Dentistry Chapter 01 Briefly state the importance of dental images

TEACH Lesson Plan

IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition

Module 1 Radiation Basics Answer Key

CHAPTER 1: RADIATION HISTORY

Basic Terminology Crossword Puzzle

Down

1. x-radiation

Across

4. radiation

Completion and Short Answer

History Highlights

1. Wilhelm Conrad Roentgen discovered x-rays.

Importance of Dental Images

1. Detection is one of the most important uses of dental images.

Uses of Dental Images

1. Dental images are used to detect lesions, diseases, and conditions of teeth and surrounding

structures that cannot be identified clinically.

2. Dental images are used to confirm or classify suspected disease.

Ordering

Highlights in Dental Imaging

History

Arrange in order of discovery from earliest to latest.

4 1. Introduction of panoramic imaging 1948

Module 1: Radiation Basics 2

TEACH Lesson Plan

CHAPTER 2: RADIATION PHYSICS

Basic Terminology Crossword Puzzle

Across

1. wavelength

Down

2. electromagnetic

Identification and Labeling

Dental X-Ray Machine

1. control panel

Dental X-Ray Tube

1. tungsten target

Dental X-Ray Tubehead

1. x-ray tube

Short Answer

Production of Dental X-Rays

1. Describe the production of x-rays in the x-ray tube illustrated in Fig. 2-5.

A. When the filament circuit is activated, the filament heats up, and thermionic emission occurs.

Module 1: Radiation Basics 3

TEACH Lesson Plan

IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition

2. Describe how “cat → nap” can help you to remember the flow of the electrons in the x-ray tube.

Multiple Choice

Properties of X-Rays

1. appearance X-rays are visible / invisible.

2. mass X-rays have weight / no weight.

CHAPTER 3: RADIATION CHARACTERISTICS

Basic Terminology Crossword Puzzle

Across

1. high

Down

2. half-value layer

Multiple Choice

Contrast

1. low contrast = long / short scale contrast = many / few shades of gray

Select All That Apply

Exposure Factors and Density

1. An image that is dark (increased density) may result from:

Module 1: Radiation Basics 4

TEACH Lesson Plan

2. An image that is light (decreased density) may result from:

Completion

Contrast

1. high contrast

Range of kV and mA

Distances

1. target-surface

Short Answer

X-Ray Beam Quality and Quantity

1. Describe how kilovoltage and milliamperage relate to x-ray beam quality and quantity. Kilovoltage

Inverse Square Law

1. If the PID length is changed from 8 to 16 inches, how does the increase in target–receptor

CHAPTER 4: RADIATION BIOLOGY

Basic Terminology Crossword Puzzle

Across

6. free radical

Down

1. radiation biology

Module 1: Radiation Basics 5

TEACH Lesson Plan

IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition

Completion and Short Answer

Radiation Injury Factors

1. Total dose: more damage occurs when tissues absorb high quantities of radiation.

2. Dose rate: more damage takes place with fast dose rates because repair cannot take place.

6. Stochastic effects: the severity of the response is independent of the dose. Stochastic effects

occur as a direct function of dose. The probability of occurrence increases with increasing

8. List examples of stochastic effects. Examples of stochastic effects include leukemia and cancer

(i.e., tumor) induction.

9. List examples of nonstochastic effects. Examples of nonstochastic effects include skin erythema,

loss of hair, cataract formation, decreased fertility, radiation sickness, teratogenesis, and fetal

death.

10. List the events in the sequence of radiation injury. The observable effects of radiation are not

Radiation Effects

1. Short-term effects are associated with large amounts of radiation absorbed in a short period of

time.

Risk vs. Benefit

1. When dental images are properly prescribed and exposed, the benefit of disease detection

outweighs the risk of damage.

Module 1: Radiation Basics 6

TEACH Lesson Plan

IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition

Identification

Radiation Effects on Tissues and Organs

Identify each tissue/organ listed as either RR (radioresistant) or RS (radiosensitive). Place an X near the

three most sensitive tissues/organs. Place a check mark (✔) near the two most resistant tissues/organs.

1. RS X bone marrow

2. RS intestinal mucosa

Identification

Radiation Measurements

Name the radiation units of measurement in both the traditional and SI systems.

Traditional system

SI system

Patient Exposure and Dose

List four of the six ways to limit patient exposure to x-radiation.

1. receptor choice––sensor or fastest film

CHAPTER 5: RADIATION PROTECTION

Basic Terminology Crossword Puzzle

Across

3. position-indicating device

Down

1. inherent

Module 1: Radiation Basics 7

TEACH Lesson Plan

IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition

Identification, Labeling, and Short Answer

Patient and Operator Protection

1. Identify the part of the tubehead labeled in Fig. 5-1. aluminum filter

Radiation Exposure Guidelines

1. Define MPD. Exposure limits have been established for the general public and persons who work

with radiation. The maximum permissible dose (MPD) for persons who work with radiation (e.g.,

dental radiographers) is 50 mSv/year (0.05 Sv/year or 5.0 rems/year). The MPD for the general

5. List the cumulative occupational dose for a person who is 35 years old. For a 35-year-old worker,

the NCRP would recommend a cumulative occupational dose of no more than 35 x 10 mSv = 350

mSv (0.35 Sv).

minimize risk.

7. Discuss the importance of using a lead apron and thyroid collar to protect a patient from excess

radiation exposure. The lead apron is a flexible shield placed over the patient’s chest and lap to

protect the reproductive and blood-forming tissues from scatter radiation; the lead prevents the

Module 1: Radiation Basics 8

TEACH Lesson Plan

IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition

MODULE 1: CRITICAL THINKING QUESTIONS

1. You explain to a new patient that it is necessary to take dental images at her new patient

appointment. The patient shows signs of concern and asks why it is necessary to have x-rays

taken. How will you respond to this patient?

Answers may vary.

POINTS TO DISCUSS

• Dental radiographs are a necessary component of comprehensive care.

2. A 40-year-old man comes to your office for a new patient examination. The patient reports not

having been to the dentist for the past 8 years. He claims to brush his teeth one time per day but

does not floss. He complains that a few of his teeth have recently become sensitive to hot and

cold. After the oral examination, the dentist orders a complete series of images. While you are

preparing the necessary receptors and holders, the patient asks “why do you need to take so

many x-rays?” How will you respond to this patient?

3. Your office has just reopened after being closed for the holidays. You have been asked to retake

an image that you just took on a patient because the dentist states that, although you captured

the correct tooth, it is of nondiagnostic quality: the film is far too light. What exposure factors will

you check in order to assure the second exposure is of diagnostic quality?

Answers may vary.

POINTS TO DISCUSS

• If using film, check that the film is not expired and has been stored properly. Check

Module 1: Radiation Basics 9

TEACH Lesson Plan

IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition

4. A 43-year-old woman calls your office and wants to become a new patient. She states that she

has not been to the dentist in over 5 years, and she is experiencing pain and discomfort. She

wants to schedule an appointment to see the dentist. You explain to her that her first visit will

consist of a comprehensive examination and a series of x-rays, but she appears apprehensive

and is asking a lot of questions. She wants to know why you need to take x–rays, if dental x-rays

are safe, and how many will be taken. How will you respond to this patient?

Answers may vary.

POINTS TO DISCUSS

• Because this patient has not been to the dentist in years and reports symptoms, a series of

images that include all tooth bearing areas is essential.

5. A new patient in your office is told that she is in need of a complete series of x-rays. She is

concerned about the risks with taking so many x-rays. The patient asks you for more background

information regarding radiation exposure. How will you respond to this patient?

Answers may vary.

POINTS TO DISCUSS

• A dentist cannot make an accurate diagnosis without dental images.

Module 1: Radiation Basics 10

TEACH Lesson Plan

IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition

6. You are assisting the dentist with a new patient, a 35-year-old woman. She has a large swelling

associated with a lower left molar and has not been able to sleep or eat for the past 2 days

because of the pain associated with her tooth. The dentist orders an image of the area. Once the

dentist leaves the room, the patient becomes reluctant to have the image taken because of the

exposure to radiation. How will you respond to this patient? What information can you share with

this patient concerning the protection steps that will be used before, during, and after x-ray

exposure?

7. As you are placing a lead apron and thyroid collar on your patient prior to beginning exposures of

dental images, the patient asks the following questions:

o My last dentist never used a lead apron, was that wrong?

o My child’s dentist does not use an apron. Should I request one?

o Why is this so high around my neck?

How will you respond to this patient?

Answers may vary.

POINTS TO DISCUSS

• A lead apron limits your exposure to scatter radiation and protects other parts of your body

Module 1: Radiation Basics 11

TEACH Lesson Plan

IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition

8. Your dentist employer wants everyone in the office to deliver a uniform message to patients about

lead apron use and how exposure to dental x-rays is limited. She asks you to prepare an example

dialogue and present it to the office staff for their use with patients. What will you prepare to

present to the office staff?