Course Content
Introduction
Here is what to expect
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About the Exam
Resourses
About The Course
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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Purpose of Radiographic Images
06:55
Periapical Radiographs (PA)
01:58
Bitewing Radiographs (BWX)
01:40
Full Mouth Series (FMX)
Occlusal Radiographs
Full-mouth survey
Panoramic Radiography
Cephalometric Radiography
Cone-Beam Computed Tomography (CBCT)
Technique
Anatomy Flashcards
Quadrants, Regions, and Tooth Numbering Systems
Practice and Review
Additional Insights
Final Unit Lesson: Reviewing Radiographic Imaging Techniques
Unit I A Practice quiz
Matching Assignment: Types of Radiographs and Their Purposes
Matching Quiz: Types of Radiographs and Their Purposes
Film/Sensor Holding Devices
Unit 1B Purpose and Technique (50%) (Technique)
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Reviewing Patient Medical and Dental Histories for Contraindications, Including Medications
Techniques: Intraoral Techniques, Including Error Correction
Extraoral Techniques, Including Error Correction
Technique Modifications Based on Anatomical Variations and Clinical Conditions
Equipment Purpose & Maintenance
Patient Management Techniques in Dental Radiography
Mounting and Anatomical Landmarks in Dental Radiography
Anatomical Structures and Dental Materials in Dental Radiography
Features of a Diagnostically Acceptable Image in Dental Radiography
Legal Requirements & Image Preparation
Unit 1B Practice Quiz
The Nature of X-rays (Physics Basics)
06:34
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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Sources of radiation for operators/other staff during radiation production
Factors Affecting X-ray Production
Radiation Characteristics and Interactions with Matter
Radiation Production Sources
Radiation Safety and Patient Exposure
Radiation Physics in Dental Imaging
Radiation Biology and Effects on Dental Tissues
Unit 2A Summary: Radiation Health and Safety in Dental Imaging
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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Radiation Safety: Causes of Unnecessary Exposure to Radiation
Patient exposure to radiation (ALARA, ADA recommendations)
Factors that Influence Radiation Safety (Filtration, Shielding, Collimation, PID Length)
Patient Radiation Concerns and Informed Consent
Informed Consent and Patient Refusal for Exposure to Radiation
Protocol for Suspected X-ray Machine Malfunctions
Summary of Unit II: Radiation Safety
Practice and Review
Unit 2 Practice Quiz
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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Introduction to Unit IIIA: Standard Precautions for Equipment and Supplies
Breakdown and Setup of Treatment Room
Use of Barriers and Position Indicating Devices (PIDs)
position indicating and beam alignment devices.
Clinical Contact Surface Maintenance
Critical and Semi-Critical Instrument Sterilization
Unit 3A Summary
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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Hand Hygiene and Infection Control
Personal Protective Equipment (PPE) Protocol
Cross Contamination Prevention Strategies
Government Agencies and Associations
Infection Control and Hazardous Materials Management
Unit IIIA: Comprehensive Summary
Unit IIIB: Summary Standard Precautions for Patients and Operators
Unit 3 Practice Quiz
Vocabulary Terms
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Glossary of Vocabulary Terms
Practice Exams
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RHS Practice Test
RHS Exam Prep

Panoramic Radiography

Extraoral Imaging & Survey Techniques

🎯 Learning Objectives

  • Define the primary purpose and limitations of a panoramic image.
  • Identify the Focal Trough and its role in image clarity.
  • Recognize and correct common positioning errors (Chin too high/low).
  • Understand the unique safety requirements for extraoral imaging.

1. Purpose & Limitations

A panoramic radiograph (Pano) provides a wide-view “landscape” of the entire maxilla, mandible, and surrounding structures on a single image.

Best For:

  • Impacted 3rd molars (wisdom teeth).
  • Evaluating growth and development.
  • Detecting large lesions or jaw fractures.

Not For:

  • Detecting interproximal caries (cavities).
  • Detailed periodontal evaluation.
  • Fine apical infections.

2. The Focal Trough

The Focal Trough (also called the image layer) is a three-dimensional curved zone where structures are clearly visible. If the patient is outside this zone, the image will be blurred or distorted.

3. Positioning Errors (The “Exam Favorites”)

The RHS exam loves to show you a distorted Pano and ask “What went wrong?” Here is your cheat sheet:

Error Appearance The Cause
“Exaggerated Smile” Patient’s chin was too low (tipped down).
“Flat Smile” or Frown Patient’s chin was too high (tipped up).
Dark shadow over roots Tongue was not against the roof of the mouth.
“Ghost Image” Metallic objects (earrings, dentures) were not removed.

🚨 DANB EXAM ALERT: Safety First

Question: How is the lead apron applied differently for a panoramic image?

Answer: For a Pano, you must use a lead apron WITHOUT a thyroid collar. Because the machine rotates around the neck, a thyroid collar will block the beam, creating a “Shark Fin” radiopaque shadow on the image.

Exercise Files
106 Panoramic.mp3.mp3
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