Radiation Protection in Dentistry
Justification is the first principle of radiation protection and states that one should only expose the patient after a thorough clinical examination and anamnesis. One should only expose the patient to ionizing radiation if the benefit outweighs the risk
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Radiation Protection in Dentistry
2.1
The Three Basic Principles of Radiation Protection
Justification is the first principle of radiation protection and states that one should only expose the patient after a thorough clinical examination and anamnesis. One should only expose the patient to ionizing radiation if the benefit outweighs the risk. That means that the information one gathers with taking a radiograph will have a substantial impact on the diagnosis, treatment, and outcome. If there is another method to gather that important piece of information, then the radiograph should not be taken. In pediatric dentistry, this also means that if the patient cannot cope with the procedure and the quality of the radiograph would not be diagnostic, the exposure should not take place. Limitation is the second principle of radiation protection. This principle states that one should always try to keep the dose as low as possible, without compromising the image quality and the diagnostic yield. Under this principle one understands ALARA (as low as reasonably achievable), which has been twisted to ALADA (as low as diagnostically achievable) ALADAIP (ALADA indication oriented and patient specific) recently. Optimization is the third principle, which states that one should always try to obtain the best image quality possible, however, with both previous principles in mind. To illustrate these principles, Fig. 2.1 shows an example of non-justifiable exposure to ionizing radiation. The 3-year-old girl was submitted to a panoramic radiograph, while there were no clinical caries, swellings of any sort, or abnormalities. This is a useless exposure, which does not add important information, as what can be observed in the radiograph is normal dental development, as expected from the clinical examination and the dental and medical history. On the contrary there is the second panoramic radiograph in Fig. 2.1, which depicts the image of a 5-year-old boy with rampant caries, who had already his right-hand-side second deciduous molar extracted at an emergency visit prior to this exposure. This exposure can be justified, as the carious lesions have caused abscesses and infection, and the
© Springer Nature Switzerland AG 2019 J. Aps, Imaging in Pediatric Dental Practice, https://doi.org/10.1007/978-3-030-12354-3_2
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2 Radiation Protection in Dentistry
Fig. 2.1 The top panoramic radiograph is the radiograph of a perfectly healthy 3-year-old girl, whereas the bottom one is a 5-year-old boy with severe caries and a history of exodontia
information that can be obtained from this panoramic radiograph will have a significant impact on the diagnostic yield and ultimately also the treatment plan.
2.2
adiation Doses of Different Medical R and Dental Diagnostic Examinations
In order to understand what radiation dose means, one has to unravel the differences between absorbed, equivalent, and effective radiation dose (Fig. 2.2). The effective radiation dose (Table 2.1) will be used to compare different diagnostic exposures with e
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