Technique Modifications
Adapting to Anatomical and Clinical Challenges
🎯 Learning Objectives
- Modify angulation for patients with a Shallow Palate.
- Identify techniques for managing a Hyperactive Gag Reflex.
- Adjust placement for Tori (Bony growths).
- Differentiate imaging needs for Edentulous vs. Pediatric patients.
1. The Shallow Palate (Low Vault)
When the roof of the mouth is low, the sensor cannot be placed parallel to the tooth. To compensate:
- The Adjustment: Increase the Vertical Angulation by 5 to 15 degrees.
- Alternative: Use the Bisecting Technique instead of the Paralleling Technique.
2. Bony Growths (Tori)
Tori are extra outgrowths of bone that can make sensor placement painful or impossible.
Mandibular Tori
Place the sensor between the tongue and the tori (not on top of the bone).
Maxillary Torus
Place the sensor on the far side of the torus (deeper into the mouth).
3. The Gag Reflex
Management is psychological and physical. The RHS exam focuses on the following order of operations:
- Sequence: Always start with Anterior projections (they are easiest to tolerate). Save the Maxillary Molars for last.
- Technique: Place the sensor firmly and quickly. Do not “creep” or wiggle the sensor.
- Distraction: Ask the patient to lift a leg or hum a song.
🎓 DANB EXAM FOCUS: Edentulous Patients
Question: How do you stabilize a bite-block for a patient with no teeth?
Answer: Use Cotton Rolls. Place a cotton roll on each side of the bite-block to “fill the space” where teeth used to be, allowing the patient to close firmly and keep the sensor stable.