COURSE DESCRIPTION

Studies radiation physics, biology, safety, and exposure techniques for intra- and extra-oral radiographic surveys. Laboratory provides practice in exposure, processing methods, mounting, and interpretation or normal findings. Lecture 2 hours. Laboratory 3 hours. Total 5 hours per week.

GENERAL COURSE PURPOSE

To instruct the dental hygiene student in exposing, processing, mounting, and interpretation of dental radiographs.

ENTRY LEVEL OF COMPETENCIES

Successful completion of one semester of dental hygiene.

COURSE OBJECTIVES

Upon completion of this course, the student will be able to accomplish the following objective with at least 75% of competency.

1. Apply the principles of radiation physics related to x-ray production in the dental office, including the concepts of voltage, amperage, current, KVP, MAS, and timing.
2. Identify the factors which may affect the quality of the finished radiograph.
3. Demonstrate an understanding of the principles of radiation safety and hygiene during clinical procedures.
4. Discuss the legal factors which must be considered regarding the exposing and utilization of dental radiographs.
5. Describe the basic principles of shadow casting and apply these to projection of the x-ray beam and film placement.
6. Explain and demonstrate accurate film placement and angulation for periapical and bitewing projections using the paralleling technique.
7. Explain and demonstrate accurate film placement and angulation for the bisecting-angle technique, and bitewing and occlusal projections.
8. Discuss the advantages and disadvantages of the panoramic radiograph as compared to full mouth radiographs, and its limitations as a diagnostic aid in dentistry.
9. Identify normal anatomical landmarks that can be observed radiographically using periapical, bitewing, occlusal, and panoramic radiographs.
10. Distinguish radiographically between normal landmarks and deviations from normal.
11. Identify various pathologic conditions that can be observed radiographically.
12. State the advantages, disadvantages, and limitations for utilizing radiographs as a diagnostic aid in dentistry.
13. Utilize a through and systematic sequence for viewing radiographs and determining deviations from normal.
14. Explain the chemical reactions taking place during each step involved in processing radiographs.
15. Identify radiographic artifacts that are due to improper techniques in radiographic processing.
16. Discuss the operational mechanism of automatic film processing equipment.
17. Utilize dental radiographs in detecting factors which might influence or alter dental hygiene procedures.
18. Identify various common developmental abnormalities that can be viewed radiographically.
19. Discuss the discovery of x-rays.
20. List the properties of electromagnetic radiation.
21. Compare the wavelengths of the various electromagnetic radiations and be able to relate this to their penetrating power.
22. Differentiate between hard and soft rays.
23. Discuss the ionization process.
24. Define: primary radiation, useful beam, leakage, secondary radiation, stray radiation, scatter radiation, ionizing radiation.
25. Differentiate between genetic and somatic tissue and state those which are more radiosensitive.
26. Discuss the types of cells within organs which are more radiosensitive.
27. Discuss the cumulative effect of x-radiation.
28. Distinguish between chronic and acute overexposure.
29. Define the term "latent period".
30. Describe the first most likely reaction to radiation overexposure.
31. Discuss the results of overexposure of radiation to the reproductive organs.
32. Discuss the taking of x-rays for pregnant women.
33. Define: threshold exposure; erythema dose; permissible dose.
34. Discuss the reasons why patients may object to dental x-ray and be able to answer these objections intelligently.
35. Compare the radiation to the reproductive cells from a complete radiographic series (CRS) with that from background radiation.
36. Describe ways in which the operator of a dental x-ray machine may protect himself from primary radiation, secondary radiation and x-ray leakage and discuss the monitoring system.
37. Discuss ways to protect the patient from excess radiation.
38. Discuss the MPD (radiation protection guide).
39. Discuss the average number of radiographic sets required from birth to 30 years of age and the ages at which these are taken.
40. Discuss in detail the production of x-rays, including: collimation, filtration, Kilovoltage, milliamperagae, milliampere seconds, distance (object-film; source-film).
41. Describe the makeup of dental radiographic film and state two purposes for the lead backing in dental film packets.
42. Describe the areas in which the various sizes of film packets are used.
43. Discuss the uses of extraoral films.
44. Differentiate between film holders and cassettes; screen film and non-screen film.
45. Discuss what is meant by "latent image".
46. Describe how black, gray and white areas are produced on exposed film.
47. Differentiate radiopaque and radiolucent.
48. Describe the basic set-up of a processing tank and a dark room.
49. Process exposed radiographic films so that they are diagnostically acceptable (in terms of processing quality).
50. List the components of the developer and give the function of each.
51. State the result of leaving the film in the developer: for too long a period of time or for too short a period of time.
52. State the reason for washing the film after developing and before fixing.
53. List the components of the fixer and give their functions.
54. Define the term "anatomical landmark".
55. Describe two types of bone found in the alveolar arch.
56. Given a slide or radiograph, be able to identify: cortical bone, lamina dura, cancellous bone, alveolar crest, periodontal membrane space.
57. Given a radiograph, be able to identify all landmarks normally seen in the maxillary and mandibular arches.
58. Describe the appearance of caries on radiographs, and given a radiograph, be able to identify geometric artifacts which simulate caries.
59. Describe and demonstrate the correct placement of the radiographic film for exposing a "bitewing" series.
60. Describe and demonstrate patient head position and vertical and horizontal direction of the central beam in exposing a "bitewing" series.
61. Differentiate (+), (-) and (o) angulation of the central beam.
62. Mount films in a series holder according to anatomical landmarks label the mounts correctly.
63. Describe and demonstrate, using the bisecting technique the correct film placement, film securement, patient's head position, and vertical and horizontal angulation of the central beam for mandibular and maxillary periapical exposures of:

1. central incisor/laterals
2. cuspid
3. bicuspids
4. molars
5. Bitewings

64. Given a series of periapical radiographs, mount each in a holder according to anatomical representation, label the mount and store properly.
65. State the geometric theory behind the bisection of the angle technique of periapical radiography.
66. Describe and demonstrate, using the paralleling technique, the correct film placement and securement, patient's head position, and vertical and horizontal angulation of the central beam for mandibular and maxillary periapical exposures of:

1. central incisors
2. cuspid/laterals
3. bicuspids
4. molars
5. accessory 3rd molars

67. Given a series of processed periapical exposures (paralleling techniques), evaluate each for diagnostic quality.
68. Contrast the geometric theories of bisecting and paralleling radiographic techniques.
69. Compare the quality of radiographic exposures obtained through bisecting and paralleling techniques.
70. State cases in which occlusal exposures are necessary.
71. State and demonstrate the procedure for exposing an anterior occlusal radiograph of the maxillary and mandibular arches and a cross-section occlusal view of the maxillary and mandibular arches.
72. Describe the Panorex unit, technique, exposure time and resulting radiograph.
73. Expose a panoramic survey.
74. Given patient history, describe and identify on radiographs: caries, anodontia, oligodontia, supernumerary teeth, macrodontia, dens in dente, gemination, root dilaceration, enamel hyperplasia, cementicle, concrescence, enamel aplasia, enamel hypoplasia, root canal.
75. Describe the possible etiology of external and internal root resorption and be able to identify both on radiographs.
76. Given a radiograph, identify retained root tips and root fractures.
77. Identify radiolucent lesions associated with pulpal diseases; radiopaque lesions.
78. Given radiographs identify periapical abscesses.
79. Define the term "cyst"; describe its appearance, and given a radiograph identify:

1. radicular cysts
2. fissural cysts
3. residual cysts
4. follicular cysts

80. Given a patient with a strong gag reflex, implement procedures to minimize gagging in completing diagnostically acceptable radiographic series.