Oral Radiography ORAD868

Course Introduction: Knowledge of radiography is essential to understanding the dangers inherent in the use of Xrays. Radiographs are used in helping the dentist to make diagnoses. ORAD868 is a study of radiation and safety theories. It will include fundamental concepts of dental radiography and familiarize you with the techniques of positioning the patient, the tubehead and film as well as exposing and processing dental radiographs. This course will cover exposure of intra-oral radiographs, quality assurance, radiographic interpretation, patient selection criteria and digital radiographic techniques. It also will include the safe and effective use of ionizing radiation as a diagnostic tool and methods to minimize risk of adverse biological effects to patients and clinician.
This is a non credit course This course runs 11 weeks The course consists of 4 units of study The last date to withdraw from this course with no penalty is: 19 September 2012 Students are encouraged to contact either instructor as needed

Course objectives: Upon completion of this course, the student will be able to: Explain the theories of radiation techniques and safety, taking radiographs, processing film and basic oral anatomy. Describe important points in the history of radiography, the x-ray tube and its components, the x-ray beam, film packets and film speed with regard to density and resolution. Demonstrate the taking of horizontal and vertical bitewing radiographs and periapical radiographs by the bisecting and the paralleling methods. Describe the development process, darkroom equipment and maintenance, automatic processing units and common darkroom errors. Identify the hazards involved in radiology and protection against the exposure to radiation, operator dosage, and protective methods from radiation hazards and regulatory measures. Locate and describe normal radiographic landmarks of the Maxilla and Mandible, supporting structures, factors affecting caries interpretation, apical lesions. Demonstrate on a phantom the use of accessory radiographic techniques such as the occlusal film and the extra oral technique of the panoramic radiograph. Course Materials:

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Textbook(s): Dental Radiography Principals and techniques, Fourth edition, Harring and Howerton Prerequisites: Proof of successful completion of a basic dental assisting course or a letter from the employing dentist verifying employment. Course requirements: To successfully complete the course, students must have a minimum average of 70% or higher. Grading Information: Method(s) of evaluation: Homework, narrative, case presentation, video presentation and final exam Participation-20% (responding in the discussion threads and case presentation) Homework-15% Narrative-15% Video Presentation-15% Case Presentation-15% Final-20%

Grading: A = 90-100 B = 80-89 C = 70-79 F = Below 70

Project Description/Assessments Homework: All assignments are due prior to the start of the following week. All assignments are to be handed in via the Assignment Folder. The lowest homework grade will be dropped prior to grade calculations. All homework is worth 15% of the overall class grade. Narrative: (covered in Module 1 which is fully developed in the prototype course) The narrative will demonstrate your understanding of the physics and geometry behind exposing oral radiographs. This is an individual project. Submit the narrative via the Assignment folder. The narrative is 15% of your overall course grade. Project Description Module 1- Narrative Objectives: ORAD868 page 2

Demonstrate knowledge of theory behind oral radiography Demonstrate an understanding of 2 of the topics listed below Apply information learned from the reading to you narrative

Background: One of the main foci of this module is on physics, geometry and how important these factors are to proper placement of XCP, resulting in a diagnostic radiograph/image. There are six topics listed below that are all essential to understanding intra- and extra- oral radiology exposure techniques. Understanding these topics can be challenging. The narrative will all you to demonstrate your understanding of these topics and will allow you the confidence needed to pass the Dental Assistant National Board Examination. Topics: Compare and contrast radiolucent and radiopaque and explain the meaning of each. Differentiate between density and contrast and explain the value of each in the diagnostic image/radiograph. Explain the uses of intra-oral verses extra-oral radiography and give examples of when each would be appropriate for diagnostic purposes. Explain the pros and cons of the paralleling technique and what factors may make implementation more difficult. Explain why, how and when to mount films. Explain adjusting kvp verses mA and the impact of each on the resultant image/radiograph. How to format your paper: 12 point font size Double spaced Times New Roman font Maximum of one page Grading: Discuss 2 of the 6 topics The project is 15% of overall course grade See Rubric for full details Where to submit your assignment: The assignment is to be submitted via the Assignment Folder under tab ASSIGN1

Video: This video is to simulate the student placing an XCP in a patients mouth. The video is to be posted on Youtube and the link placed in you Assignment folder. The video should not extend past 4 minutes. The video is 15% of your overall class grade. Case Presentation: ORAD868 page 3

There will be a group project for this case presentation. One person from each group should post the presentation in the conference area and each student should post to their OWN assignment folder. The presentation is 15% of your overall class grade. COURSE OUTLINE AND SCHEDULE: Week 1: 27 August-31 August Reading Assignment: Chapters 8 and 16 After completing this lesson you should be able to: Chapter 8-Dental X-ray Image Characteristics Differentiate between radiolucent and radiopaque area on a dental radiograph Describe diagnostic radiographs List factors that influence film density and contrast Describe the difference between film density and contrast Describe the stepwedge List factors that influence sharpness, magnification and distortion

Chapter 16-Introduction to Radiographic Examinations List three types of intraoral radiographic examinations List and know the location of all films in a (CMRS) Complete Mouth Radiographic Series List examples of Extraoral radiographic procedures

Week 2: 3 September-7September Reading Assignment: Chapters 25 and 28 After completing this lesson you should be able to: Chapter 25-Digital Radiography Discuss the fundamentals of digital radiography List and describe equipment used in digital radiography List and describe the two types of digital imaging List advantages and disadvantages of digital imaging Chapter 28-Film Mounting and Viewing

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List reasons to use a film mount Describe when and where films should be mounted List the information placed on a film mount Describe how the identification dot is used to determine film orientation Describe optimal viewing conditions

Week 3: 10 September -14 September Reading Assignment: Chapters 2, 8 and 17 After completing this lesson you should be able to: Chapter 2-Radiation Physics Identify the structure of an atom Describe the process of ionization Identify the component of the x-ray machine List the properties of x-radiation Label the parts of the dental x-ray tubehead and the dental x-ray tube List the possible interactions of x-rays with matter List characteristics of electromagnetic radiation

Chapter 8-Dental X-ray Image Characteristics Differentiate between radiolucent and radiopaque area on a dental radiograph Describe diagnostic radiographs List factors that influence film density and contrast Describe the difference between film density and contrast Describe the stepwedge List factors that influence sharpness, magnification and distortion

Chapter 17-Paralleling Technique State the basic principle of the paralleling technique Illustrate the placement of the film holder, positioning indicating device (PID) and central ray Discuss how the object to film distance affects the radiographic image and how target to film distance is used to compensate for such changes Describe the different sizes of film used with the paralleling technique and how each film is placed in the bit block Discuss exposure techniques Explain the modifications in the paralleling technique that are used for a patient with a shallow palate, bony growth or a sensitive premolar region ORAD868 page 5

Name advantages and disadvantage of the paralleling technique

Narrative Due on 21 September by midnight Week 4: 17 September-21 September Reading Assignment: Chapters 18 and 19 After completing this lesson you should be able to: Chapter 18-Bisecting Technique State the rule of isometry State the basic principals f the bisecting technique Illustrate the location of the films, tooth, imaginary bisector, central ray and position indicating device Discuss the finger holding technique describe the incorrect and correct horizontal angulation Describe the in correct and correct vertical angulation

Chapter 19-Bite-wing Technique Describe the purpose and use of the bite-wing film Describe the appearance of opened and overlapped contact area on a dental radiograph List ways a film can be stabilized for bite-wing radiographs List four film sizes and state their use for bite-wing films Describe correct and in correct horizontal angulations State what teeth are required for premolar and molar film positioning

Week 5: 24 September-28 September Reading Assignment: Chapters 2, 3 and 6 After completing this lesson you should be able to: Chapter 2-Radiation Physics Identify the structure of an atom Describe the process of ionization Identify the component of the x-ray machine List the properties of x-radiation ORAD868 page 6

Label the parts of the dental x-ray tubehead and the dental x-ray tube List the possible interactions of x-rays with matter List characteristics of electromagnetic radiation

Chapter 4-Radiation Biology Describe the mechanisms, theories and sequences of radiation injury Discuss short and long term effects as well as somatic and genetic effects of radiation Identify relative sensitivity if a given tissue to x-radiation Define the units of measurement used in radiation exposure Discuss dental radiation and exposure risks Discuss risks verses benefits of dental radiographs

Chapter 6-Dental X-ray Equipment Discuss the regulation of dental x-ray machines at the federal, state and local levels Recognize dental x-ray machines used for intraoral and Extraoral films Identify the component parts of the dental x-ray machine Describe the purpose and use of dental x-ray film holders and devices Identify commonly used dental x-ray film holders and devices

Week 6: 1 October-5 October Reading Assignment: Chapters 2, 8 and 27 After completing this lesson you should be able to: Chapter 2-Radiation Physics Identify the structure of an atom Describe the process of ionization Identify the component of the x-ray machine List the properties of x-radiation Label the parts of the dental x-ray tubehead and the dental x-ray tube List the possible interactions of x-rays with matter List characteristics of electromagnetic radiation

Chapter 8-Dental X-ray Image Characteristics Differentiate between radiolucent and radiopaque area on a dental radiograph Describe diagnostic radiographs List factors that influence film density and contrast Describe the difference between film density and contrast ORAD868 page 7

Describe the stepwedge List factors that influence sharpness, magnification and distortion

Chapter 27-Normal Anatomy: Intraoral Films State the differences between cortical and cancellous bone Identify and describe normal anatomic landmarks Identify and describe radiographic tooth anatomy Identify anatomic landmarks that are radiopaque and radiolucent

Video Presentation Due 5 October Midnight

Week 7: 8 October-12 October Reading Assignment: Chapter 3 After completing this lesson you should be able to: Chapter 3-Radiation Characteristics Describe the effect that the kilovoltage peak has on the quality of the x-ray beam Describe how milliamperage influences the quanity if the x-ray beam Identify the range of kilovoltage and millamperage required for dental radiographs Describe how increasing and decreasing exposure factors affect the density and contrast of the film Describe how kilovoltage, millamperage, exposure time and source to film distance influence the intensity of the x-ray beam Calculate an example of radiation intensity using inverse square law

Week 8: 15 October-19 October Reading Assignment: Chapters 4, 5, 22 and 29 After completing this lesson you should be able to: Chapter 4-Radiation Biology Describe the mechanisms, theories and sequences of radiation injury Discuss short and long term effects as well as somatic and genetic effects of radiation Identify relative sensitivity if a given tissue to x-radiation Define the units of measurement used in radiation exposure Discuss dental radiation and exposure risks ORAD868 page 8

 Discuss risks verses benefits of dental radiographs Chapter 5-Radiation Protection Describe in detail the basics of patient protection before x-ray exposure Describe different types of filtration, and state the recommended total filtration for dental x-ray machines operating above and below 70kVp. List 6 ways to protect the patient from excessive radiation during x-ray exposure Discuss operator protection Discuss radiation exposure guidelines, including radiation safety legislation, MPD, MAD, and ALARA

Chapter 22-Panoramic Radiography Describe the purpose and use of panoramic radiographs Describe the fundamental of panoramic radiographs Identify the patient preparation of positioning errors seen on panoramic radiographs Discuss the causes of patient preparation and positioning errors and the necessary measures needed to correct such errors

Chapter 28-Normal Anatomy: Panoramic Films Identify and describe Bony landmarks of the mandible and maxilla Air spaces on panoramic radiographs Soft tissues on panoramic radiographs

Case presentation due 19 October midnight Register for synchronous session by 19 October midnight Week 9: 22 October-26 October Reading Assignment: Chapters 7, 9 and 10 After completing this lesson you should be able to: Chapter 7-Dental X-Ray Film Describe in detail film composition and latent image formation List and describe different x-ray films used in dentistry Define and describe intraoral film and its packaging Identify types and sizes of intraoral film ORAD868 page 9

Describe the differences between screen and non screen film Describe the use of intensifying screens and cassettes Describe duplicating film Discuss proper film storage and protection

Chapter 9-Dental X-ray Film Processing Describe how a latent image becomes a visible image Describe and list the steps in film processing Discuss the location, size, lighting and equipment requirements necessary for the darkroom Discuss safe lighting Describe the processing tank Describe the differences between manual and automatic processing Describe film processing problems that result from: chemical contamination errors, film handling errors and lighting errors

Chapter 10-Quality Assurance in the Dental Office List quality control tests Describe the purpose and frequency of testing dental x-ray machines Describe the tests used to check for fresh film and adequate film screen contact Describe the test used to check for darkroom light leaks and proper safe lighting Describe the preparation of the reference radiograph and the standard stepwedge radiograph

Week 10: 29 October-2 November Reading Assignment: Chapters 9 and 20 After completing this lesson you should be able to: Chapter 9-Dental X-ray Film Processing Describe how a latent image becomes a visible image Describe and list the steps in film processing Discuss the location, size, lighting and equipment requirements necessary for the darkroom Discuss safe lighting Describe the processing tank Describe the differences between manual and automatic processing Describe film processing problems that result from: chemical contamination errors, film handling errors and lighting errors ORAD868 page 10

Chapter 20-Exposure and Technique Errors Indentify and describe the appearance of: Under exposed film Over exposed film Film exposed to light Unexposed film Forshortened images Elongated images Come-cut images Indentify bite-wing errors Identify and describe the appearance of the following technique errors: Film bend Film creasing Phalangioma Double exposure Movement Reverse film Describe horizontal and vertical angulation

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Oral Radiology Assignment Schedule

Module 1 Week1 Chapter PaPagege Questions

Module 1

DATE
August 2731

Chapter
8

Page
84

Questions to answer
MC 1-4

Week 2 September 3-7

16 25

154 311

Participate in the conference Matching 1-10 and Short Answers 11 and 14 T/F 10-18 MC 19-23

28

355

T/F 12 Short Answer 22 and 23 For Question 23- (List the step by step procedure for film mounting.) Put the following steps in order: Orientate the radiographs into Maxillary and Mandibular images Orientate film into horizontal and Vertical Orientate which films are on the right and left side of the mount Place all the embossed dots up (not a dimple but a pimple) Orientate bite-wings and periapicals Participate in the conference MC 1-10

Week 3 September 10-14

21

8 17

84 179

Week 4 September 17-21

18

208

MC 5 & 6, 13-17 Matching 1-8 Fill in the blank 9-13 MC 16-21 Participate in the conference Narrative Due 21 September midnight Fill in the blank 14-15 MC 16-19 Fill in the blank 1-10 MC 11-14 Participate in the conference ID 11-18 ID19-26 MC 27-31 MC 1-20 MC 1-8 Participate in the conference MC 32-36 ID 37-40 MC 41-44 MC 5-12 & 18 Matching 1-8 ID 9-16 Participate in the conference Video Presentation Due 5 October midnight MC 1-6

19

225

Week 5 September 24-28

22

3 6 Module 2 Week 6 October 1-5 2

32 61 23

8 27

84 343

Week 7

32

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October 8-12

Also, answer the following questions: 1. The degree of darkening of the radiographic image is know as: a) Definition b) Contrast c) Density d) Penumbra 2. Which of the following describes the radiograph image produced with a kVp exposure setting of 100? a) Long scale b) Short scale c) High contrast d) Low density 3. The dental radiograph will appear less dense (lighter) if one increases the : a) mA b) kVp c) Exposure Time d) Target-film distance 4. Which of the following is appropriate to increase radiographic contrast while maintaining image density? a) Increase kVp and increase the exposure time b) Increase kVp and decrease the exposure time c) Decrease the kVp and increase the exposure time d) Decrease the kVp and decrease the exposure time 5. A patient presents whose radiographs must be taken utilizing the bisecting technique. The radiographer decides to replace the 16 in. (41cm) PID taken with 12 impulses, with an 8 in. (20.5cm) PID. To maintain image density, what will the new impulse setting be with an 8 in. (20.5cm) PID? a) 3 b) 6 c) 24 d) 48 6. A dental radiographer stands 3 feet from the source of radiation where the measured intensity is 100 milliroentgens (mR) per minute. The radiographer then moves to a new location 6ft from the source of radiation. What is the radiation intensity at the new location? Participate in the conference MC 1-25

Module 3

Week 8 October 15-19

43

54

29 22

367 271

T/F 1-5 MC 6-15 Fill in the Blank 16, 17, 19, 20 ID Questions 1 and 2 (there are about 31 questions) MC 1-5 Matching 6-20 ID 26-28

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Module 4

Week 9 October 22-26

73

107

10 Week 10 October 29November 2 9

119 109

Register for synchronous session by 19 October midnight Case presentation due 19 October midnight Participate in the conference Fill in the blank 1-4 ID 5 -11 MC 12-30 MC 1-18 Matching 31-36 ID 37- 45 T/F 46-50 MC 1-16 Participate in the conference Matching 31-36 ID 37- 45 T/F 46-50

20

236

Week 11November 2-9

ID 1-10 Matching 11-15 MC 16-20 Participate in the conference Mock DANB with a synchronous session post the examination (2 days after the examination)

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