The importance of the ANSI ADA Standard for digital intraoral radiographic systems-a pragmatic approach to quality assurance.

The need for quality assurance (QA) for digital dental radiography has existed since the introduction of digital imaging; however, the methods and phantoms required to achieve it were not available. This resulted in a chaotic approach to address QA based largely upon subjective analysis of image quality. The American National Standards Institute (ANSI)/American Dental Association (ADA) Quality Assurance Standard 1094 for Digital Intraoral Radiographic Systems (DIRS) presents a paradigm shift to a scientific and objective method of QA rather than one based on subjective assessments. This standard takes into account the contributions of all components of the digital imaging chain that affect final image quality rather than assessing the various components in isolation. The optimal image is determined for each DIRS through objective analysis of the image quality properties of dynamic range, spatial resolution, and contrast perceptibility. Image optimization, a critical component of a quality assurance program, is the proper balance between diagnostic image quality and radiation dose to the patient. This publication counters disseminated myths and misconceptions with scientific evidence and will help dental practitioners appreciate and understand the benefits of the new ANSI/ADA Standard on QA for DIRS.

Quality assurance: acceptance testing for digital dental intraoral sensors.

OBJECTIVE: The aim of this study was to demonstrate the need for acceptance testing with digital dental intraoral sensors (DIOS) as the first step of a comprehensive quality assurance (QA) program. STUDY DESIGN: Five commercially available DIOS were tested by using a QA test phantom, satisfying the requirements for intraoral QA testing as specified in American Dental Association Technical Report No. 1094 (TR 1094). All DIOS were evaluated for sensor discrepancies. QA parameters of contrast perceptibility, spatial resolution, dynamic range, and latitude were measured. Optimal radiation exposures for the adult molar bitewing were determined and compared with the diagnostic reference level (DRL), achievable dose (AD), and entrance skin exposure (ESE) for each DIOS. RESULTS: Thirty-five of the 147 DIOS (23.8%) evaluated were found to have discrepancies. The discrepancies included nonuniformity, latent images, delamination, a damaged USB (Universal Serial Bus) connector, and intermittent termination of image acquisition after radiographic exposure without generation of a radiographic image. Only 1 manufacturer's DIOS products were free from defects. The optimal exposure dose for every DIOS was within published limits. CONCLUSIONS: Acceptance QA testing was effective in detecting discrepancies and establishing optimal exposure doses that were within the DRL and AD established by the National Council on Radiation Protection and Measurements and the ESE established by the state of Texas.

Out in the country: rural sexual minority mothers.

Rural and urban sexual minority mothers' parenting experiences related to sexual orientation were compared. Participants were 414 mothers in same-sex relationships with at least one child under the age of 18 years living in their home who was planned with their current partner. Rural mothers were more likely to be biological parents and not adoptive parents. Rural mothers reported higher rates of discrimination from strangers and people in service or helping professions. Although outness for rural and urban mothers did not differ, for children, classmates' parents and neighbors were less likely to know the family's status in rural areas. Rural and urban mothers did not differ on internalized homophobia, social support, or stigma consciousness. Clinical and policy implications are discussed.

Tongue piercing: case report and ethical overview.

A case of infection following piercing of the tongue is presented. A dentist allegedly provided local anesthesia to the tongue prior to piercing. To avoid criticism from the first dentist, the patient saw a different dentist to treat the infection. The patient had symptoms of pain, inflammation, purulence, salivary incontinence, and difficulty speaking and swallowing. The ornament was discarded and the infection was resolved with antibiotic therapy. Ethical issues of administering anesthesia prior to piercing also are discussed.