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radiation protection in dentistry. Dr. Krisztián Csomó. What are we protecting ?. Patient Ourselves Colleagues Environment. The 3 bases of radiation protetcion. Reasonable Benefit > Risk Optimization ALARA ( As Low As Reasonably Achievable ) Dose limitation. Equipment.
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radiationprotection in dentistry Dr. Krisztián Csomó
Whatare we protecting? • Patient • Ourselves • Colleagues • Environment
The 3 bases of radiationprotetcion • Reasonable • Benefit > Risk • Optimization • ALARA (AsLowAsReasonablyAchievable) • Doselimitation
Equipment • Dentist and staff • Service and controll • ALARA • Staffprotection • Patientprotection
Dentist and staff • Protectyourself! • Distanceprotection • Protectingwall • Never hold the film in yourownhands!!!!!!
Distanceprotection • The intensity of radiation is in reverseproportiontothedistancesquared • Useable in placeswhereonly a fewpicturesare made (max 50 per week) • The minimaldistance is 2 meters (preferably 3 m) • The personaccompanying a minor can’t be pregnant, orunder 18, also has towear a protectingsuit!
Protectingwall • The bestoption: Protectedcabin • The wallcan be made of: • brick • concrete • Lead betweenwoodenplates • In case of lowcirculation: protectingwall • Atleast 1.5 m fromthefocus of the X-raymachine • Atleast 2 m high • Atleast 0.7 mm lead-equivalent • Ateye-level: 600 cm2 1 mm lead-equivalent lead-glasswindow
Licensing • Standardized, givenbytheHungarianhealth and safetyboard (ANTSZ). • It is PROHIBITED totake an X-raywithout a permit!
Whatprotectsthepatientprotectsthestaffaswell • The X-ray image must be justified • The persontakingthepicture must be welltrained, must haveadequateskills and nottakeunnecessaryrepeats • The chosentechnique must: • Be quick • Havethelowestachievableradiationdose • Be targeted • Be ableto be storedforfuturereference • Filmholder • Headchair • Sensitive film – digitalradiography • Knowingthelimits of ourpatient – anatomicalaswellasmentallimits • Lead apron • Use of a tube of adequategeometry
Equipment We havetochoose: • Which is the most ideal X-raymachineforourpurposes • What is ourpurpose: • The lowestachievableradiationdose • The highestachievable image quality • A lowerdose of diffuseradiationcanusually be achievedusing modern equipment • Howdoesthedigitalsystemhelp?
Radiationprotection in regards of digitalradiography • The radiationdose is lowercomparingintraoralimages • Can be storedelectronically, imagesareeasilymultiplied and thereby no needfor re-takes • The benefits of thesoftware: • No needfor re-takes • Over- orunderexposedimagescan be salvaged • The contrast and thedefinitioncan be modified
Maintenance and control • Optimallocalization • Maintenanceevery 2 years (the program is abletomeasurethis) • Radiation and electricinsulationneedsto be controlledregularly • The expositionvalueneedsto be standardized • Keeptrack of theamortization!
Always monitor yourownradiationexposure! • It is very important toknowthedoseyouhavebeenexposedtoconsideringthestochasticeffetcts!
Protectionquantities • Minorsarenotallowedtowork in a radiatingenvironment • Pregnantcolleague! The fetus is entitledtotheresidentiallevels of exposure!
Control of theoccupationalexposure • 1. Measuring • 2. Registration, summarization, control (every 3 months) • 3. Protectionmeasurements
Measuring • Termoluminescent-dosimeter (TLD) • (Film dosimeter) • Must be wornatalltimeswhileatwork!!!