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

Diagnostic Acceptability Standards

Criteria for Clinically Useful Radiographs

🎯 Learning Objectives

  • Define the criteria for a diagnostic Periapical (PA) image.
  • Identify the requirements for a diagnostic Bitewing (BW).
  • Understand the importance of Contrast, Density, and Sharpness.
  • Recognize when an image must be retaken in accordance with ALARA.

1. The Periapical (PA) Standard

A periapical radiograph is designed to show the entire tooth from crown to root tip. For the RHS exam, remember the “2-3mm Rule”:

  • Full Coverage: The entire crown and the entire root must be visible.
  • The Apex: There must be 2 to 3 mm of bone visible beyond the root apex (tip).
  • Geometry: The image should have minimal distortion (no elongation or foreshortening).

2. The Bitewing (BW) Standard

Bitewings are used to detect interproximal decay and monitor bone levels. An acceptable bitewing must show:

  • Open Contacts: The interproximal spaces must not be overlapped.
  • Equal Distribution: An equal amount of maxillary and mandibular crowns and alveolar bone must be shown.
  • Occlusal Plane: The biting surfaces should be centered horizontally across the image.

3. Visual Characteristics

The “Big Three” terms for image quality that appear on every DANB exam:

Term Definition
Density The overall darkness or blackness of the image.
Contrast The difference in degrees of blackness between adjacent areas (Shades of Gray).
Sharpness The detail or clarity of the outlines of structures.

🚨 DANB EXAM FOCUS: To Retake or Not?

An image is non-diagnostic if the area of concern (e.g., the apex of a tooth with a suspected abscess) is not visible. However, if an image has a small error but the dentist can still see the necessary information, you do not retake it. Retakes should be a last resort to minimize radiation exposure.