Unit 314

Question 1

What do the letters IR(ME)R stand for?

Answer 1

Ionising Radiation (Medical Exposure) Regulations.

Question 2

What does IR(ME)R relate to?

Answer 2

The safety of patients undergoing an x-ray exposure.

Question 3

What are local rules?

Answer 3

They are a practices written policies and protocols regarding the use of x-ray equipment.

Question 4

What should be included within local rules?

Answer 4

• The name of the RPS.
• Names of all who are qualified to make exposures.
• What to do if the machine malfunctions.
• The controlled area.

Question 5

Give 2 reasons why it is important to have a Quality Assurance programme in relation to dental radiographs.

Answer 5

• To keep radiation ALARP by learning from mistakes.

- IR(ME)R regulations have to!

Question 6

What does ALARP stand for?

Answer 6

As low as reasonably possible.

Question 7

What do the initials RPS stand for?

Answer 7

Radiation Protection Supervisor.

Question 8

What responsibilities does the RPS have?

Answer 8

They ensure there are local rules and that all staff are complying with them.

Question 9

What does the latest ionising radiation guides suggest about lead aprons?

Answer 9

They are not needed for any patients.

Question 10

What are the first actions that should be taken in the event of the X-ray unit not functioning properly?

Answer 10

• Switch off
• Place sign on not to use
• Call engineer

Question 11

What precautions should be taken to ensure radiation is used safely in a dental practice.

Answer 11

• Switch off after use
• Only qualified to take
• Only fully trained to process.

Question 12

State two ways in which the ALARP principle is implemented in the dental practice.

Answer 12

• Having a QA programme.
• Only qualified to take.
• fastest film speed.
• Only when clinically necessary.

Question 13

What do the initials RPA stand for?

Answer 13

Radiation Protection Advisor.

Question 14

What are the qualifications and responsibilities of an RPA?

Answer 14

Qualified radiation physicist who advises the supervisor on dosages and ALARP.

Question 15

What is meant by ionising radiation?

Answer 15

Radiation capable of altering the structure of atoms and cells.

Question 16

What are the hazards associated with ionising radiation?

Answer 16

Deterministic or stochastic somatic or genetic.

Question 17

List 3 intra oral radiographs.

Answer 17

• Bitewing
• PA
• Occlusal

Question 18

List 3 extra oral radiographs.

Answer 18

• OPG/ OPT/ DPT/ Pan
• Ceph
• lateral Oblique

Question 19

What is a bitewing radiograph used for?

Answer 19

Detection of inter-proximal/ secondary caries (perio)

Question 20

What is a PA radiograph used for?

Answer 20

Full length for apical pathology/ endo

Question 21

What is an occlusal radiograph used for?

Answer 21

Ortho to detect impacted anterior teeth.

Question 22

What are OPG/OPT/DPT/Pan radiographs used for?

Answer 22

Ortho - development of permanent teeth/ surg 8’s/ TMJ/ cancer/ generalised perio

Question 23

What is a Ceph radiograph used for?

Answer 23

Ortho treatment planning and diagnosis.

Question 24

What is a Lateral Oblique radiograph used for?

Answer 24

As OPG but no anteriors.

Question 25

State two things lateral Oblique radiographs would usually be taken to show.

Answer 25

- Development of permanent teeth. - TMJ - Bitewings for gaggers - Salivary glands.

Question 26

State two disadvantages of using digital radiography over radiographic films.

Answer 26

- Expensive - Pixelates when magnified - Depends on technology

Question 27

How many intensifying screens are there in an extra oral cassette?

Answer 27

2

Question 28

What are intensifying screens in extra oral cassettes used for?

Answer 28

To reduce the amount of radiation needed. The screens are coated in phosphors that fluoresce (emit light) which affect the film rather than the x-rays.

Question 29

What are the stages of processing and exposed x-ray film?

Answer 29

Developer Wash Fixer Wash

Question 30

Describe the developing process of an x-ray

Answer 30

Developer at 18oC - 22oC (ideal 20) for given time of 30 secs - 5 mins. Put lid on to prevent oxidisation.

Question 31

Describe the first wash process of an x-ray.

Answer 31

Agitate in water for a few seconds.

Question 32

Describe the fixing process of an X-ray.

Answer 32

Put in fixer for double the amount of development time (no need to agitate)

Question 33

Describe the last washing process of an X-ray.

Answer 33

Wash under running water for a minimum of 10 mins. (Doubt more than 20)

Question 34

List the layers of an intra-oral X-ray film packet from the collimator through the packet.

Answer 34

Outer wrapping 1st and last. ``` Inside - black paper Card Film Black paper Lead foil ```

Question 35

Which type of radiograph would be most appropriate to show he position of an impacted wisdom tooth?

Answer 35

OPG

Question 36

What colour and wattage should the safety light for manual processing be?

Answer 36

Red - approx 15 watts.

Question 37

A fast film will mean reduced exposure time. Is this statement true or false?

Answer 37

True.

Question 38

Give two advantages of manual processing.

Answer 38

- Less expensive. | - the person has full control or timing and chemicals.

Question 39

Give two disadvantages of manual processing.

Answer 39

- Chemical waste and needs dark room. | - Time consuming.

Question 40

State two advantages of using digital radiography over radiographic films.

Answer 40

- uses less radiation - can manipulate image - instant - nurse does not leave the room

Question 41

Which methods of waste disposal would be suitable for spent processing liquids.

Answer 41

Non infectious hazardous (special) waste.

Question 42

How should the processing liquids be stored?

Answer 42

In a cool, dry cupboard on a low shelf, labelled, sealed and away from radiation.

Question 43

Why is it important to rotate film stock?

Answer 43

Because expired films become fogged.

Question 44

State 3 hazards of handling the processing chemicals used in dental radiography.

Answer 44

- developer oxidises. - fixer is acidic. - irritant.

Question 45

What should you do if you have a chemical spillage of the processing liquids?

Answer 45

Follow manufactures instructions to clear. Ventilate area.

Question 46

What is the ideal time and temperature used to develop a radiographic film?

Answer 46

20oC | 30secs - 5 mins

Question 47

State 4 reasons why a radiography film may appear too dark after processing.

Answer 47

Overdeveloped - developer too hot. Overdeveloped - in developer for too long. Overexposed - wrong setting on machine. Overexposed - taken twice or left in radiation before use.

Question 48

How will a radiograph look if it has been damaged by light?

Answer 48

Black.

Question 49

How will a radiograph look if it has gone over the development time?

Answer 49

Dark.

Question 50

How will the radiograph look if it is under the fixing time.

Answer 50

Opaque and image will fade.

Question 51

How will the radiograph look if it has had inadequate washing time?

Answer 51

White crystalline deposits over film.

Question 52

How will the radiograph look if it is under-strength of developer?

Answer 52

Pale/light image

Question 53

How will the radiograph look if it has handling defects?

Answer 53

Scratches/blotches/lines/prints

Question 54

How will the radiograph look if you have used an out of date film?

Answer 54

Fogged.

Question 55

Why might a radiograph come out clear?

Answer 55

Because they are unexposed films or put through the fixer first.

Question 56

State two stages of a clinical audit of developed radiographs.

Answer 56

- Collate radiographs and grade 1-3 | - Summarise into % and ensure mistakes are noted and learned.

Question 57

What can be used to correctly orientate a periapical radiograph for mounting?

Answer 57

Pimple towards you and patient anatomy.

Question 58

List two ways a patients radiographs can be correctly identified for storage on their records.

Answer 58

Date/ name/ DOB/ Date Taken. Records contemporaneous and patient charting.

Question 59

What could happen if a radiograph is mounted incorrectly?

Answer 59

Wrong treatment may be done.

Question 60

After processing a film the radiograph is given a quality assurance grade of 2. What does that mean?

Answer 60

Diagnostically acceptable.

Question 61

State 3 pieces of information that must be recorded to ensure that dental radiographs can be retrieved and identified for each patient, regardless of how it was taken and processed.

Answer 61

- patients full name/ DOB - Date radiograph was taken. - what radiograph was taken.

Question 62

When would it be necessary to take a Cephlametric Radiograph?

Answer 62

Orthodontic treatment planning and diagnosis.

Question 63

List the role of the dental nurse during the taking of a radiograph.

Answer 63

Ensure all things are sterile. Disinfected before and after. Communication with the patient and ensure the area is clear.

Question 64

There are two major variants of digital image capture devices. Explain each below.

Answer 64

Direct CCD/CMOS metallic digital sensor goes straight onto computer. Indirect latent image on phosphor plate that is scanned (laser) onto computer screen.

Question 65

How do you store radiograph films?

Answer 65

Films need to be upright to prevent artefacts on the film.