the importance and use of dental images
Image interpretation is an essential part of the diagnostic process. The ability to evaluate and recognize what is revealed by a dental image enables the dental professional to play a vital role in the detection of those diseases, lesions, and conditions of jaws which cannot be identified clinically. The chapters in this part of the text present an overview of interpretation topics. Detailed information on interpretation is beyond the scope of this text.
The purpose of this chapter is to present the basic concepts of image interpretation and to review interpretation guidelines.
An explanation of what is viewed on a dental image, or interpretation, is an important component of patient care. Before the dental radiographer can inspect dental images adequately, a thorough understanding of the terminology and importance of interpretation is necessary.
Before discussion of the principles of interpretation, an explanation of basic terms is provided below:
Interpret: To offer an explanation.
Interpretation: An explanation.
Image interpretation: An explanation of what is viewed on a dental image; the ability to read what is revealed by a dental image.
Diagnosis: The identification of a disease by examination or analysis. In the dental setting, the dentist is responsible for establishing a diagnosis. Other members of the dental team are restricted by law from providing a diagnosis.
In addition to understanding the importance of dental images, the dental radiographer must also understand the importance of interpretation. As described in Chapter 11, dental images are essential for diagnostic purposes. All dental images must be carefully reviewed and interpreted. A great deal of information about teeth and supporting bone is obtained from interpretation. Consequently, image interpretation is of paramount importance to the dental professional. As mentioned above, image interpretation enables the dental professional to play a vital role in the detection of those diseases, lesions, and conditions of teeth and jaws which cannot be identified clinically.
The dental radiographer must know who can interpret dental images, the difference between interpretation and diagnosis, when and where images are interpreted, and how to use interpretation to educate the dental patient.
Training is necessary to interpret dental images. Any dental professional with training in interpretation can examine images. Both the dentist and the dental hygienist are trained to interpret dental images; dental and dental hygiene curricula include instruction in image interpretation. The dental assistant, however, may or may not be trained in the interpretation of dental images. The amount and scope of training in dental radiography dictate whether the dental assistant can perform image interpretation.
The dental radiographer plays an important role in the preliminary interpretation of dental images. The dental radiographer acts as an additional pair of eyes examining the images, and can direct the attention of the dentist to any areas of question or concern. To interpret images, the dental radiographer must be confident in the identification and recognition of the following:
• Normal anatomy (see Chapters 27 and 29)
• Dental restorations, dental materials, and foreign objects (see Chapter 32)
• Dental caries (see Chapter 33)
• Periodontal disease (see Chapter 34)
• Trauma, pulpal lesions and periapical lesions (see Chapter 35)
In the dental setting, the terms interpretation and diagnosis are often confused; it is important to note that these terms have very different meanings and should not be used synonymously. Interpretation refers to an explanation of what is viewed on a dental image, whereas diagnosis refers to the identification of disease by examination or analysis. In dentistry, a diagnosis is made by the dentist after a thorough review of the medical history, dental history, clinical examination, radiographic examination, and clinical or laboratory tests.
Although any dental professional with training in interpretation may examine dental images, the final interpretation and diagnosis are the responsibilities of the dentist. Dental hygienists and dental assistants are restricted by law from rendering a diagnosis.
It is essential to remember that dental images are taken to benefit the patient. To benefit the patient optimally, dental images must be taken at the beginning of the dental appointment, mounted, interpreted, and then used for diagnostic, therapeutic, and educational purposes. Ideally, dental images should be reviewed and interpreted immediately after mounting them in the presence of the patient. If any suspicious or questionable areas are seen on the images, the patient can be examined by the dentist or dental hygienist to obtain additional information or to confirm the suspected problem. If the patient were not present during the interpretation of dental images, much needed clinical information would be unavailable.
Digital images are typically viewed by the dental professional on a computer monitor in the operatory. Dental radiographs are usually examined on the viewbox in the operatory and are best interpreted in a room with dimmed lighting, as described in Chapter 28.
Interpretation of dental images can be used as an educational tool in the professional setting. In addition to providing a preliminary interpretation, the dental radiographer can educate the patient by identifying and discussing what is normally found on a dental image. Then the dentist can focus on specific problems or areas of concern. In this manner, all members of the dental team can work together using interpretation to educate patients about the importance and use of dental images.
• Image interpretation is an explanation of what is viewed on a dental image, or the ability to read what is revealed by a dental radiographic image.
• Image interpretation is an important component of patient care and enables the dental professional to detect diseases, lesions, and conditions that cannot be identified clinically.
• Any dental professional with training in interpretation can examine images. To interpret dental images, the dental radiographer must be confident in the identification and recognition of normal anatomy; restorations, dental materials, and foreign objects; dental caries; periodontal disease; traumatic injuries; and periapical lesions.
• Although any dental professional with training in interpretation may examine dental images, final interpretation and diagnosis are the responsibilities of the dentist.
• Dental auxiliaries are restricted by law from providing a diagnosis but can facilitate patient care by performing a preliminary image interpretation.
• Dental radiographic examination should take place at the beginning of the appointment, and dental images should be interpreted in the presence of the patient.
• The dental professional can use interpretation to educate patients about the importance and use of dental images.
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, Preliminary interpretation of the radiographs. Essentials of dental radiography for dental assistants and hygienists, ed 8, Upper Saddle River, Pearson, 2007.
Miles, DA, Van Dis, ML, Williamson, GF, Jensen, CW, Interpretation: normal versus abnormal and common radiographic presentation of lesions. Radiographic imaging for the dental team, ed 4, St. Louis, Saunders, 2009.
White, SC, Pharoah, MJ, Principles of image interpretation. Oral radiology: principles of interpretation, ed 6, St. Louis, Mosby, 2009.
1. Summarize the importance of image interpretation.
2. Define the roles of each member of the dental team in the interpretation of dental images.
3. Discuss the difference between interpretation and diagnosis.
4. List the members of the dental team who may interpret dental images.
5. Describe when and where dental images are interpreted.
6. Describe how interpretation can be used to educate the patient about the importance and use of dental images.
___ 7. All images must be carefully reviewed and interpreted.
___ 8. Any dental professional with training in interpretation can examine images.
___ 9. The amount and scope of training received dictate whether the dental assistant can perform image interpretation.
___ 10. The terms interpretation and diagnosis can be used synonymously.
___ 11. Any dental professional can provide a diagnosis.
___ 12. Dental images should not be interpreted in the presence of the patient.
___ 13. No specific guidelines exist regarding when and where dental images should be interpreted.
___ 14. The dental radiographer can educate the patient by identifying and discussing what is normally found on a dental image.
___ 15. All members of the dental team can work together using interpretation to educate patients about the importance and use of dental images.