22-11-2012, 06:29 PM
GUIDELINES FOR THE SELECTION OF PATIENTS FOR DENTAL RADIOGRAPHIC EXAMINATIONS – 2004
GUIDELINES FOR.pdf (Size: 60.1 KB / Downloads: 41)
Background
The dental profession is committed to delivering the highest quality of care to each of its
individual patients and applying advancements in technology and science to continually
improve the oral health status of the U.S. population. These guidelines were developed
to serve as an adjunct to the dentist’s professional judgment of how to best use diagnostic
imaging for each patient. Radiographs can help the dental practitioner evaluate and
definitively diagnose many oral diseases and conditions. However, the dentist must
weigh the benefits of taking dental radiographs against the risk of exposing a patient to
x-rays, the effects of which accumulate from multiple sources over time. The dentist,
knowing the patient’s health history and vulnerability to oral disease, is in the best
position to make this judgment in the interest of each patient. For this reason, the
guidelines are intended to serve as a resource for the practitioner and are not intended to
be a standard of care, requirements or regulations.
Introduction
The guidelines titled “The Selection of Patients for X-Ray Examination” were first
developed in 1987 by a panel of dental experts convened by the Center for Devices and
Radiological Health of the U.S. Food and Drug Administration (FDA). The development
of the guidelines at that time was spurred by concern about the U.S. population’s total
exposure to radiation from all sources. Thus, the guidelines were developed to promote
the appropriate use of x-rays. The guidelines have served dentists and other interested
parties well during the subsequent 15 years. In 2002, the American Dental Association,
recognizing that dental technology and science continually advance, recommended to the
FDA that the guidelines be reviewed for possible updating. The FDA welcomed
organized dentistry’s interest in maintaining the guidelines, and so the American Dental
Association undertook this review.
The Guidelines
Radiographs and other imaging modalities are used to diagnose and monitor oral
diseases, as well as to monitor dentofacial development and the progress or prognosis of
therapy. Radiographic examinations can be performed using digital imaging or
conventional film. The available evidence suggests that either is a suitable diagnostic
method (1-3). Digital imaging may offer reduced radiation exposure and the advantage
of image analysis that may enhance sensitivity and reduce error introduced by subjective
analysis (4). In addition, new imaging technology offers the possibility of threedimensional
visualization of skeletal and other structures.
The development and progress of many oral conditions are associated with a patient’s
age, stage of dental development, and vulnerability to known risk factors. Therefore, the
guidelines on page 5 are presented within a matrix of common clinical and patient
factors, which may determine the type(s) of radiographs that is commonly needed. The
guidelines assume that diagnostically adequate radiographs can be obtained. If not,
appropriate management techniques should be used after consideration of the relative
risks and benefits for the patient.