Course Content
Introduction
Here is what to expect
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Unit 1A: Purpose and Technique (50%) (Purpose)
A. Purpose of radiographic images 1. Periapical 2. Bitewing 3. Full mouth series 4. Occlusal 5. Full-mouth survey 6. Panoramic 7. Cephalometric 8. CBCT (cone-beam computed tomography) B. Technique 1. Review patient medical and dental histories for contraindications, including medications. 2. Intraoral techniques, including error correction. a. Paralleling b. Bisecting angle 3. Extraoral techniques, including error correction. a. Panoramic b. Cephalometric c. CBCT (cone-beam computed tomography) basics 4. Technique modifications based on anatomical variations and clinical conditions. 5. Purpose and maintenance of radiographic equipment. 6. Patient management techniques. 7. Mounting and anatomical landmarks that aid in mounting. 8. Anatomical structures and dental materials observed on images (e.g., differentiating between radiolucent and radiopaque areas). 9. Features of a diagnostically acceptable image. 10. Prepare images for legal requirements (e.g., HIPAA).
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Unit 2A: Radiation production (25%)
Radiation production. 1. Sources of radiation for operators/other staff during radiation production. 2. Factors affecting x-ray production (e.g., kVp, mA, exposure time). 3. Radiation characteristics. 4. Radiation physics. a. Primary. b. Scatter (secondary). 5. Radiation biology. a. Short-and long-term effects of radiation on cells and tissues. b. Concepts of radiation dose.
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Unit 2B: Radiation Safety
Radiation safety. 1. Causes of unnecessary exposure to radiation. 2. Patient exposure to radiation (ALARA, ADA recommendations). 3. Factors that influence radiation safety (e.g., filtration, shielding, collimation, PID length). 4. Patient radiation concerns. 5. Informed consent or patient refusal for exposure to radiation. 6. Protocol for suspected x-ray machine malfunctions.
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Unit 3A: Standard precautions for equipment and supplies (25%)
Standard precautions for equipment and supplies according to ADA, CDC and OSHA, including but not limited to: 1. breakdown and setup of treatment room. 2. barriers. 3. position indicating and beam alignment devices. 4. clinical contact surfaces. 5. critical and semi-critical instrument sterilization
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Unit 3B: Standard precautions for patients and operators
Standard precautions for patients and operators according to ADA, CDC and OSHA, including but not limited to: 1. hand hygiene. 2. PPE (donning, doffing). 3. cross contamination.
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Vocabulary Terms
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Practice Exams
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RHS Exam Prep

Legal Requirements & Image Preparation

Documentation, Privacy, and Record Keeping

🎯 Learning Objectives

  • Identify the essential labeling requirements for radiographs.
  • Understand the statute of limitations for record retention.
  • Apply HIPAA guidelines to the digital transfer of images.
  • Define the legal ownership of dental radiographs.

1. Essential Labeling

A radiograph is a legal document. To be admissible in court or for insurance claims, every image (or set of images) must be labeled with:

  • Patient’s Full Name: First and Last.
  • Date of Exposure: Crucial for tracking disease progression.
  • Dentist’s Name/Office: To identify the origin of the record.
  • Number of Images: (e.g., “4 Bitewings”).

2. HIPAA & Digital Privacy

The Health Insurance Portability and Accountability Act (HIPAA) protects patient privacy. In radiography, this means:

Transferring Images: Images should be sent only via encrypted email or secure portals. Never post patient X-rays to social media without written consent, even if the name is removed.

Screen Privacy: Position monitors so that other patients walking by cannot see the radiographs of the person currently in the chair.

3. Retention & Ownership

The legal lifespan of a radiograph is determined by state law, but generally follows these rules:

Category Legal Standard
Retention Period Typically, 7 to 10 years after the patient is no longer of record (varies by state).
Ownership The Dentist owns the physical record; the patient owns the information within it.

🚨 DANB EXAM FOCUS: Requesting Originals

If a patient requests their X-rays to take to a specialist, never give them the original films or delete the original digital file. You must provide a duplicate or a digital copy. The original must always remain in the office where it was taken for legal protection.