1. radiation protection in dentistry
Dr. Krisztián Csomó

2. What are we protecting?
Patient
Ourselves
Colleagues
Environment

3. The 3 bases of radiation protetcion
Reasonable
Benefit > Risk
Optimization
ALARA (As Low As Reasonably Achievable)
Dose limitation

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

5. Dentist and staff Protect yourself!
Distance protection
Protecting wall
Never hold the film in your own hands!!!!!!

6. Distance protection
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. Protecting wall 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 cm2 1 mm lead-equivalent lead-glass window

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

9. What protects the patient protects the staff as well
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. Equipment 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. Radiation protection in regards of digital radiography
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. Maintenance and control
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. Always monitor your own radiation exposure!
It is very important to know the dose you have been exposed to considering the stochastic effetcts!

14. Protection quantities
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-lens
Skin
Occupational
20 mSv/year
Residential
1 mSv/year
15 mSv/year
50 mSv/year

15. Control of the occupational exposure
1. Measuring
2. Registration, summarization, control (every 3 months)
3. Protection measurements

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

17. Thank you for your attention!