If you’ve been in Dentistry for many years, you’ve probably held a film or sensor in a patient’s mouth during radiographic exposure. Children, patients with a small mouth or tori, severe gaggers, or uncooperative patients can make it seem like there’s no other way to get the perfect shot without compromising your health.
Because radiation is cumulative, it builds over time and can cause significant damage to the body. Exposure has lessened dramatically since the introduction of digital technology, and harmful effects are rare today, but that doesn’t mean that it’s ok to stay in the operatory during exposure. Following are some things to consider while taking x-rays:
- Use appropriately sized film. Unfortunately, there aren’t many options for film or sensor sizes. However, a pediatric size is a must because it can be used for an adult with a small mouth, sensitive gag reflex, or tori.
- Have the patient hold the film. If there’s no other way to get a decent shot, the patient can be instructed to hold the film. It’s a bit risky because the film or film holder must be held firmly, but it’s better than exposing yourself. It also may or may not work with a child. But again, it’s worth a try.
- OSHA mandates that employers provide a safe workplace which includes limiting radiation exposure. Therefore, dosimeters and barrier shields (lead aprons and lead lined walls) should be in place anywhere x-rays are taken. A dosimeter is a scientific instrument (usually a badge that the clinician wears) used to measure exposure to radiation. The badge is monitored by the company from which it’s purchased.
- Employees must be educated and take a course in radiation protection, and anyone who takes x-rays must be certified by the state.
- The maximum annual dose of radiation for healthcare employees is 50 millisieverts (mSv). The maximum allowable lifetime dose is ten mSv multiplied by your age.
- Pregnant clinicians can expose x-rays, but they must wear their dosimeter and a lead apron every time and never remain in the room during exposures. While this may seem like overkill, it’s prudent to have team members who are pregnant stay far from any radiation. Many pregnant practitioners refuse being exposed to any radiation, and their decision should be respected.
- Continued exposure to dental X-rays is linked with an increased risk of cancer. Again, most clinicians today aren’t overexposed because of advances in technology that require far less radiation and precise and focused beams, but it certainly can happen. Specific types of cancer such as thyroid and tumors involving the hands or fingers are linked to the dental profession.
Dental offices are busy places and staying on schedule is a must. It’s easy to justify getting a diagnostic x-ray by holding the film in the patient's mouth, but it shouldn’t occur. Perhaps it’s time to find a course that teaches alternative ways to get a readable x-ray without exposing yourself. Always remember that radiation is cumulative and dangerous when not respected.