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83 Cards in this Set
- Front
- Back
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Quality Assurance |
Procedures used to assure the production of HIGH QUALITY diagnostic radiographs. |
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Quality control tests: Equipment and supplies (4) |
X-ray machine, X-ray film, screens/cassettes, viewing equipment |
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X-ray machines |
Tested, monitored at regular intervals. Tests should ID malfunctions |
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X-ray film |
Boxes tested for freshness, process 1 unexposed film, film should be clear with slight blue tint |
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Screens and cassettes |
Checked for dirt, cleaned monthly, anti static solution applied, adequate screen-film contact |
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Viewing equipment |
View box has fluorescent light bulbs, opaque plastic/plexiglass, examined for dirt, replace bad bulbs |
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Film processing: darkroom lighting |
Checked for light tightness proper safelighting, |
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Coin test |
Proper: no visible image is seen Improper: image of coin is visible |
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Film processing: processing equipment |
Meticulously maintained. •Manual: checked daily - thermometer, timer, liquid levels •Auto: Checked daily - water circulation, solution levels, unwrap 2 unexposed films (1 exposed to light) and process both films. |
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Film processing: Processing solutions |
Replenished daily. Changed every 3-4 weeks. Compare film densities to test strength of developer. |
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Ways to test developer (3) |
Reference Radiograph, Stepwedge, Normalizing Device |
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Reference Radiograph |
processed under ideal conditions and used to compare densities to daily radiographs. If density of daily radiograph is lighter = weak/old developer. Density is darker = too concentrated/warm developer |
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Stepwedge |
Expose 20 films with stepwedge on top. Process a film each day. View standard radiograph and daily radiograph side by side to compare |
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Normalizing Device |
Commercially available monitoring device |
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What happens when the fixer loses strength? |
The film takes a longer time to clear (unexposed silver halide crystals) or become transparent |
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Quality Administration program includes: |
1. Description of the plan 2. Assignment of duties 3. Monitoring schedule 4. Maintenance schedule 5. Record-keeping log 6. Plan for evaluation and revision 7. In-service training |
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T/F An assigned staff member may oversee the daily quality control testing and results |
True: the dentist can serve just as the administrator |
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Interpersonal skills |
skills that promote good relationships between individuals |
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Communication skills- Verbal, Nonverbal, Listening |
Verbal: avoid slang, words that carry harsh tones Nonverbal: body language is consistent with verbal language Listening: more than hearing, don't allow distractions, summarize what the patient has disclosed - helps build rapport |
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Facilitation skills |
Skills used to ease communication and develop a trusting relationship, encourages questions |
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First Impression |
Appearance is key. Don't eat, drink, chew gum while working with pts. Greet pt by name and tell them your name. |
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Chairside manner |
make the pt feel comfortable and at ease. Don't say "Oops"!!! |
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Attitude |
courteous, patient and honest |
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Patient education |
"Comprehensive dental health ed is one of the greatest services that a dental pro can provide for the pt" |
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Methods of education |
1. Oral Presentation 2. Printed info 3. Both methods combined (most effective) |
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T/F Treatment w/o necessary radiographs is considered negligent |
True |
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T/F There are many recorded cases of dental xrays causing cancer |
FALSE - not a single case has been reported |
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T/F Patients may request a copy of their radiographs or view them upon request |
True - although the dentist DOES own the radiographs. Radiographs are to be forwarded directly to dentist. |
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Consumer-Pt Radiation Health and Safety Act |
•Requirements for the safe use of dental xray equipment •Maintenance of equipment •Training and certification of dental radiographers |
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Licensure requirements |
licensed dentists and DH are not required to obtain additional certification to expose dental radiographs |
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*Informed consent |
Prior to treatment, pt should be made aware of aspects of the proposed treatment, as well as the effects of receiving no treatment and give consent |
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*Self-determination |
pt has legal right to make choices about their treatment |
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*Disclosure |
process of informing pt of all aspects to treatment |
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Malpractice issues: Negligence, Standard of Care, *Statute of Limitations |
Negligence: Diagnosis or tx falls below standard of care Standard of Care: quality of care delivered to each pt in similar locality, under same conditions *Statute of Limitations: time period that a pt may bring malpractice action against dentist |
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Documentation |
informed consent, type of radiographs and rationale for exposure, diagnosis made on basis of radiographs |
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Confidentiality |
Everything is confidential, shouldn't be shared |
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*Ownership/Retention |
dentist owns the radiographs and should keep them indefinitely (pt has reasonable access to records) |
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T/F Pts cannot consent to negligent care |
True - the Dr could still be held responsible |
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3 ways for infectious diseases to be transmitted |
1. Pt to dental professional 2. Pt to pt 3. Dental professional to pt |
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Routes of transmission |
1. Direct contact 2. Indirect contact w/ contaminated objects 3. Direct contact w/ airborne contaminants |
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Conditions of infection |
1. A susceptible host 2. pathogen 3. Portal of entry |
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Define: Antiseptic, Asepsis, Disinfect, Exposure incident, parenteral exposure, Sterilize |
•Antiseptic: inhibits growth of bacteria •Asepsis: Absence of pathogen •Disinfect: Inhibit/destroy pathogen •Exposure incident: contact w/ blood (pin prick) •Parenteral exposure: exposure to blood by puncture •Sterilize: Chemical procedure to destroy spores |
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Protective attire includes |
Protective clothing: removed before leaving office Gloves: worn when touching contaminated items Masks/Eyewear: mask changed between pts, eyewear washed between pts |
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Handwashing |
Before and after gloving |
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*Sterilization of instruments categories |
Critical: used to penetrate soft tissue or bone Semi-critical: contact but don't penetrate soft tissue or bone (Mirror, XCP) Noncritical: don't come in contact w/ mucous membranes (just need lysol to disinfect) (glasses, hand mirror) |
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Preparing the treatment area |
All surfaces likely to be touched should be covered |
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Preparing supplies and equipment |
have everything out before you begin (film, film holding device, paper towel, cup) |
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Preparing the pt |
Position chair, headrest, thyroid collar, removal of objects that would interfere with exposure |
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Preparing the dental radiographer (YOU!) |
handwashing, gloving, mask, eyewear (optional), assembling film holding device |
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During Exposure |
Dry exposed film w/ paper towel, don't place exposed films in lab coat/uniform - place in cup, don't place contaminated devices on uncovered surface |
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After exposure |
Dispose items while still wearing gloves, lead apron removal after hands have been washed, disinfection of uncovered areas: use utility gloves and hospital-grade disinfectant |
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Digital Radiography |
filmless imaging system that uses sensors instead of film to capture the x-radiation or light to create an electronic image |
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Charge-couple device (CCD) |
image receptor that converts xray energy into electrons that can be detected electronically |
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Pixel |
digital equivalent of a silver halide crystal |
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Digital subtraction |
reversing the gray-scale when viewing an image |
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Digitize |
convert an image into digital form |
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Sensor |
detector that captures the radiation/light to form the image (analogous to the film) |
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T/F Digital sensor requires 50-80% less radiation than f-speed film |
True - it is more sensitive to x-rays |
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X-radiation source |
Must be capable of adapting the exposure time (1/100 instead of 1/60) |
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Intraoral sensor (3 types) |
1. Charged-coupled device (CCD): most common 2. CMOS/APS: 25% greater resolution, less expensive, greater durability 3. Charge injection device: no computer required to process image |
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Computer |
Serves as the processor, storage unit, view box |
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Types of digital imaging |
Direct Digital: Most used Indirect Digital imaging: existing xray is digitized. Similar to scanning an image into a computer Storage Phosphor imaging: wireless digital system, less rapid than direct |
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Procedures |
Sensor: must be covered w/barrier, placed with paralleling technique (further into the mouth usually) |
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Advantages |
•Superior gray-scale resolution: 256 colors of gray! WOW! •Reduced exposure •Increased speed of viewing •Lower equipment and film cost •Increased efficiency •Enhancement of diagnostic image •Effective pt ed tool |
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Disadvantages |
•Initial costs •Image quality •Sensor size: thicker/more rigid •Infection control •Legal issues: original image can be manipulated |
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DICOM data |
universal format for handling, storing, transferring 3D images |
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Voxel |
Smallest element of 3D image (3D pixel) |
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Field of View (FOV) |
image capture area |
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Multiplanar Reconstruction (MPR) |
reconstruction of raw data into images imported into viewing software |
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Cone beam computed tomography |
3D format - cone shape |
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Cone beam volume tomography |
block of tissue being imaged |
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Advantages of 3D imaging |
•Lower radiation •Brief scanning time •Anatomically accurate •Ability to save and easily transport images |
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Disadvantages of 3D imaging |
•Pt movements/artifacts •Size of FOV (can be small and miss areas) •Cost of equipment •Lack of training in interpretation of image data |
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Paralleling technique |
XCP, right angle technique, long-cone technique |
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Principles |
1. Film placed parallel to long axis of tooth 2. central ray is perpendicular to film and tooth 3. film holder must be used 4. film placed toward midline 5. Object-to-film distance: increased to stay parallel, results in image magnification and loss of definition 6. Target-to-film distance: must be increased |
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Rules |
1. Film placement 2. Film position "dot in the slot" 3. Vertical angulation 4. Horizontal angulation 5. Film exposure |
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Anterior Technique |
1. Size 1 films: 7 anterior (4 maxillary) 2. Size 2 films: 6 anterior 3. Begin w/ #6, move right to left. Move to #22 and move right.
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Posterior Technique |
1. Begin w/ max right 2. Move to man left 3. Reassemble XCP and move to max left 4. Finish up with man right |
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Film placement |
•Canine: centered on canine •Max incisor: Size 1 - centered on contact between central and lateral. Size 2 - centered on contact between centrals. •Man incisor: centered on contacts •Premolar: centered on 2nd premolar •Molar: centered on 2nd molar |
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Shallow palate |
Bite block tilting occurs. Can compensate with cotton rolls and vertical angulation |
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Bony growths |
Max torus: Film placed on FAR side Man tori: Film placed between the tori and tonguw |
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Advantages of paralleling technique |
•Little to no distortion •Accuracy •Simplicity •Duplication •Less exposure to thyroid gland •Pt position is not critical |
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Disadvantages of paralleling technique |
•Film placement (difficult with children and pts with small mouth or shallow palate) •Pt discomfort |
