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

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:

  1. Sequence: Always start with Anterior projections (they are easiest to tolerate). Save the Maxillary Molars for last.
  2. Technique: Place the sensor firmly and quickly. Do not “creep” or wiggle the sensor.
  3. 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.

Exercise Files
112 Technique modifications.mp3.mp3
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