Radiation Safety Practices of Dental Hygienists in the United States
Dental radiographs are a necessary part of proper dental care. When emitting ionizing radiation to capture an image for a radiograph there are risks that should be acknowledged. Along with the ADA’s guidelines for frequency of radiographs based on the individual patient’s needs, hygienists need to follow guidelines to protect themselves as the patient. A quantitative study collected data via a survey from 1500 dental hygienists in the United States. The results were published in August 2019 in The Journal of Dental Hygiene.1
The study investigated three different areas of radiation safety, these include the use of ADA selection criteria guidelines, policies implemented by practice settings, and use of handheld radiographic devices. The survey contained 22 questions, six were closed-ended questions to establish demographics questions inquired about education, number of semesters of radiology in the curriculum, primary work setting, age, years of experience, location of current practice. The remaining 16 questions were regarding the previous three categories mentioned above.
ADA selection criteria guidelines recommend determining the frequency of radiographs based on the individual’s disease state, risk factors, age, current patient status (new or returning patient), medical and dental histories, and findings from the comprehensive clinical examination. More than one-fourth of respondents stated the decision to expose radiographs was based on third-party reimbursement and not necessarily the ADA’s guidelines.
When exposing pediatric patients, it is important to consider bone density. Children under the age of 12 typically have less dense bone structure, this indicates the exposure time should be reduced by 30%. Though 90% of the respondents indicated they were aware that settings should be altered for children, most admitted to not adjusting the settings to reduce exposure time.
The current ADA guidelines for radiographs during pregnancy references the American College of Obstetrics and Gynecologists. The guidelines state “exposing pregnant patients to necessary dental radiographs during any stage of pregnancy is considered safe as long as abdominal and thyroid shielding is used”. The survey showed that 14% of respondents had practice policies prohibiting taking any radiographs during pregnancy, 50% stated they only exposed radiographs on pregnant patients in the case of an emergency, 12% reported taking radiographs dependent on the trimester, while 8% required written permission from the patient’s obstetrician. Only 1% of respondents were following current recommendations.
Handheld devices are becoming more popular in dental practices. It is imperative to make sure the handheld device has been certified by the FDA and that all manufacturer safety precautions are followed. Of the respondents that used handheld radiographic devices, 43% stated they had not received training prior to use on patients and less than half reported holding the device properly.
The study concluded that dental hygienists with more years of experience, a higher level of education, and those that have recently attended a CE on radiation safety were more likely to follow ADA guidelines. The study calls for more regular radiation safety CE’s to keep dental professionals up to date on current guidelines and new technologies.
These are just a few of the highlights from this study, we encourage you to read the entire study for yourself. Do you currently follow the ADA’s selection criteria guidelines? What are your office policies on exposing radiographs on a pregnant patient? If you use a handheld radiographic device, did you receive training prior to use? When was the last time you took a CE on radiation safety?
- Lintag K, Bruhn AM, Tolle SL, Diawara N. Radiation Safety Practices of Dental Hygienists in the United States. J Dent Hyg. 2019;93(4):14–23.
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