The field of dental care is constantly evolving, driven by technological advancements and new research. In February 2024, the American Dental Association (ADA) collaborated with expert panels and the U.S. Food and Drug Administration (FDA) to update its guidelines regarding the use of radiation in dental radiography. These changes are set to revolutionize how dentists approach imaging, with a focus on patient safety and the optimization of diagnostic procedures.

Out with the Old: Reassessing the Use of Lead Aprons and Thyroid Collars

In the past, lead aprons were commonly used in dental X-rays as a way to protect against radiation. In 2017, the ADA said it was no longer appropriate to use lead aprons when taking radiographs. However, recent research suggests that thyroid collars are also not necessary due to advancements in dental X-ray equipment and practices. According to a detailed review, modern technology significantly reduces stray radiation exposure, making lead aprons and thyroid collars sometimes unnecessary. The American Dental Association (ADA) has updated its guidelines to reflect these findings and to avoid repeated X-rays and increased radiation exposure caused by the use of unnecessary protective gear.

Embracing Modern Technology: Digital Over Film

There has been a recent shift towards using digital radiography, which is an essential aspect of current recommendations. Digital X-ray systems are highly advantageous as they not only reduce radiation exposure compared to traditional film but also provide higher-quality images that are pivotal for accurate diagnoses. Dentists are encouraged to use digital systems and employ techniques such as rectangular collimation, which confines the X-ray beam to the area of interest, resulting in further reduced exposure.

Strategic Imaging: Using X-rays Wisely

The principle of "As Low As Reasonably Achievable" (ALARA) is an important aspect of radiation safety. The latest guidelines highlight the need to use X-rays prudently, depending on the specific diagnostic requirements, and not as a routine part of check-ups. Dentists are advised to carry out a comprehensive clinical examination and evaluate any existing images before ordering new X-rays.

Cone-Beam Computed Tomography (CBCT): Reserved for Necessity

CBCT (Cone Beam Computed Tomography) technology is used in dentistry for various treatments and diagnoses. Its three-dimensional images provide detailed information, but it should only be used when absolutely necessary. This is because it delivers a higher radiation dose compared to other dental imaging modalities. Guidelines recommend that CBCT should be used only when other options cannot provide the required diagnostic information. Its use should be justified by the potential benefits to patient care.

Regulatory and Practical Aspects: Ensuring Compliance and Best Practices

Dentists must follow a complex set of radiation safety regulations. The latest guidelines highlight the significance of complying with all federal, state, and local regulations. It is highly recommended that dental practices establish a radiation safety program, conduct regular staff training sessions, and ensure that their imaging equipment is well-maintained and operated according to the highest standards.

Educating and Protecting Patients

One of the crucial elements of the new guidelines is patient education. Dentists are advised to have open communication with their patients regarding the advantages and disadvantages of dental imaging. This conversation is necessary not only to obtain informed consent but also to assure patients about the safety measures in place to prevent them from being exposed to unnecessary radiation.

Conclusion

The latest ADA guidelines represent a significant change in the way dental radiography is conducted. The guidelines aim to improve patient safety and diagnostic accuracy by reducing reliance on outdated protective measures and promoting the use of modern technology and strategic imaging practices. As dental practices worldwide begin to implement these changes, the focus will shift towards maximizing the health benefits of dental radiography while minimizing risks, ensuring that it continues to be a safe and effective tool in oral healthcare.

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Source:

Article Title: Optimizing radiation safety in dentistry

Journal Title: The Journal of the American Dental Association

CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.adaj.2023.12.002

Content Type: article

Good News: Dental X-rays Are Much Safer Than You Think