As a dental assistant in Florida, one of the most important roles you will be involved with is diagnostic imaging, especially taking dental X-rays. X-rays enable the dentist to view structures hidden beneath a patient’s teeth and gums. This provides the dental professionals with an excellent opportunity to diagnose cavities, infections, bone loss, or other defects in the teeth. A dental assistant is usually responsible for preparing the patient, positioning the X-ray equipment, and ensuring that the process is performed safely and efficiently.
Step-by-Step Instructions for Dental X-rays
As a dental assistant in Florida-or any other state-you will have some protocol that needs to be done when taking X-rays so you can meet the state’s regulatory requirements alongside having the best quality of patient care. In this blog, we will walk you through the process of taking a dental X-ray, what safety measures you must take, and some helpful tips to help the process go as smoothly as possible.
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- Preparation of the Patient and the Room
Before one even starts the process of X-ray, it is important that the patient and the room are prepared.
Step 1.1: Ensure Proper Equipment
- Ensure availability of all the required equipment: the X-ray machine itself, digital sensor or film, lead apron, and any other protective items.
- Double-check the X-ray machine for proper working conditions and calibration per manufacturer recommendations.
Step 1.2: Medical History Check
- Review medical history for contraindications to taking an X-ray, for instance, pregnancy, unless it is of utmost importance.
- The patient is always asked about a probable pregnancy and the confirmation of the procedure.
Step 1.3: Position the Patient
- Place the patient comfortably in the dental chair.
- Stabilize the head and adjust positioning of the head as needed to properly capture image.
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- Protect the Patient
In most states, including Florida, patient protection and radiation protection are the most important aspects in taking an X-ray. The dental assistants should take all the protective measures to reduce the exposure of the patient to radiation.
Step 2.1: Lead Apron and Thyroid Collar
- Lead Apron: A lead apron should be placed over the chest and the lap of the patient always. Lead apron helps in absorbing the scatter radiation which may reach the body of the patient.
- Thyroid Collar: Place a thyroid collar around the neck of the patient to protect the thyroid gland. The thyroid gland is very sensitive to radiation.
Note: Even though the use of a lead apron is a very common practice, Florida law does not require thyroid collars but as a best practice it reduces unnecessary exposure.
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- Positioning the X-Ray Equipment
Accurate X-ray results are mostly based on proper positioning of both the X-ray equipment and the patient. Misalignment will result in unclear images or a need to retake the X-ray.
Step 3.1: Select X-Ray Type
- Bitewing, periapical, and panoramic X-rays are the most common forms of dental X-rays. The dentist makes the decision of which type should be taken that will be required by the needs of the patient.
O Bitewing X-rays show the teeth and the bone and are the ones usually taken to check for cavities between the teeth and bone loss.
O Periapical X-rays attempt to show as much of the tooth and its root as possible in one image, along with the form and density of the surrounding bone.
O Panoramic X-rays display an image of the entire mouth in a single image: all the teeth, the jaw, sinuses, nasal fossa, and TMJ.
Step 3.2 Position the X-Ray Sensor or Film
- For a digital sensor, the sensor should be placed in the patient’s mouth, taking care to establish proper angulation relative to the tooth or area of interest. Conventional X-ray film requires film placement in the mouth of the patient using a film holder. In many instances positioning devices, or positioning arms can help stabilize the film or sensor and guide the X-ray beam. Step 3.3: Align X-Ray Machine
- Position the X-ray tube with regard to the area of interest in the patient’s mouth. Ensure proper positioning of the tube head so that the X-ray beam is always perpendicular to the sensor or film.
- In precise imaging, the X-ray beam should strike the sensor or film without angulation.
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- Take the X-Ray
Now it is time to actually take the X-ray; however, before you do you want to make sure the patient is comfortable and knows what to expect.
Step 4.1: Ask the Patient to Bite Down
- Bitewing X-rays ask the patient to gently bite down on a bite block or positioning device to hold the sensor or film in place.
- Position the patient to remain as still as possible during the procedure to prevent blurred images.
Step 4.2: Take the X-Ray
- Step behind a protective barrier, or use a lead shield if one is available.
- Turn on the X-ray machine and take the exposure. The length of time of exposure is usually very short, often just a matter of a few seconds.
- Where multiple X-rays are being taken, make sure the patient moves or readjusts between exposures. This might well necessitate adjusting the position of the X-ray machine and sensor or film after each shot.
Tip: With a digital X-ray system, you would normally get to see the X-ray image on the computer screen in practically no time, hence immediate feedback and adjustment is possible.
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- Post-Exposure: Review and Safety Protocols
Step 5.1: Check the Image
- Following exposure, the resultant radiograph should be examined for distortion, underexposure or overexposure indications that a retake should be taken.
- If using film, the X-ray must be processed in accordance with the manufacturer’s recommendations. With digital systems you will immediately review the image on the computer screen.
Step 5.2: Patient Safety and Comfort
- When the X-ray is done, have the patient remove the lead apron and thyroid collar and ask if they need anything else before leaving.
- Give the patient proper aftercare instructions which should include how long it might be before the dentist is able to review the results of the X-rays.
Step 5.3: Dispose and Clean Appropriately
- If you are using disposable barriers such as plastic covers for sensors, dispose of those in accordance with your office’s infection control instructions.
- Clean and disinfect any reusable equipment in accordance with your office’s sterilization procedures.
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- Florida-Specific Guidelines and Regulations
Like most states, Florida has its own set of laws and regulations with regard to radiation safety. Dental assistants will be expected to know and adhere to these regulations, including:
- Radiation Safety Course: This course is required for those dental assistants that take X-rays. This will be state-approved and must successfully pass in order to handle the devices that radiate with utmost care to keep both the patient and the staff that is standing around you safe.
- Lighting: Dental assistants X-raying patients in Florida are required to have updated radiology certification provided by the Florida Board of Dentistry. This is a legally required certification that will ensure you’re properly trained in safe and effective radiographic techniques.
- Exposure Limits: Florida accepts federal recommendations for limiting radiation. You should always use the lowest dose of radiation necessary to capture a diagnostic image. As a dental assistant you will be expected to follow protocols designed to limit radiation exposure to patients and yourself.
Taking dental X-rays as a dental assistant in Florida requires a lot more than operating an X-ray machine, but in fact, it involves multiple aspects: radiology, patient management, and safety. You would follow a step-by-step process: preparation of the patient, positioning of the equipment, taking the X-ray, and observing post-exposure protocols. You help provide important diagnostic information that is usually very useful in the treatment of the patients.
By staying current with specific regulations in Florida, taking the required certification, and always adhering to guidelines concerning radiation safety, you will be doing more than providing the best service-you will also be caring for and ensuring the safety of each patient.