COURSE OUTLINE DHT 1032 Dental Radiography 2 Credit Hours Course Description This course prepares the dental hygiene student to expose, process and critique intra and extraoral radiographs for clinical practice. Emphasis is placed on technique and individual patient radiographic need using standardized ALARA concepts. Students process, mount and evaluate radiographs for diagnostic value associated with patient care. Radiation production, biology and safety are required for students to make informed decisions and adjustments for optimum patient care. Prerequisite(s) Acceptance into the Dental Hygiene program Purpose of Course To prepare the student for exposing, processing and interpretation of diagnostic dental radiographs while practicing biologic safety for the clinician and the client. Required Materials Textbook(s): Supplies: Thomson and Johnson. (2011). Essentials of Dental Radiography for Dental Assistants and Hygienists, (9 th Edition). Prentice Hall Thomson and Johnson. (2011). Exercises in Oral Radiography Techniques a Laboratory Manual (3 rd Edition). Prentice Hall Rinn XCP Radiographic Positioning Device (supplied in instrument kit) Snap-a-Ray Positioning Device (supplied in instrument kit) Kwik-Bite Positioning Device (supplied in instrument kit) Learning Outcomes The intention is for the student to be able to. 1. Demonstrate an understanding in radiation safety and exposure. 2. Demonstrate ability to identify intraoral anatomy on a radiograph. 3. Demonstrate the ability to take quality radiographs. Course Competencies Actions that are essential to achieve the learning outcomes: 1. Describe the properties of radiation and its production in a dental X-ray unit. (C5, C7) 2. Describe the biological effects of ionizing radiation, and practice principles of radiation hygiene and safety as they relate to the dental office. (C2, C3, C5)
3. Identify and discuss film characteristics: density, contrast definition and distortion. (C7) 4. Demonstrate the ability to take acceptable images on Dexter. (C3) 5. Demonstrate the ability to expose diagnostically acceptable bitewing, periapical, occlusal and panoramic radiographs on pedodontic and adult patients. (C9) 6. Describe the general principles of darkroom construction, equipment and safe lighting, and process exposed radiographs utilizing proper darkroom procedures. (C3, C7) 7. Correctly mount, label and critique intra and extraoral radiographs. (C9) 8. Differentiate between radiographic anatomical landmarks and abnormal anatomy or findings. (HP4, PC2) 9. Describe and perform the proper maintenance procedures for processing and imaging dental radiographs. (C9) 10. Evaluate radiographs for film quality, technique and processing errors. (C9, C4) 11. Conduct patient education to various age groups utilizing radiographs as an educational tool. (C7, PC10) 12. Determine frequency and type of radiographic exposure based on patient need and clinical considerations. (C1, C2, C3, C4 and C5) 13. Demonstrate proficiency in duplicating radiographs. (C4) 14. Demonstrate proper infection control procedures when exposing radiographs in the clinic and processing in the darkroom or imaging room. (HP6) 15. Develop traditional radiographs, and mount in proper way to be viewed for diagnosis. (C3, C11, PC1) 16. Expose and process images of a complete mouth series on a live patient. (C9, C10, HP6, PC1) Weekly Units I. Week One a. State when x-rays were discovered and by whom b. Trace the history of radiography, noting the prominent contributors. c. List two historical developments that made dental x-ray machines safer d. Explain how rectangular PIDs reduce patient radiation exposure e. Identify the two techniques used to expose dental radiographs f. List five uses of dental radiographs g. Become aware of other imaging modalities available or use in the detection and evaluation of oral conditions h. Draw and label a typical atom i. Describe the process of ionization j. Differentiate between radiation and radioactivity k. Explain the inverse relationship between wavelength and penetrating power of x-rays l. List the properties of x-rays m. Identify and describe the two processes by which kinetic energy is converted to electromagnetic energy within the dental x-ray tube n. List and describe the four possible interactions of dental x-rays with matter o. Define the terms used to measure x-radiation p. Match the Systeme Internationale(SI) units of x-radiation measurement to the corresponding traditional terms q. Identify three sources of naturally occurring background radiation
r. Identify and specify the function of the components of an intraoral dental x-ray machine s. Demonstrate the safe operation of an intraoral dental x-ray machine following a systematic sequence of steps t. Demonstrate safety protocol to protect oneself and other members of the oral health care team during patient exposure. II. Week Two a. Demonstrate the process of exposing and developing traditional radiographs using the automatic processing machine. b. Demonstrate appropriate infection control while exposing and developing traditional radiographs. III. Week Three a. Identify the three major components of a dental x-ray machine b. Identify and explain the function of the five controls on the control panel c. State the three conditions necessary for the production of x-rays d. Label a dental x-ray tube e. Identify the parts of the cathode and explain its function in the production of x-rays f. Identify the parts of the anode and explain its function in the production of x-rays g. Trace the production of x-rays from the time the exposure button is activated until x-rays are released from the tube h. Demonstrate, in sequence, steps in operating the dental x-ray machine i. Evaluate radiographs for quality Differentiate between radiolucent and radiopaque areas on a dental radiograph j. Define radiographic density and contrast k. List the rules for casting a shadow image l. Differentiate between subject contrast and film contrast m. List the factors that influence magnification and distortion n. List the geometric factors that affect image sharpness o. Summarize the factors affecting the radiographic image p. Describe how ma, kvp, and exposure time affect image density q. Discuss how kvp affects the image contrast r. Explain target-surface, object-image receptor, and target-image receptor distances s. Demonstrate the practical use of the inverse square law t. Demonstrate proficiency in placing, exposing, and processing bitewing radiographs IV. Week Four a. Discuss the effects of radiation exposure b. Explain the difference between direct and indirect theories of biological damage c. Identify critical tissues for dental radiography in the head and neck region d. Discuss the risks versus benefits of dental radiographs e. Adopt an ethical responsibility to follow ALARA f. Use the selection criteria guidelines to explain the need for prescribed radiographs g. List the two functions of a collimator h. Advocate the use of the lead/lead equivalent thyroid collar and apron i. Explain the roles time, shielding, and distance play in protecting the radiographer from unnecessary radiation exposure. j. List the organizations responsible for recommending and setting exposure limits
k. State the maximum permissible dose for radiation workers and for the general public. l. Identify the components of a radiographic digital imaging system m. Place and expose a digital sensor and photostimuable phosphor plate to produce a diagnostic quality image n. Demonstrate examples of digital image manipulation that will enhance the diagnostic quality of a digital radiograph V. Week Five a. List and describe the four parts of an intraoral film b. Describe latent image formation c. Match the type of intraoral projection with radiographic need d. Explain the difference between intraoral and extraoral radiographic film e. List the seven conditions that fog stored film f. Explain how a latent image becomes a visible image g. List in sequence the steps in processing dental films h. Discuss the factors that affect safelighting i. Describe the role of rapid chairside processing j. Identify equipment needed for automatic film processing k. List the chemicals used in automatic film processing l. Identify advantages and limitations of digital radiography list and describe five software features used to enhance digital image interpretation m. Discuss digital radiography effect on radiation exposure. n. Demonstrate proficiency in placing, exposing and processing anterior and posterior periapical radiographs using the paralleling technique VI. Week Six a. State the purpose of infection control b. Describe the possible routes of disease transmission c. Identify agencies responsible for recommending and regulating infection control guidelines d. List the personal protective equipment recommended for the dental radiographer e. Explain disinfection and sterilization f. Discuss the federal and state regulations for exposing dental radiographs g. Identify specific risk management strategies for radiography h. Discuss how to manage patients that refuse dental radiographs i. List aspects that help patient relations and gain confidence and cooperation j. State examples of interpersonal skills that are used to communicate effectively k. State why patient education in radiography is valuable l. Demonstrate proficiency in placing, exposing, and processing anterior and posterior periapical radiographs using the bisecting technique VII. Week Seven a. Compare the three intraoral radiographic examinations b. Identify the two intraoral techniques c. Explain horizontal and vertical angulation d. Demonstrate a systematic and orderly sequence of the exposure procedure e. Select the type and number of image receptors required for a full mouth survey f. Identify vertical angulation errors made when using the paralleling technique
VIII. IX. g. List the advantages and disadvantages of the paralleling technique h. Discuss the principles of the bisecting technique i. List the advantages and disadvantages of the bisecting technique j. Locate facial landmarks used for determining the points of entry used with the bisecting technique k. Demonstrate methods of mounting radiographs for viewing l. Locate distinct maxillary and mandibular anatomical landmarks on a radiographic image Week Eight a. Describe the bitewing radiographic technique b. List the four sizes of image receptors that can be used for bitewing surveys explaining advantages and dis advantages of each size c. Compare methods used for holding the bitewing image receptor in positon d. Describe the image receptor placement, horizontal and vertical angulation and point of entry for a vertical anterior bitewing examination e. State the purpose of the bitewing radiograph f. State the purpose of the occlusal examination g. List the indications for the occlusal radiographs h. Determine the areas to be imaged using the topographical and cross-sectional techniques i. Discuss the process of identifying and correcting radiographic errors Week Nine a. Midterm exam b. Demonstrate infection control protocol prior to, during and after the radiographic procedure with practice partner. X. Week Ten a. Apply the appropriate corrective actions for technique errors b. Recognize errors caused by incorrect radiographic techniques c. Recognize and correct errors caused by incorrect radiographic processing d. Recognize and correct errors caused by incorrect handling of radiographic image receptor e. Explain the relationship between quality assurance and quality control f. List the steps of a quality assurance program g. List the four objectives of quality control tests h. Adapt basic radiographic techniques to obtain quality diagnostic images when presented with special needs patients i. Identify agencies responsible for regulations regarding safe handling of hazardous radiographic products j. Use MSDS to identify proper handling and disposal of chemicals and materials associated with radiographic procedures k. Identify radiographic wastes that are considered hazardous to personnel and harmful to the environment XI. Week Eleven: a. Demonstrate mounting radiographs according to the suggested step presented b. List anatomic generalizations that aid in mounting radiographs c. List considerations for reading digital radiographic images not encountered when reading film-based radiographs
XII. XIII. XIV. XV. d. Demonstrate placing, exposing and processing the various types of occlusal radiographs e. Determine why it is important to recognize and identify normal anatomical landmarks of the face and head f. Identify significant anatomy normally seen on intraoral radiographs of the maxilla and the mandible g. Identify the radiographic appearance of dental materials, of developmental anomalies, of periapical abscesses, cysts, and granulomas. h. Identify the radiographic appearance of external and internal tooth resorption, calcifications and ossifications i. Identify the radiographic appearance of odontogenic tumors, nonodonogenic tumors and appearance of fractures. j. Demonstrate proficiency in utilizing localization to enhance radiographic interpretation k. Apply acceptable deviations from standard techniques when presented with unique situations Week Twelve a. Describe the use of radiographs in the detection of dental caries b. List and describe the four categories of the caries depth grading system c. Define and identify the radiographic appearance of recurrent dental caries d. List conditions that resemble dental caries radiographically and discuss how to distinguish these from caries. e. List the uses of radiographs in the assessment of periodontal diseases f. Differentiate between horizontal and vertical bone loss g. Recognize the role vertical and horizontal angulations play in imaging periodontal diseases h. Identify the appearance of the normal periodontium Week Thirteen a. State the basis for prescribing dental radiographs for children b. Identify suggested exposure intervals for the child patient c. Identify adaptations or modifications in standard techniques that aid in radiographic procedures for children d. Interpret radiographs taken on children with primary and transitional dentition e. Discuss methods for managing the apprehensive patient f. Describe methods to manage the patient with special needs. g. Value the need for cultural sensitivity h. Demonstrate the ability to adapt standard techniques when necessary i. List the three methods of localization j. Describe the step by step procedures for duplicating radiographs k. demonstrate correct patient positioning to achieve a quality panoramic radiograph l. identify and apply corrective actions for common image errors of the panoramic radiograph Week Fourteen a. No Class or Lab Thanksgiving Break! Week Fifteen a. Describe the purpose and use of extraoral radiographs
XVI. b. List extraoral radiographs that contribute to the treatment of dental patients c. Explain the role of the extraoral film cassette d. Explain cone beam computed tomography and describe its role in oral health care e. Explain how the panoramic technique relates to the principles of tomography f. List the components of the panoramic machine g. List and identify anatomic landmarks on a panoramic image Week Sixteen a. Demonstrate knowledge of all concepts discussed in the DHT103 class thus far to actively participate in a review session designed to prepare students for the DHT103 final exam Method of Delivery/Instruction Face-to-face Blended Online Learning activities will be assigned within and outside the classroom to assist the student to achieve the intended learning outcomes through lecture, Instructor-led class discussion, guest speakers, group activities, lab, drills/skill practice, and others at the discretion of the instructor. Method of Grading and Evaluation The student will be graded on learning activities and assessment tasks. Grade determinants may include the following: daily work, quizzes, chapter or unit tests, comprehensive examinations, student projects, student presentations, class participation, and other methods of evaluation employed at the discretion of the instructor