Assessment of Regional Diagnostic Reference Levels in Dental Radiography in Tamil Nadu.

Aim: The aim of this article is to assess Tamil Nadu adult diagnostic reference levels (DRLs) by collecting radiation dose data from the four different dental modalities. Materials and Methods: The study was carried out using routine adult exposure settings in 131 intraoral, 75 panoramic, 35 cephalometric, and 10 dental cone beam computed tomography (CBCT) X-ray devices. DRLs were assessed for intraoral and extraoral (panoramic, cephalometric, and CBCT) examinations in terms of incident air kerma (Ka, i) and kerma area product (PKA), respectively. Air kerma measurements, for all dental units, were made using calibrated RTI black Piranha 557 dosimeter (RTI Electronics AB, Sweden). The dosimeter was kept at the exit cone of the X-ray tube and on the detector side of the X-ray unit for intraoral and extraoral air kerma measurements, respectively. The obtained air kerma in extraoral modalities is multiplied with the beam area to evaluate PKA. Results: The third quartile values calculated from the median for adult intraoral (mandibular molar), panoramic, cephalometric, and CBCT were 1.5 mGy, 116 mGycm2, 40 mGycm2, and 532 mGycm2, respectively. The proposed DRL in the present study was comparable to those reported in Germany, Greece, the UK, Japan, and Korea. Conclusion: This study revealed the need for dose management and radiation dose optimization, in various dental facilities in the state. It was also found that dental facilities employed with the digital type of detector are not always related to lower exposure.