Protection from Radiation

 Radiation protection is to do those things that will minimize exposure of patient and
dental personnel and still provide benefits for the patient from use of diagnostic
radiography
It is essential to decrease the harmful effect of ionizing radiation.
 All doses should follow the concept of keeping radiation exposure "as low as
reasonably achievable"— The ALARA Principle, which recognizes the possibility that
no matter how small the dose is, some stochastic effect may result.

The ALARA Principle

. Radiation Workers:
i. Occupationally exposed person—50 mSv (5 rem) in any one year.
ii. Women of reproductive age and pregnancy shall not exceed — 10 mSv (1 rem)
II. Members of the Public:
i. Annual effective dose for the public should not exceed— 1 mSv (0.1 rem)
ii. In any one year, members of public shall not receive an effective dose equivalent in
excess of — 5 mSv (0.5 rem)
The application of radiation protection principles is called Health Physics.

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Protection schemes depend upon time , distance and barriers.
The greater the distances, atomic number and thickness of the barrier, and short exposure
time the smaller the exposure rate.
The most commonly used material as a barrier is Lead, this is because lead has:
• Higher atomic number.
• Higher density.
• Higher linear coefficient of attenuation.
• Lead can be used in form of:
• Viewing windows, that is glass into which lead is incorporated.
• As lead plywood that is lead sandwiched between layers of wood.

Sources of Radiation in a Dental Radiology

1. Primary beam which is radiation originating from the focal spot.
2. Scattered or secondary radiation is the radiation originating from the irradiated tissues
of the patient.
3. Leakage or stray radiation from the X-ray tube head housing.
4. Scattered radiation from filters and cones.
5. Scattered radiation coming from the objects other than the patient such as the walls
and furnitures that the primary beam may strike.

Protection for the Operator

The two most important sources of X-
rays to which the operator is exposed
to are the primary X-ray beam and
scattered radiation originating from
the irradiated tissues of the patient.
Lesser Importance Include :
• Leakage radiation through the tube
head housing.
• Scattered X-ray from filters, cones.

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Protection against primary beam:
 The operator should leave
the room or take a suitable
position behind a barrier or wall
during exposure.
 Dental Operatory should be
designed to meet the minimum
shielding requirements
 Position Distance Rule-which
states that the operator should
stand at least six feet away from
the source of radiation or at an
angle of 90° to 135°, with respect
to the direction of the central ray
considers that in this position the
patient's head will absorb the
most scattered radiation.

 The film should never be held by the

operator.
 Avoid holding the X-ray tube head of
the machine. The suspension arms should
be adequately maintained to prevent
housing movement and drift.

A barrier,
made of
suitable
material
should be
available, or
the operator
should use a
lead apron.

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Protection from secondary and scattered radiation:

 Use of high speed films.

 Replace the short plastic cone
with an open ended lead lined
cone.
 Adequate filtration of the
primary beam.
 Use of collimator, to reduce
the diameter of the beam.
 Use of film badge ,Dosimeter, for personnel radiation
monitoring, to avoid accumulated over exposure, wear
the film badge above any protective clothing at collar
level.

Patient Protection
Patient dose from dental radiography is the amount of radiation received by target organs.
One of the most common measurements is the skin or surface exposure. Other target
organs include the bone marrow, thyroid glands and gonads
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 bone marrow dose relevant to a particular stochastic effect, e.g. leukemia.
 The proximity of thyroid gland to the X-ray beam is important in determining the
magnitude of dose received. Particular concern has been expressed over the
exposure of thyroid because it has one of the highest radiation induced cancer
rates.
 Radiographs that involve the abdomen result in the highest dose to the
gonads.while the dental X-ray examinations result in a generally insignificant dose
to the gonads.
 Selection of the Image Receptor:
 Use of high speed films, which will
help reduce the exposure time, E
speed films are routinely used
without loss of diagnostic
information.
 Use of screen films helps reduce
exposure time , but the diagnostic
result of non screen films are far
superior.
 Focal Spot Film Distance: As X-rays
are less divergent at a longer
distance, there is a decrease in the
volume of the patient
exposedLonger FSFD results in 32%
reduction in exposed tissue volume. Also it
increases the resolution of the radiograph.

 Collimation of the Beam: Collimation helps to

control the size and shape of the X-ray beam,
allowing only the useful beam to emerge
Intraoral machines use fixed collimators .
The extraoral machines use adjustable
collimators.
The recommended beam size is not more than 2
¾" in diameter at the patient's face, when the
source film distance is 18 cm or more.

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Collimation decreases the risk of radiation, minimises scattered radiation and
decreases the fog, with a sharper image and better contrast

 Filtration: Filtration absorbs low energy

photons which are undesirable as they
add to the patient's skin dose but do not
have enough energy to penetrate the
tissue and bring about the image
formation.
 filtration helps to reduce the patient
exposure by 20%.
 The disadvantage of using filters is that it
leads to an increase in the exposure time
and a decrease in the contrast.
 Use of high kVp: Higher kVp is used to
keep the incident skin doses acceptable.
The equipment should be capable of
operating at a kilo voltage of 60 kVp or
higher.
 Film holding devices reduces frequency of
retakes . Some of the holders also
collimate the beam to the size of the film
being used, which further reduces patient
exposure. The exposure to the patient's
fingers is also reduced.

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 Use of protective barriers :
 Leaded aprons should be used to protect the patient, especially in case of children,
individuals of reproductive age and pregnant women.
 Use of leaded thyroid shields, this is recommended especially with children because
of greater sensitivity of thyroid in young people.
 Use of film holders with facial shields.
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 Use of proper technique and proper processing the
image to avoid retakes and decrease patient
exposure.
Protection for the Environment
The surrounding environment must be protected
from radiation to avoid exposure to other persons
Quality assurance may be defined as any planned
activity to ensure that a dental office will
consistently produce high quality images with the
minimum exposure to patients and personnel.
Patient should be positioned such that the X-ray
beam is aimed at the wall of the room and not
through a door or other opening where people may
be located.
Walls made of 3” of concrete, 3” × 16” of steel or 1 mm of lead will suffice to protect
adjacent rooms.

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 As an alternative Barium also can be used in the form of Barium Plaster or Barium
Concrete.
If it is not possible to incorporate lead or barium into
the walls, they can be lined with lead plywood, 0.25
mm of lead sandwiched between layers of wood.
Primary barrier should be incorporated in any part of
the floor or ceiling of the room
Secondary barrier in the walls, provide protection
against scattered or leakage radiation and as
exposure rates are small they are ½ the thickness of
the primary wall.
Lead glass should be used for windows.
Doors of the radiology room should also
function as secondary barriers.
Regular radiation surveys, should be performed
at regular intervals .

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Definitions
genome: complete set of DNA, has all the information needed to develop and grow.
Aberration: distortion of image.
By stander effect: the inability influence of the presence of others on a person
willingness to help some in need.
Apoptosis: a type of cell death in which a series of molecular steps in a cell lead to its
death. This happened when body need to get ride of abnormal cell or un needed cell, this
blocked cancer cells.

Vasculature: vascular system.

Reproductive: producing children.
Fractionization: separation process. Certain quality of mixture divided into number of
smaller quantities, different in component according to gradient.
Gestation: period of development inside the uterus between conception (un fertilized
egg) and birth.
Off spring: the young creation of a living organ. (child=parent, puppy= dog).
Spontaneous mutation: the net result of all that can go wrong with DNA during life
time of an organ.
New mutation: the genetic alteration that is present for the first time in family member
as a result of a variant or mutation in germ cell (egg or sperm). Or one present in fertilized
egg itself during early embryogenesis.

Vasculature: vascular system.

Reproductive: producing children.
Fractionization: separation process. Certain quality of mixture divided into number of
smaller quantities, different in component according to gradient.
Gestation: period of development inside the uterus between conception (un fertilized
egg) and birth.
Off spring: the young creation of a living organ. (child=parent, puppy= dog).
Spontaneous mutation: the net result of all that can go wrong with DNA during life
time of an organ.
New mutation: the genetic alteration that is present for the first time in family member
as a result of a variant or mutation in germ cell (egg or sperm). Or one present in fertilized
egg itself during early embryogenesis.

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