Justification in dental radiology

Frequently asked questions by the health professionals

» How can I avoid unnecessary examinations? 
» What advice is there to help me select X-ray examinations? 
» Is it a good idea to monitor the dental development of children using a panoramic radiograph? 

» How can I avoid unnecessary examinations?

By making sure that radiographs are selected for each individual patient based on clinical need. You should avoid using a “routine” protocol for X-rays of patients and always examine the patient before choosing any X-ray procedures. Just as you prescribe drug therapy, such as antibiotics or painkillers, to suit a patient’s diagnosis, so you should try to select any X-ray examinations according to their clinical need.

» What advice is there to help me select X-ray examinations?

Guidelines that can support you and the patient in this decision, called referral criteria (or selection criteria), have been developed by various professional organizations (EC-RP136; Haute Autorité de Santé; SEDENTEXCT Provisional Guidelines; Espelid et al., 2003; Harris et al., 2002; Isaacson et al., 2008; Pendlebury et al., 2004). These are systematically developed statements of “good practice” for radiology in specific clinical dental situations. Even though they are not rules, they can give you a framework against which to consider your patient’s needs.

» Is it a good idea to monitor the dental development of children using a panoramic radiograph?

No, there is no justification for this routine practice. Radiography may be required when a clinical examination suggests the presence of an abnormality, or when interceptive and active orthodontic treatment is being considered. Clinical indicators, used to identify patients who might benefit from a panoramic radiograph, are effective in excluding children for whom an X-ray examination is not likely to be of value.