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

Final Review: Radiographic Techniques

Mastery & Troubleshooting for the RHS Exam

You have covered individual techniques—from PAs to CBCT. This final review synthesizes that knowledge into a Clinical Decision Matrix. Use this to double-check your logic before taking the unit exam.

1. Selecting the Right Image

The exam will describe a patient’s need. You must select the most appropriate survey:

Patient Presentation Correct Choice
Suspicion of interproximal decay (standard). Horizontal Bitewings
Generalized bone loss / Periodontal disease. Vertical Bitewings
Suspected apical abscess (infection at root). Periapical (PA)
Large lesion, impacted wisdom teeth, or jaw fracture. Panoramic
Measuring bone volume for a dental implant. CBCT (3D)

2. The “Fix-It” Guide (Troubleshooting)

If an image is non-diagnostic, you must identify the technical cause. This table is high-yield for the exam:

  • Problem: Overlapped contacts.
    Solution: Correct Horizontal angulation.
  • Problem: Elongated or Foreshortened images.
    Solution: Correct Vertical angulation.
  • Problem: Cone-cut (clear unexposed area).
    Solution: Center the PID over the sensor/film.
  • Problem: Blurred image.
    Solution: Instruct patient to remain still (eliminate movement).

3. Geometry of the Beam

Recall the rules for shadow casting to minimize distortion:

  • The sensor should be parallel to the tooth.
  • The beam should be perpendicular to the sensor.
  • The focal spot (inside the tubehead) should be as small as possible.
  • A longer PID (16″ vs 8″) reduces magnification and increases image sharpness.

✅ Ready for the Unit Exam?

If you can differentiate between Vertical and Horizontal errors and know which sensor sizes belong to which technique (Size 2 for adult PAs/BWs, Size 4 for Occlusal), you are ready to move forward.

Exercise Files
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