Dental radiography-prescribing practices: a nationwide survey of dental hygienists.

Potential harm from ionizing radiation has led to the development of guidelines to protect patients and practitioners from unnecessary radiation exposure; however, these guidelines may or may not be followed in practice. This study surveyed US dental hygienists with regard to radiology policies in the workplace. The survey, consisting of 62 knowledge and practice items regarding use of dental radiography, was based on the 2012 publication by the American Dental Association (ADA) and the US Food and Drug Administration (FDA): Dental Radiographic Examinations: Recommendations for Patient Selection and Limiting Radiation Exposure. The survey link was emailed to 10,000 subscribers of the Dimensions of Dental Hygiene magazine and posted on the magazine's Facebook page. Five hundred seventeen dental hygienists completed the survey. Data analysis included descriptive statistics, cross-tabulations, and chi-square analyses. Approximately 45.9% of respondents reported that the dentist determined the need for radiography, and 41.8% reported that the decision was made by the dental hygienist. The majority of respondents (82.4%) reported that there were times when a clinical examination was not performed before imaging, and 69.9% reported that images had been ordered on the basis of a set time interval. Approximately 35.6% reported that images had been requested on the basis of the patient's insurance reimbursement. For adult recall patients with no clinical caries and low caries risk, general and corporate dental practices made bitewing radiographs more frequently (every 12 months) compared with educational institutions (P < 0.05). In the case of children and adolescent recall patients without caries and with low caries risk, for children, corporate dental practices made bitewing radiographs more frequently (every 6 months) than educational institutions (P < 0.05); for adolescent patients, corporate and general dental practices preferred to make bitewing images every 12 months, whereas educational institutions preferred to make bitewing images every 18 months (P < 0.05). The findings suggest that some dental practices are not strictly following the ADA/FDA guidelines with regard to frequency of radiographic exposures.

Advances in diagnostic imaging for pathologic conditions of the jaws.

Advances in dental and maxillofacial imaging are delineated along with the advantages and disadvantages of each imaging modality. The imaging modalities that are included are intraoral radiography, panoramic radiography, cone-beam computed tomography, multidetector computed tomography, magnetic resonance imaging, nuclear medicine, and ultrasound.

Panoramic radiography: digital technology fosters efficiency.

Panoramic imaging continues to be a clinically popular tool in the diagnosis and assessment of dental patients. Digital technology improves the efficiency of the imaging system, may reduce overall costs and radiation risk, and aids in optimal interpretation of the image.

Computer-aided dental identification: an objective method for assessment of radiographic image similarity.

A pilot study evaluated a computer-based method for comparing digital dental images, utilizing a registration algorithm to correct for variations in projection geometry between images prior to a subtraction analysis. A numerical assessment of similarity was generated for pairs of images. Using well-controlled laboratory settings, the method was evaluated as to its ability to identify the correct specimen with positive results. A subsequent clinical study examined longitudinal radiographic examinations of selected anatomical areas on 47 patients, analyzing the computer-based method in making the correct identification based upon a threshold level of similarity. The results showed that at a threshold of 0.855, there were two false negative and two false positive identifications out of 957 analyses. Based on these initial findings, 25 dental records having two sets of full mouth series of radiographs were selected. The radiographs were digitized and grouped into six anatomical regions. The more recent set of films served as postmortem images. Each postmortem image was analyzed against all other images within the region. Images were registered to correct for differences in projection geometry prior to analysis. An area of interest was selected to assess image similarity. Analysis of variance was used to determine that there was a significant difference between images from the same individual and those from different individuals. Results showed that the threshold level of concordance will vary with the anatomical region of the mouth examined. This method may provide the most objective and reliable method for postmortem dental identification using intra-oral images.

Infection control practices in dental radiology.

The potential for cross-contamination in dental radiology is extremely high, especially when intraoral radiographs are exposed and processed. This report describes specific infection control practices that are recommended to decrease the potential for cross-contamination in dental radiology and reduce the likelihood of disease transmission.

Reporting of child abuse: a follow-up survey of Texas dentists.

PURPOSE: Child abuse is a disturbingly common finding in society today. There have been substantial and significant increases in the incidence of child abuse since the last national incidence study was conducted in 1986. Kassebaum first reported the under-reporting of child abuse by Texas dental professionals in a survey in 1986. The objective of the current study was twofold: (1) assess the level of knowledge and attitudes among dental professionals on the important issue of child abuse; (2) evaluate and compare the results of the current study with a similar survey conducted in 1986. METHODS: A 24-question survey similar in format and content to the 1986 questionnaire was mailed to 1,046 Texas dentists, randomly selected from a membership roster provided by the Texas Dental Association. Both general dentists and selected specialists were included in the study group. The questionnaire consisted of multiple-choice and dichotomous yes/no questions. RESULTS: There were 383 responses to the questionnaire, yielding a response rate of 38%. The majority (N=289) of the respondents were general dentists. In answering questions about suspected and reported cases of child abuse, nearly 50% of the responding dentists reported they had suspected at least 1 case of child abuse. In the 1986 study, only 36% of the responding dentists reported they had suspected at least 1 case of child abuse. Between 1986 and 2001, the survey has shown that the percentage of dentists who reported at least 1 case to authorities slightly increased from 19% in 1986 to 25% in 2001, but the ratio of suspected to reported cases had not changed since 1986. CONCLUSIONS: Although the composite percentage of suspecting and reporting cases of child abuse from this survey is higher than the percentage demonstrated in 1986 study, there was no significant change in the relative ratio of reported cases to suspected cases in both surveys. This indicates that under-reporting of child abuse cases is still a significant problem in the dental profession in Texas.