Radiology Review: Chp. 40

Which of the following statements is true regarding federal and state regulations on the use of dental x-ray equipment?

• All dental x-ray machines manufactured or sold in the United States after 1934 must meet federal regulations.

• The use of dental x-ray equipment is regulated by federal but not state regulations.

• The federal government requires x-ray machines to be registered and charges a fee for this registration.

• Most states have laws that require inspections of dental x-ray equipment on a regular basis.

Answer explanation

Most states have laws that require inspections of dental x-ray equipment on a regular basis. All dental x-ray machines manufactured or sold in the United States after 1974 must meet federal regulations. The use of dental x-ray equipment is regulated by both federal and state regulations.

The Consumer-Patient Radiation Health and Safety Act is a federal law that requires all

• persons who use x-rays to take dental images to be properly trained and certified.

• persons who take dental x-rays to be registered with a national practitioner databank.

• dental x-ray machines to be registered.

• persons who expose dental x-rays to wear radiation safety badges.

Answer explanation

The Consumer-Patient Radiation Health and Safety Act is a federal law that requires all persons who use x-rays to take dental images to be properly trained and certified. There is no national practitioner databank for use of dental x-rays. It is up to individual states to establish individual policies. Individual state guidelines may require x-ray machines to be registered.

Failure to obtain informed consent from a patient prior to exposure of dental radiographs can lead to charges of

• informed consent.

• disclosure.

• respondeat superior.

• negligence.

Answer explanation

If the dentist has not obtained informed consent from a patient before exposure of dental radiographs, a patient may legally claim malpractice or negligence. The process of informing the patient about the nature and purpose of dental imaging is termed disclosure. Informed consent is permission for a procedure, granted by a patient after being informed about the procedure’s details. Respondeat superior means that the employer is responsible for the actions of the employee.

Dental images are the property of the

• dentist.

• patient.

• patient’s insurance company.

• state board.

Answer explanation

Dental images are the property of the dentist because they are a part of the patient’s dental records. Patients have a right to reasonable access to their records and can request a copy of their records. The patient’s insurance company may have paid for the dental images to be taken, but the dental images are part of the patient’s record. Dental images are not the property of the state board.

What should the dental assistant do if a patient refuses dental imaging?

• Document in the patient’s record the fact that he or she refused recommended dental imaging.

• Tell the patient that the dentist doesn’t mind working without dental images.

• Attempt to take the dental images anyway.

• Ask the patient to sign a waiver releasing the dentist from any liability for treating the patient without taking dental radiographs.

Answer explanation

The dental assistant should explain to the patient the importance of dental images in detecting disease and planning treatment; if the patient still refuses dental images, it should be documented in the patient’s record. A lack of radiographs compromises the patient’s diagnosis and treatment in most cases. Dental images should not be taken without the patient’s consent. A waiver or release would be considered invalid if an injury were to result.

Quality assurance in the dental office is a way of ensuring that everything possible is being done to produce high-quality diagnostic images and includes quality control

• tests and administration procedures.

• of dental staff credentials.

• during shipping from the manufacturer to the supplier.

• of the manufacturing process.

Answer explanation

Quality assurance is a way of ensuring that everything possible is being done to produce high-quality diagnostic images; this includes both quality control tests and quality administrative procedures. Staff credentials are controlled by federal and state regulations. Quality assurance during manufacturing and shipping are the responsibility of the people who make and ship the product to the dental office rather than the workers in the dental office who use the product.

According to the test for x-ray film freshness, the film is fresh and has been properly stored and handled when the processed film appears clean with a slight ______ tint.

• orange

• green

• blue

• red

Answer explanation

According to the test for x-ray film freshness, if the processed film appears clean with a slight blue tint, the film is fresh and has been properly stored and handled. If the film appears solid black, it probably was exposed to light, heat, or radiation. If the film appears fogged, the film has been improperly stored or exposed to radiation.

The safelight in the darkroom can be tested by

• using the coin test.

• turning off all the lights in the darkroom and looking for any white light.

• using a step wedge.

• taking a reference image.

Answer explanation

The darkroom safelight can be tested by using the coin test. Turning off the light in the darkroom is a test to check for light leaks. A step wedge is used to check the quality of the developer chemicals. A reference image is used to check the quality of the developer chemicals.

The most critical component in film processing quality control is

• processing two test films each day.

• maintaining the freshness of the processing solutions.

• maintaining the darkroom.

• checking the safelight.

Answer explanation

Fresh processing solutions are the most critical component in the quality control of film processing. The solutions must be replenished each day and changed every 3 to 4 weeks, as recommended by the manufacturer. Processing two test films daily is not a recognized quality assurance test for the dental office. This is an important consideration, but it is not the most critical component in quality assurance in film processing.

Developer strength can be checked by using

• a reference image or a stepwedge image.

• the time it takes the film to “clear.”

• a test strip to check the strength of the solution.

• a thermometer.

Answer explanation

An easy way to check the strength of the developer solution is to compare film densities with a standard; this can be done by using a reference image or a stepwedge image. Clearing time is an indicator of fixer strength rather than developer strength. Using a test strip to check the solution is not a recognized quality assurance test in dental imaging. The thermometer will check the temperature of the developing solution rather than its strength.