Home Dental Radiology A survey on radiation exposure reduction methods including rectangular collimation for intraoral radiography by pediatric dentists in the United States

A survey on radiation exposure reduction methods including rectangular collimation for intraoral radiography by pediatric dentists in the United States

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Figure 1

Photo of (A) round collimator and (B) rectangular cone.

Figure 2

Obtaining radiographs according to graduation year. Results are shown as percentages of responses for obtaining radiographs for each group of graduates according to year. ADA/AAPD: Follows guidelines of American Dental Association and American Academy of Pediatric Dentistry. Check insurance: Checks insurance coverage before obtaining radiographs. Examination first: Examines patient before obtaining radiographs. Routine: Obtains radiographs at routine intervals, for example, every 6 months.

Figure 3

Awareness of Image Gently Campaign in Dentistry (IGCD). Results are shown as percentages of responses aware of, or not aware of, IGCD and percentages of how respondents learned of IGCD. Totals do not add to 100. Nonresponses are not shown.

Figure 4

Reasons for not using rectangular collimation according to graduation years. Results are shown as percentage of responses by group according to graduation years.

Figure 5

Dose selection according to graduation years. Results are shown as percentage of responses by graduation year. Adult: Uses adult setting only. Child: Uses child setting only. No change: Does not change setting, adult or child not specified. Not sure: Unsure what setting is used.

Abstract

Background

The authors conducted a survey of the American Academy of Pediatric Dentistry (AAPD) to determine awareness of the Image Gently Campaign in Dentistry (IGCD) and to ascertain radiologic practices, including radiation dose-reduction strategies such as rectangular collimation.

Methods

An institutional review board approved an electronic survey sent to 7,087 AAPD members covering practitioner demographic characteristics, radiographic techniques, and dose-reduction practices, including rectangular collimation. Responses were tabulated and analyzed using binomial tests, χ2 tests, and Fisher exact tests.

Results

A total of 1,124 pediatric dentists or residents in pediatric dentistry responded, (response rate 16%, margin of error ± 2.7%). The largest group (23.8%) graduated after 2010. More than 90% indicated that they followed American Dental Association (ADA)-AAPD radiation exposure guidelines, but only 33.5% were aware of IGCD. Almost all respondents used direct digital systems, storage phosphor plates, or both. Only 22.3% (n = 220) used rectangular collimation. Nonusers indicated that they were unfamiliar with collimation (33.3%) or concerned about potential for increased cone cuts (30.2%), 11.6% of respondents were unaware of any regulatory requirements for inspections of radiographic equipment recurring at regular intervals, and 4.1% of respondents considered use of lead aprons optional.

Conclusions

Although the pediatric dentists surveyed believe they are in compliance with ADA-AAPD guidelines, most are unaware of IGCD recommendations. Use of digital radiography is almost ubiquitous, but use of rectangular collimation is limited.

Practice Implications

Dentists treating children should be familiar with ADA-AAPD radiation exposure guidelines and should consider using the dose-reduction strategies recommended by IGCD.



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