Re: Dental X-rays

[John Pickering <johnjp@email.sjsu.edu>]

A number of years ago there was a program called DENT which explored and
made recommendations for dental x-ray procedures.  I believe the BRH was
administering the program.  Some people may have copies still on their
shelves which provides doese based upon specific procedures.  There were
several programs at the time NEXT, DENT and BENT being reviewed at the same
time.

As far as recommendations, the Army Medical program at one time performed
full mouth procedures on soldiers every 1 to 3 years.  There was an effort
to change the procedure to performing only once.  If there was a significant
change in the bit wing, then new x-rays would be justified.  The Army used
this method as a primary means to identify the dead.  Although there are
times when an absas can be found with such procedures.

Several of us who were trying to adjust the concepts of reducing exposures
encouraged to dentist to use other means to screen patients.  After these
other means (what ever they may be) were performed and more information was
needed, then order the x-rays.  Just because 5 years and even much longer
time periods have gone by, I see no reason to subject the patient to more
x-rays to update records.  There should be clinical reasons to subject the
patient to any procedure.

John Pickering
San Jose State University


At 10:59 AM 2/25/97 -0600, you wrote:
>
>I would like to hear RADSAFERs' comments on having full mouth X-rays
>taken. The following are the facts as I know it:
>
>The American Dental Association recommends having full mouth X-rays taken
>every 3 to 5 years.
>
>Full mouth Xrays could range from 14 to 20 exposures (including four
>bitewings).
>
>The recommended cone-tip exposures (DENT RANGE) PER EXPOSURE  for good quality
>films could range anywhere from 50mrem (100Kvp) to 320 mrem (50Kvp) for "E"
>speed films and could range from 100 mrem to 575 mrem for "D' speed films.
>depending on the Kvp.
>
>When the patient asks the hygienist what kind of dose this entails she
>says "It is equivalent to being outside for 30 days in a year" (meaning  30
>days of background radiation). The dentist , on the other hand says: "It
>is equivalent to being out in the sun for 30days". Apparently, thats what
>their textbooks teach them.
>
>The following are my questions:
>
>1. Does anyone know what the actual dose to the face would be?
>  Is the comparison that the hygienist made correct?
>  Is there a scattered dose to the thyroid?
>
>2. If there is a DIAGNOSTIC reason, there maybe no  question that this should
>be done. But is is OK to be used as a SCREENING procedure? Is it ALARA?
>Is there a benefit? Or is it just a money-making proposition for the dentist?
>
>If you think it is of interest to the group, please post to RADSAFE. If
>not please email me directly.
>
>As always, thanks for your insight and input.
>
>
>Ninni Jacob
>Radiation Safety Officer
>University of Rhode Island/
>Rhode Island Nuclear Science Center
>16 Reactor Road
>Narragansett,RI 02882
>
>Phone: (401) 789-9391
>Fax:   (401) 782-4201
>email: njacob@gsosun1.gso.uri.edu
>
>