1 DA105 RADIOLOGY RADIATION HEALTH AND SAFETY

– Radiation Control for Health and Safety Act – Standardized xray equipment; required filtration, collimation, quality control programs

– Consumer – Patient Radiation Health and Safety Act – Each state must monitor and regulate, in it’s Dental Practice Act who is allowed to take xrays and the training for that person

4 Radiation comes from 2 sources Natural Background radiation – earth, sun, atmosphere Artificial – Diagnostic and therapeutic, atomic testing, scientific experimentation

5 CHARACTERISTICS OF DENTAL XRAYS Positive Decay Cysts Infection Retained roots Foreign bodies Tooth development Growth irregularities

6 Negative Can penetrate tissues that are radiosensitive Ionize change, or alter tissues Most sensitive tissue – Growing or immature cell tissue

7 Tissues which are radiosensitive FROM MOST TO LEAST Embryonic tissue (in Pregnant women_ Blood and bone marrow Skin Connective tissue Nerve Brain Muscle cells Bone enamel Embryonic tissue (in Pregnant women_ Blood and bone marrow Skin Connective tissue Nerve Brain Muscle cells Bone enamel

8 CUMULATIVE EFFECT Long lasting effects from exposure which can add up to harmful amounts. SCATTER RADIATION – Remains in cells but the body can slough it off in hours Repeated exposure does not give the body enough time to slough off the damaged cells and permanent tissue damage can occur Long lasting effects from exposure which can add up to harmful amounts. SCATTER RADIATION – Remains in cells but the body can slough it off in hours Repeated exposure does not give the body enough time to slough off the damaged cells and permanent tissue damage can occur

9 LATENT PERIOD The time from exposure to xray until there is observable damage

10 SHORT TERM EFFECTS Short term effect from high doses lead to biological damage –High Doses (nuclear accident) can cause erythema and epilation. Dental xrays are not high dose, not possible at xray machine settings Short term effect from high doses lead to biological damage –High Doses (nuclear accident) can cause erythema and epilation. Dental xrays are not high dose, not possible at xray machine settings

11 LONG TERM EFFECTS Long term effects chronic after years of exposure. Ex. Operator hold xray in patient mouth = dermatitis and subsequent development of cancerous lesions of finger

12 OTHER LONG TERM EFFECTS Erythema Epilation Split fingernails Blindness sterility Erythema Epilation Split fingernails Blindness sterility

13 Any exposure to radiation conveys potential risks, even low dose such as dental xray. It’s important for a DA to learn critical organs because radiation safety is directed at minimizing exposure to highly sensitive organs Any exposure to radiation conveys potential risks, even low dose such as dental xray. It’s important for a DA to learn critical organs because radiation safety is directed at minimizing exposure to highly sensitive organs

14 CRITICAL ORGANS Hematopoietic – function and form of blood elements Thyroid gland - cancer Breast- cancer Salivary glands – sublingual, submandibular, parotid Hematopoietic – function and form of blood elements Thyroid gland - cancer Breast- cancer Salivary glands – sublingual, submandibular, parotid

15 Reproductive organs – male and female Pregnancy – genetic effects, changes in reproductive cells, leads to radiation-induced mutations Skin – early aging Lens of eyes – cataracts – have patient close eyes Reproductive organs – male and female Pregnancy – genetic effects, changes in reproductive cells, leads to radiation-induced mutations Skin – early aging Lens of eyes – cataracts – have patient close eyes

16 Pregnant Patient Do not take x rays on pregnant patients unless emergency OBGYN must approve all exposures Do not take x rays on pregnant patients unless emergency OBGYN must approve all exposures

17 SECONDARY Radiation coming from or bounce or deflection off soft tissue, patient’s head, lead materials, cone apron

18 SCATTERED Radiation deflected by impact with matter (object); travels to all parts of body and all over the room; undesirable xrays

19 SAFETY PRECAUTIONS ALARA As Low as Reasonably Achievable (National Committee on Radiation Protection 1971 Maximum diagnostic benefit with minimum exposure possible determine if radiation is preferable agent for making diagnosis. Avoid retakes/check to see if current xrays exist before taking one ALARA As Low as Reasonably Achievable (National Committee on Radiation Protection 1971 Maximum diagnostic benefit with minimum exposure possible determine if radiation is preferable agent for making diagnosis. Avoid retakes/check to see if current xrays exist before taking one

20 FILTRATION Removes non-useful, low energy soft radiation from primary beam. Aluminum disc placed at window Federal Law – 1.5 mm aluminum filter at KvP. 2.5 mm Above 70 KvP Removes non-useful, low energy soft radiation from primary beam. Aluminum disc placed at window Federal Law – 1.5 mm aluminum filter at KvP. 2.5 mm Above 70 KvP

21 COLLIMATION Restricts size of beam by use of lead lined PID One of the most important ways to minimize patient exposure Federal law – dental xray can be no more than 2.75 inches at patient face Restricts size of beam by use of lead lined PID One of the most important ways to minimize patient exposure Federal law – dental xray can be no more than 2.75 inches at patient face

22 CONTINUING EDUCATION Learning about new procedures and discoveries

23 CARDINAL PRINCIPLES 1. Use least amount of radiation that is needed 2. Operator never hold film for patient 1. Use least amount of radiation that is needed 2. Operator never hold film for patient

24 EFFECTS OF ORAL RADIATION THERAPY Xerostomiadry mouth Dysphagiadifficulty in swallowing Radiation caries caused by lack of saliva from xerostomia Osteoradionecrosis – death of alveolar bone Inflammed gingiva Mobility of teeth Loss of appitite Xerostomiadry mouth Dysphagiadifficulty in swallowing Radiation caries caused by lack of saliva from xerostomia Osteoradionecrosis – death of alveolar bone Inflammed gingiva Mobility of teeth Loss of appitite