01/27/2014

CDA’s updated radiation safety guide now available


To ensure compliance with state radiation regulations, dental practices, clinics and dental educational programs should obtain the recently updated Radiation Safety in Dental Practice.

All sources of radiation must have a copy of the radiation regulations and also a written radiation safety program. Radiation Safety in Dental Practice, the updated guide, contains both the regulations applicable to dentistry and a template for completing a written safety program.

“Dentists should review the Radiation Safety Guide, as it is their responsibility to practice ALARA (As Low As Reasonably Achievable) and protect patients and their personnel,” said Elham Radan, DDS, MSc, director of the Radiology Clinic at the Herman Ostrow School of Dentistry of USC.

Radan was one of the dental school faculty members who, with assistance from the Department of Public Health (DPH), helped update the guide. Kenneth Abramovitch, DDS, MS, director of Radiology and Imaging Services at the Loma Linda University School of Dentistry, and Linda Angin, DDS, health sciences clinical professor at the UCSF School of Dentistry, also played key roles.

“It is essential to know the basic knowledge and potential risks regarding ionizing radiation with the rapid increase of diagnostic imaging and advanced image modalities,” Radan said. 

X-ray technology has changed considerably since 1996, when the guide was first published. Digital systems are more common today and the use of cone beam computed tomography is increasing. However, the regulations have changed little. Quality assurance regulations for X-ray film were adopted in 2012, and the DPH now requires all sources of radiation to have a written radiation safety program. And the use of protective aprons continues to be a requirement.

The guide reviews the responsibilities of the licensed dentist and X-ray machine owner, as well as the essential principles for reducing patient and occupational exposure to radiation. A table summary of the ADA/FDA radiographic prescription guide that was updated in 2012 is included. The use of portable X-ray units and CBCTs is addressed. A section on dental monitor display and image quality considerations has been added.

“This guide is updated to reflect recent advances and position statements for CBCT with additional information on digital imaging. It promotes quality assurance, which is proven to reduce exposure, increase and maintain image quality and limit the health care costs,” Radan said.

The radiation safety program template included in the guide allows the dentist or X-ray machine owner to fill in the necessary information. The template was created with the assistance of the DPH, which also has a guidance document on its website (cdph.ca.gov) to assist all X-ray machine registrants in developing a written radiation safety program.

One requirement of the radiation safety program is for employers to track, to the extent possible, the concurrent occupational radiation exposure of employees who work at other dental practices or clinics. CDA has created a new resource, titled Employee Occupational Exposure to Radiation, to assist employers in obtaining information from their employees.

The Radiation Safety in Dental Practice guide is likely to be updated again in five years given the ongoing development in technology and usage, and the expected publication of a supplement to the National Council on Radiation Protection and Measurements (NCRP), Report Number 145 (2004), Radiation Protection in Dentistry. The supplement will be released in 2015 or 2016.

The Radiation Safety in Dental Practice guide is available for download on the CDA website.