Staff Protection & Facility Management
Questions
- What are typical staff dose levels in dental radiology?
- Is there a need for personnel monitoring in dental practice?
- Can a pregnant employee continue to work in the dental radiology department?
- Who should hold dental film during radiography?
- Is it necessary to provide structural shielding in dental radiography department?
- Who may be present in the room during radiographic exposure?
1. What are typical staff dose levels in dental radiology?
Employees performing dental radiography should not normally receive significant radiation dose provided normal radiation protection measures are employed, such as distance and shielding. A report from UK estimates a mean level of less than 0.1 mSv per year, in the practice conditions that prevail there [NRPB 263]. In the USA the mean dose received by dental workers is reported to be 0.2 mSv [NCRP 107].
2. Is there a need for personnel monitoring in dental practice?
Given the low doses received by staff involved in dental radiography, routine personnel monitoring is generally considered to be desirable but not necessary [EC-RP 136]. However, due regard must be paid to national regulations, which are variable in this area. UK guidance recommends that monitoring is not normally required unless the risk assessment indicates that individual doses are likely to exceed 1 mSv per year. However, national guidance in other countries recommends personal monitoring for all dental practices using X ray equipment [EC-RP 136]. Where regulations do not require individual personnel monitoring, it may be valuable to monitor the practice through monitoring one or more individuals form time to time.
3. Can a pregnant employee continue to work in the dental radiology department?
It is unusual for any member of staff in dental radiology to get the foetal dose limit of 1 mSv from work. However, a female staff member should inform her employer if she becomes pregnant. The practitioner should ensure that the pregnant employee’s working conditions are optimised and that the prescribed dose limits are not exceeded. Generally the working conditions, after declaration of pregnancy, should be such that it is unlikely that the foetal dose will exceed 1 mSv during the remainder of the pregnancy. For extensive coverage of pregnancy Details ».
4. Who should hold dental film during radiography?
Film should not be hand held by a member of the dental practice staff. If necessary it should be held by the patient, but only when it cannot otherwise be kept in position. If the patient can not hold it, and a comforter/carer must be involved, then this should be done using forceps or other device (eg., a specifically designed dental film holder) so that fingers are not in primary beam.
5. Is it necessary to provide structural shielding in dental radiography department?
The purpose of facility design includes ensuring that prescribed dose limits are not exceeded. This requires consideration of workload, the size of the facility, the duration for which people are in the surrounding area, and is best achieved with the advice of a radiation protection expert. Formal approval and/or licensing for the structural shielding and other radiation safety measures may be required, depending on national regulations.
6. Who may be present in the room during radiographic exposure?
In the case of a single-chair room, persons must not be present in the room during a radiographic exposure unless their presence is necessary for conduct of the examinations. Persons present must be located behind a shield allowing a view of the patient and the “exposure on” indicator, or wearing protective apron, or at least 2 m from the source of scattered radiation, i.e. the patients head, and not in line with the primary beam [RPS 10]. In the case of the multi-chair room, there should be adequate shielding between the chairs.
References
- EUROPEAN COMMISSION, European Guidelines on Radiation Protection in Dental Radiology, RP 136, Luxembourg (2004).
- NATIONAL RADIOLOGICAL PROTECTION BOARD, Radiation Exposure of the UK Population, Review NRPB R263, Chilton (1993).
- NATIONAL COMMISSION FOR RADIATION PROTECTION, Implementation of the Principle As Low As Reasonable Achievable (ALARA) for Medical and Dental Personnel, NCRP Report 107, NCRP (1990)
- AUSTRALIAN RADIATION PROTECTION AND NUCLEAR SAFETY AGENCY, Radiation Protection in Dentistry, Code of Practice and Safety Guide, RPS 10, Canberra, Australia (2005).
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