PEDIATRIC DENTISTRY
PERFORMANCE IMPROVEMENT

Criteria for Record and Radiographic Review

Radiographic Review

Criteria for the appropriateness of prescribing radiographs must be applied on an individual basis. The criteria established by ADA HHS (see "Guidelines for Prescribing Dental Radiographs" will be used to determine appropriateness.

The three categories for review are:
1. Appropriate quantity of films
2. Evidence of patient's name and date on all films made within the last 3 years.
3. Quality of radiographs

Criteria

1. Appropriate quantity of films

Quantity of films to comply with the guidelines recommended by the American Dental Association.

Acceptable: Adherence to the guidelines

Unacceptable: Too few or too many films according to the guidelines.

2. Evidence of patient data on all films, mounts or packets made within the last 3 years.

Acceptable: All film mounts or packets are labeled with name and date.

Unacceptable: If one or more mounts or packets are not labeled with patient's name and date.

3. Quality of Radiographs

All films will be reviewed for each of the criteria listed in the "Criteria for Diagnostically Acceptable Radiographs" (See Table II). Those areas that are a problem should be checked. These should be considered in making the final assessment as to the films acceptability.

Acceptable/Desirable

  1. Filming correctly mounted, labeled and dated.

  2. All apices of teeth plus 2mm of bone visible on the film.

  3. Sufficient density and definition.

  4. Correct angulation of the teeth.
    4.1 Posterior teeth must have long axis 90° to long axis of film
    4.2 Anterior teeth must have long axis parallel to long axis of film

  5. Incisal or occlusal tips of teeth visible.

  6. Teeth correctly positioned on film.

  7. Occlusal plane correct.

  8. Clear view of interproximal contact areas.

  9. Unless accompanied by a Panographic film., all areas- dentulous and edentulous - must be visible.
Incisor view Mesial surface of both laterals visible
Lat/canine view

Mesial of lateral and distal of canine visible
Premolar view Second premolar in center of film
Molar view Distal of second premolar visible (or area where that tooth should have been)
BITE WING VIEWS

Occlusal plane of teeth in middle of film and parallel to long axis of film.

Primary Molar
B-W

 Anterior border of film opposite middle of canine and primary 1st and 2nd molars visable on film.
Premolar B-W Anterior border of film opposite middle of canine teeth & 2nd premolar in center of film.
Molar B-W Anterior border of film opposite middle of second premolar or 2nd molar in center of film.

 

Unexpected/Undesirable

1. Overlapping teeth

2. Foreshortening or elongation

3. Cone cutting

4. Blurred images

5. Double exposures

6. Incorrectly mounted films

7. Films exposed the wrong side

8. Radiographs incorrectly positioned or incorrectly placed in the X-ray mount.