1. Dr. Krisztián Csomó

2.  Patient  Ourselves  Colleagues  Environment

3.  Reasonable  Benefit > Risk  Optimization  ALARA (As Low As Reasonably Achievable)  Dose limitation

4. ALARA Equipment Service and controll Staff protection Patient protection Dentist and staff

5.  Protect yourself!  Distance protection  Protecting wall  Never hold the film in your own hands!!!!!!

6.  The intensity of radiation is in reverse proportion to the distance squared  Useable in places where only a few pictures are made (max 50 per week)  The minimal distance is 2 meters (preferably 3 m)  The person accompanying a minor can’t be pregnant, or under 18, also has to wear a protecting suit!

7.  The best option: Protected cabin  The wall can be made of:  brick  concrete  Lead between wooden plates  In case of low circulation: protecting wall  At least 1.5 m from the focus of the X-ray machine  At least 2 m high  At least 0.7 mm lead-equivalent  At eye-level: 600 cm 2 1 mm lead-equivalent lead- glass window

8.  Standardized, given by the Hungarian health and safety board (ANTSZ).  It is PROHIBITED to take an X-ray without a permit!

9.  The X-ray image must be justified  The person taking the picture must be well trained, must have adequate skills and not take unnecessary repeats  The chosen technique must:  Be quick  Have the lowest achievable radiation dose  Be targeted  Be able to be stored for future reference  Filmholder  Headchair  Sensitive film – digital radiography  Knowing the limits of our patient – anatomical as well as mental limits  Lead apron  Use of a tube of adequate geometry

10. We have to choose:  Which is the most ideal X-ray machine for our purposes  What is our purpose:  The lowest achievable radiation dose  The highest achievable image quality  A lower dose of diffuse radiation can usually be achieved using modern equipment  How does the digital system help?

11.  The radiation dose is lower comparing intraoral images  Can be stored electronically, images are easily multiplied and thereby no need for re-takes  The benefits of the software :  No need for re-takes  Over- or underexposed images can be salvaged  The contrast and the definition can be modified

12.  Optimal localization  Maintenance every 2 years (the program is able to measure this)  Radiation and electric insulation needs to be controlled regularly  The exposition value needs to be standardized  Keep track of the amortization!

13.  It is very important to know the dose you have been exposed to considering the stochastic effetcts!

14.  Valid until 2016!!!!  Minors are not allowed to work in a radiating environment  Pregnant colleague! The fetus is entitled to the residential levels of exposure! Type of exposure Effective quantity Equivalent quantity Eye-lensSkinExtremities Occupational50 mSv/year and 100 mSv/5 years 150 mSv/year500 mSv/year Residential1 mSv/year15 mSv/year50 mSv/year

15.  New legislation in 2016  More severe limitations

16.  1. Measuring  2. Registration, summarization, control (every 3 months)  3. Protection measurements

17.  Termoluminescent-dosimeter (TLD)  (Film dosimeter)  Must be worn at all times while at work!!!