Guidelines for prescribing dental radiographs
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An expert panel from the dental profession under the supervision of the Food and Drug Administration developed guidelines for prescribing dental radiographs. The panel was concerned with patient safety. Dentists use the guidelines as recommendations to help determine the type of radiograph needed, how often and under what conditions radiographs should be taken. Dentists prescribe radiographs on the basis of clinical observation and the patient’s health history. Patient selection criteria include descriptions of clinical conditions derived from patient signs, symptoms and history that identify patients who are likely to benefit from a particular radiographic examination. The recommendations in the chart are subject to each Dentist’s clinical judgment and may not apply to every patient. [i]
Guidelines for Prescribing Dental Radiographs [ii]
Clinical situations for which radiographs may be indicated include:
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Positive Historical Findings |
Positive Clinical Signs or Symptoms |
Evidence of Facial Trauma |
High Risk of Carious Lesions Possible |
|
Previous periodontal or endodontic therapy
History of pain or trauma
Familial history of dental anomalies
Postoperative evaluation of healing
Presence of implants
|
Clinical evidence of periodontal disease
Large or deep restorations
Deep carious lesions
Malposed or clinically impacted teeth
Swelling |
Mobility of teeth Fistula or sinus tract infection Clinically suspected sinus pathology Growth abnormalities Oral involvement in known or suspected systemic disease Positive neurological findings in the head and neck Evidence of foreign objects Pain and/or dysfunction of the temporomandibular joint Facial asymmetry Abutment teeth for fixed or removable partial prosthesis Unexplained bleeding Unexplained sensitivity of teeth Unusual eruption, spacing or migration of teeth Unusual tooth morphology, calcification or color Missing teeth with unknown reason
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Failing existing restoration(s) Poor oral hygiene Inadequate fluoride exposure Prolonged nursing (bottle or breast) Diet with high sucrose frequency Poor family dental health Developmental enamel defects Developmental disability Xerostomia Genetic abnormality of teeth Many multi-surface restorations Chemo/radiation therapy
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A licensed dentist or a properly supervised dental student must determine the number and types of x-rays. Taking radiographs based on a predetermined timetable (every year or every 6 months) is not considered an acceptable standard of care. The needs of each patient should be evaluated clinically before the decision of taking x-rays is made.
The dentist is responsible for keeping the equipment in good working condition. The dentist is also legally responsible to use licensed personnel for taking x-rays.
Dentists and allied dental professionals often seek CE
courses from ADA CERP recognized providers to fulfill their CE requirements
for re-licensure. Most state and provincial licensing
boards will accept CE credits issued by ADA CERP recognized providers.
In the spring of 2003, the FDI World Dental Federation became the
first internationally based CE provider to be granted ADA CERP recognition.
Please contact your state board directly for their specific rules
and regulations. Most states approve supervised self-study courses
that are ADA CERP accredited.
Those dentists, hygienists, dental assistants and radiographers interested in receiving 3 continuing education credits for this course may take a 10 question test at a cost of $35 and receive their certificate immediately by clicking here.
Those dentists, hygienists, dental assistants and radiographers interested in receiving 8 continuing education credits for this course may take a 25 question test at a cost of $66 and receive their certificate immediately by clicking here.
Note: There are no questions on tables or Glossary.
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[i] Eastman Kodak Company Recommendations developed by an expert dental panel comprised of representatives from the Academy of General Dentistry, American Academy of Dental Radiology, American Academy of Oral Medicine, American Academy of Pediatric Dentistry, American Academy of Periodontology, and the American Dental Association under the sponsorship of the Food and Drug Administration (FDA).
[ii] American Academy of Pediatric Dentistry
- Introduction to Radiology
- X-ray characteristics
- Effects of Radiation
- Film imaging terms
- Film Speed
- Film Processing
- Mounting Radiographs
- Prescribing radiographs
- Who gets which radiographs?
- Intraoral Radiographic Surveys
- Patient Management
- Qualities of Excellent X-Rays
- Common Errors
- Infection Control
- Shadow Casting Principles
- Shadow Ttricks
- Digital Radiography
- How a Panorex Works
- CAT Scans
- Cone Beams and 3D Imaging
- Glossary
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