Introduction
How many times have we walked into the college RVG room without wearing a lead apron, or have handled a digital dental x-ray machine thinking that one x-ray would not harm us? And how many times have we convinced patients that these X-rays are safe? It’s easy to neglect and convince ourselves that a single invisible, odourless beam will not do much harm, but the cumulative effect of radiation on patients and on us as dentists or the staff who work with us can reach dangerous levels. Often, we are so engrossed in the procedures that we overlook the fact that we are working with a sensitive device. It does not take long for a harmless X-ray to turn into 20, and before we know it, we have put ourselves at risk. The World Health Organization (WHO) has classified radiation as carcinogenic. Therefore, we must do everything we can to reduce radiation exposure and be careful in our work with patient radiation protection.
Patient Protection
It is prudent to avoid unnecessary patient radiation exposure and to take diagnostic radiographs only when deemed necessary. The patient dose for each examination should be optimized according to the ALARA principle (as low as reasonably achievable) and be compatible with the required image quality. The equipment used should undergo routine quality control, be properly maintained, and have standard dose reduction features. Lead aprons (0.5 mm lead) should be provided for anxious patients, and thyroid collars should be used when the thyroid gland may be exposed to the main beam or to a significant amount of scattered radiation. Especially in children, where the thyroid gland is the most radiation-sensitive organ. The lead apron should be checked regularly for cracks. It should not be wrinkled or folded, but hung on hangers, as wrinkles cause tears and allow radiation to penetrate. Use the fastest image receptor available. Use cone beam computed tomography only when necessary because it emits higher radiation. All persons who are not needed during the x-ray should not be in the room.
Operator safety
As operators, we are the most exposed to radiation, so it is important to ensure our safety. We should be educated about radiation safety. We should stand at least 6 feet (1.83 m) away at an angle of 90° to 135° from the direct beam path or behind a protective barrier. The barrier should have a viewing window through which we can see the patient; the window should be leaded glass. We should never hold the film or the tube head with our hands when taking radiographs.
The equipment used
The tube housing should not drift out of its position during exposure. Instabilities in the suspension arms should be reported and corrected immediately. Digital sensors offer greater dose savings and must be used. Use the long source-to-skin distance, as this reduces exposure by 10 to 25 percent. Intensifying screens should be used to reduce radiation. Collimators limit the size and shape of the useful rays. Rectangular collimators are preferred for periapical radiographs because they significantly limit radiation. Faster image receptors and film holders that precisely align the film with the collimated rays are recommended for periapical and bitewing radiographs.
Conclusion
As responsible dentists and as someone who deals with radiation on a regular basis, we cannot neglect our safety and that of our patients’. As the saying goes, “Prevention is better than cure.” Taking a step towards safety will go a long way toward preventing the disastrous effects of radiation.