Essentials of Dental Radiography for Dental Assistants and Hygienists

447 Pages·2011·6.589 MB·English

by  Evelyn Thomson, Orlen Johnson

Essentials of Dental Radiography
for Dental Assistants and Hygienists
N I N T H E D I T I O N
Evelyn M. Thomson, BSDH, MS
Adjunct Assistant Professor
Gene W. Hirschfeld School of Dental Hygiene
Old Dominion University
Norfolk, Virginia
Orlen N. Johnson, BS, DDS, MS
College of Dentistry
University of Nebraska Medical Center
Lincoln, Nebraska
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10 9 8 7 6 4 3
ISBN-13: 978-0-13-801939-6
www.pearsonhighered.com ISBN-10: 0-13-801939-8
To my husband, Hu Odom, once again your loving patience,
support, and encouragement gets me through.
—Evie
Contents
Preface ix
Acknowledgments xi
Reviewers xii
PART I: Historical Perspective and Radiation Basics 1
Chapter 1 History of Dental Radiography 1
Chapter 2 Characteristics and Measurement
of Radiation 8
Chapter 3 The Dental X-ray Machine: Components
and Functions 20
Chapter 4 Producing Quality Radiographs 32
PART II: Biological Effects of Radiation and Radiation Protection 47
Chapter 5 Effects of Radiation Exposure 47
Chapter 6 Radiation Protection 57
PART III: Dental X-ray Image Receptors and Film Processing
Techniques 74
Chapter 7 Dental X-ray Film 74
Chapter 8 Dental X-ray Film Processing 83
Chapter 9 Digital Radiography 97
PART IV: Dental Radiographer Fundamentals 114
Chapter 10 Infection Control 114
Chapter 11 Legal and Ethical Responsibilities 131
Chapter 12 Patient Relations and Education 138
PART V: Intraoral Techniques 147
Chapter 13 Intraoral Radiographic Procedures 147
Chapter 14 The Periapical Examination—Paralleling Technique 161
Chapter 15 The Periapical Examination—Bisecting Technique 179
Chapter 16 The Bitewing Examination 196
Chapter 17 The Occlusal Examination 215
vii
viii CONTENTS
PART VI: Radiographic Errors and Quality Assurance 227
Chapter 18 Identifying and Correcting Undiagnostic Radiographs 227
Chapter 19 Quality Assurance in Dental Radiography 241
Chapter 20 Safety and Environmental Responsibilities
in Dental Radiography 251
PART VII: Mounting and Viewing Dental Radiographs 264
Chapter 21 Mounting and Introduction to Interpretation 264
Chapter 22 Recognizing Normal Radiographic Anatomy 273
Chapter 23 Recognizing Deviations from Normal Radiographic
Anatomy 289
Chapter 24 The Use of Radiographs in the Detection of Dental
Caries 303
Chapter 25 The Use of Radiographs in the Evaluation of Periodontal
Diseases 314
PART VIII: Patient Management and Supplemental Techniques 325
Chapter 26 Radiographic Techniques for Children 325
Chapter 27 Managing Patients with Special Needs 340
Chapter 28 Supplemental Radiographic Techniques 350
PART IX: Extraoral Techniques 364
Chapter 29 Extraoral Radiography and Alternate Imaging
Modalities 364
Chapter 30 Panoramic Radiography 377
Answers to Study Questions 403
Glossary 407
Index 423
Preface
The study of oral radiological principles and the practice of oral radiography techniques require an under-
standing of theoretical concepts and a mastery of the skills needed to apply these concepts. Essentials of
Dental Radiography for Dental Assistants and Hygienistsprovides the student with a clear link between
theory and practice. Straightforward and well balanced, Essentials of Dental Radiography for Dental
Assistants and Hygienistsprovides in-depth, comprehensive information that is appropriate for an intro-
ductory course in dental radiography, without overwhelming the student with nonessential information. It
is comprehensive to prepare students for board and licensing examinations and, at the same time, practi-
cal, with practice points, procedure boxes, and suggested lab activities that prepare students to apply the-
ory to clinical practice and patient management.
True to its title, Essentials of Dental Radiography for Dental Assistants and Hygienists clearly
demonstrates its ability to explain concepts that both dental assistants and dental hygienists must know.
The examples and case studies used throughout the book include situations that pertain to the roles of both
dental assistants and dental hygienists as members of the oral health care team.
Essentials of Dental Radiography for Dental Assistants and Hygienistsis student-friendly, beginning
each chapter with learning objectives from both the knowledge and the application levels. Each objective
is tested by study questions presented at the end of the chapter, allowing the student to assess learning out-
comes. The objectives and study questions are written in the same order that the material appears in the
chapter, guiding the student through assimilation of the chapter content. Key words are listed at the begin-
ning of each chapter and bolded within the text with their definitions, and realistic rationales for learning
the material are presented in each chapter introduction. The chapter outline provides a ready reference to
locate the topics covered. Meaningful case studies relate directly to radiological applications presented in
the chapter and challenge students to apply the knowledge learned in the reading to real-life situations
through decision-making activities.
The thirty chapters of the ninth edition are organized into nine topic sections.
• Historical Perspective and Radiation Basics
• Biological Effects of Radiation and Radiation Protection
• Dental X-ray Image Receptors and Processing Techniques
• Dental Radiographer Fundamentals
• Intraoral Techniques
• Radiographic Errors and Quality Assurance
• Mounting and Viewing Dental Radiographs
• Patient Management and Supplemental Techniques
• Extraoral Techniques
Educators can easily utilize the chapters and topic sections in any order and have the option to tailor
what material is covered in their courses. The sequencing of material for presentation in this text begins
with the basics of radiation physics, biological effects, and protection to give the student the necessary
background to operate safely, followed by a description of the radiographic equipment, film and film pro-
cessing, and digital image receptors to help the student understand how radiation is utilized for diagnostic
purposes. Prior to learning radiographic techniques, the student will study the fundamentals of infection
control, legal and ethical responsibilities, and patient relations. The student will then be prepared to begin
to practice the intraoral technique skills necessary to produce diagnostic-quality periapical, bitewing, and
occlusal radiographs and learn to mount, evaluate, and interpret the images. Following the interpretation
chapters, the student will now possess the basic skills of intraoral radiography and is ready to grasp sup-
plemental techniques and alterations of these basic skills by studying management of special patients and
extraoral and panoramic techniques.
ix
x PREFACE
Changes made to this ninth edition represent educators’requests for an up-to-date book that speaks
to both dental assisting and dental hygiene students, provides comprehensive information without over-
whelming the student with nonessential details, and is student centered. Outstanding features of this edi-
tion include the following:
• Integration of digital imaging where appropriate throughout the text. Film-based imaging is an
established standard of care, and licensing board examinations continue to require oral health
care professionals to demonstrate a working knowledge of the use of film-based radiography.
However, digital imaging has become an integral part of oral health care practice. For this reason,
the all-encompassing term image receptoris used to allow educators the option to teach the use of
film, solid-state digital sensors, or photostimuable phosphor plate technology. Additionally the
chapter on digital imaging has been moved from the section on supplemental techniques to a
position earlier in the book to assist with integration of this technology as the student learns the
basics of radiography.
• The paralleling and bisecting techniques have been separated into their own chapters to provide dis-
tinct lessons for the student. Teaching strategies suggest that introducing two similar, but difficult,
concepts together may impede learning either technique well. Placing these two important radi-
ographic techniques into their own chapters will allow the educator to assign one or the other in any
order and at distinctly different times in the curriculum.
• The addition of the chapter on safety and environmental responsibilities in radiography is in
response to the awareness of the ecological impact of oral health practice today. Students should be
trained in the safe handling and environmentally sound disposal of potentially hazardous materials
and chemicals used in radiography.
• Update on extraoral radiography and alternate imaging modalities. It is beyond the scope of this
book to teach extraoral maxillofacial imaging to competency, and many oral health care profession-
als who may be called on to utilize these techniques will most likely require additional training.
Therefore, the information on the seven common techniques was condensed to key points and
placed into a table that enhances learning without overwhelming the student. This chapter now
builds on the students’knowledge of digital imaging with an introduction to cone beam computed
tomography (CBCT), purported to become the standard of care for periodontal implant assessment
in the future.
• Each chapter was critically evaluated to update material, add new study questions, redraw complex
illustrations, and include new images, all to enhance student comprehension.
• Each of the 30 chapters in the ninth edition continues to provide Procedure Boxes, which highlight
and simplify critical steps of radiographic procedures and serve as a handy reference when provid-
ing radiographic services in a clinical setting; Practice Points, which call student attention to possi-
ble use of theory in real-life situations, providing a “mental break” from studying theory by
illustrating how that theory is applied; and Case Studies and activities for possible lab exercises,
research outside class time, essay writing, and investigation using the Internet.
The focus of the ninth edition of Essentials of Dental Radiography for Dental Assistants and
Hygienists is on the individual responsibility of the oral radiographer and conveys to the reader the
importance of understanding what ionizing radiation is and what it is not; protecting oneself, the patient,
and the oral health care team from unnecessary radiation exposure; practicing within the scope of the
law and ethically treating all patients; producing diagnostic-quality radiographs and appropriately cor-
recting errors that diminish radiographic quality; knowing when and how to apply supplemental tech-
niques; and assisting in the interpretation of radiographs for the benefit of the patient.
WhereasEssentials of Dental Radiography for Dental Assistants and Hygienistsis written primar-
ily for dental assisting and dental hygiene students, practicing dental assistants, dental hygienists, and
dentists may also find this book to be a helpful reference, particularly when preparing for a relicensing
examination in another jurisdiction. Additionally, Essentials of Dental Radiography for Dental Assis-
tants and Hygienistsmay be a valuable study guide for on-the-job-trained oral health care professionals
who may be seeking radiation safety certification credentials.
Acknowledgments
Thank you to Dr. Orlen Johnson for his continued confidence in allowing me to coauthor this ninth edition
ofEssentials of Dental Radiography for Dental Assistants and Hygienists.It is a privilege to be associated
with a textbook with this long-standing history. Thank you to everyone at Pearson for their guidance and
patience. I particularly want to express appreciation to Mark Cohen, editor-in-chief, who 14 years ago
guided my first efforts at textbook writing; Melissa Kerian, associate editor, who has worked patiently
with me on several book editions now; and John Goucher, executive editor, who has kindly encouraged
me and listened to my ideas. The quality of this edition is the direct result of the assistance and support of
the students, faculty, and staff at the Gene W. Hirschfeld School of Dental Hygiene at Old Dominion Uni-
versity, Norfolk, Virginia. I would like to express my special appreciation to the class of 2011 for helping
me to remember why I so enjoy teaching oral radiology.
Evie Thomson
xi
Reviewers
Roberta Albano, CDA, RDH Jean Magee, RDH, Med
Springfield Technical College NHTI Community College
Springfield, Massachusetts Concord, New Hampshire
Dr. Robert Bennett Jennifer Meyer, RDH, BSDH
Texas State Technical College Southern Illinois University
Harlingen, Texas Carbondale, Illinois
Joanna Campbell, RDH, MA Ann Prey RDH, MS
Bergen Community College Milwaukee Area Technical College
Paramus, New Jersey Milwaukee, Wisconsin
Armine Leila Derdiarian, DDS Judith E. Romano, RDH, MA
Oxnard College Hudson Valley Community College
Oxnard, California Troy, New York
Barbara R. Ellis, RDH, MA Jennifer S. Sherry, RDH
Monroe Community College Southern Illinois University
Rochester, New York Carbondale, Illinois
Mary Emmons, RDH, MSEd Jane H. Slach BA
Parkland College Kirkwood Community College
Champaign, Illinois Cedar Rapids, Iowa
Joy L. Evans, RDA, EFDA, BS Gail Renee St. Pierre-Piper, RDH, MA
IntelliTec College Iowa Central Community College
Grand Junction, Colorado Fort Dodge, Iowa
Ann Gallerie, AAS, RDA Desiree Sutphen, BA
Hudson Valley Community College Volunteer State Community College
Troy, New York Gallatin, Tennessee
Carol Anne Giaquinto, CDA, RDH, MEd Victoria Viera CDA, RDA
Springfield Technical College Missouri College
Springfield, Massachusetts Saint Louis, Missouri
Martha L McCaslin, MA Darlene Walsh,RDH, EdM
Dona Ana Community College State University of New York—Orange
Las Cruces, New Mexico Middletown, New York
Frances McConaughy RDH, MS Janice M. Williams, BSDH, MS
Weber State University Tennessee State University
Ogden, Utah Nashville, Tennessee
xii