RADIOGRAPHS

DENTAL RADIOGRAPHS FOR CHILDREN

The objective is to minimize the exposure to radiation. Dental radiographs should be prescribed according to individual patient need and should be made using techniques that will maximize the yield of diagnostic information while minimizing the exposure to ionizing radiation.

Children should be exposed to dental ionizing radiation only after a complete review and evaluation of their dental, oral, and general health. Following this review, dental radiographs should be ordered on the basis of the findings of a thorough clinical examination. Only a dentist should order the films to be exposed.

RATIONALE FOR RADIOGRAPHS:

1. A patient should be exposed to diagnostic radiation when the planned radiograph will provide information which:
   
   A. Cannot be gained in another manner; and
   B. May affect the prognosis or treatment to be rendered.
   
   
2. The decision as to how many and which radiographs are to be taken must be individually determined for each patient. A patient should never be exposed to diagnostic radiation if you are not confident the result will be an image of diagnostic quality.

RADIOGRAPHS

The majority of patients being seen for the first time in the Pediatric Dental Clinic will have no radiographs in their chart. Before the patient is seated check the gold envelope in the front of the chart for recent radiographs.

NOTE: It is clinic policy that the faculty and students will confer together to determine which radiographs are appropriate for each specific patient. There are no "routine" radiographs taken in Pediatric Dentistry; no exposures of children to ionizing radiation are to occur prior to an assessment of radiographic needs.

Most pediatric patients do not require full mouth series. Periapical exposures of selected areas should be made after consultation with a faculty member. During the transitional dentition stage a panoramic radiograph may be indicated if the presence and position of succedaneous teeth can not be evaluated on previous radiographs. A final pediatric panoramic radiograph may be ordered after all of the permanent teeth (except third molars) have erupted (14-17 years old).

Intraoral radiographs should be taken by the student who is assigned to examine the patient and may be taken on the 7th, 8th or 9th floors. Bitewings are taken using bitewing loops or tabs which are available in the Radiology Department. Generally children under age 6 best tolerate the small (size 0) film for bitewing exposures. Children who have permanent molars erupted into occlusion can usually tolerate the larger (size 2) film. Size 2 film are preferred because of the greater radiographic information obtained for the same amount of exposure. It is both permissible and considerate to bend the corners of the film in order to make the patient more comfortable. However, do not make a sharp crease in the film on an area of critical detail.

All patients must be draped with a lead apron and thyroid collar for all radiographic exposures.

NO RADIOGRAPHIC EXPOSURES ARE TO BE MADE ON PEDIATRIC DENTAL PATIENTS WITHOUT THE EXPRESS KNOWLEDGE OF A PEDIATRIC DENTISTRY FACULTY MEMBER.

There is no provision for parent's to sign an "x-ray refusal form". Children whose parents refuse to consent to the radiographs deemed necessary by the faculty cannot receive non-emergency dental treatment. There are to be NO exceptions to this policy.