YourRPA - Independent Radiation and Laser Protection Adviser, 96 Sefton Road, Morecambe, Lancashire, LA3 1UD.
Br Dent J. 2013 Mar;214(6):E16. doi: 10.1038/sj.bdj.2013.274.
To illustrate the authors' experience in the provision of radiation protection adviser (RPA)/medical physics expert (MPE) services and critical examination/radiation quality assurance (QA) testing, to demonstrate any continuing variability of the compliance of X-ray sets with existing guidance and of compliance of dental practices with existing legislation.
Data was collected from a series of critical examination and routine three-yearly radiation QA tests on 915 intra-oral X-ray sets and 124 panoramic sets. Data are the result of direct measurements on the sets, made using a traceably calibrated Unfors Xi meter. The testing covered the measurement of peak kilovoltage (kVp); filtration; timer accuracy and consistency; X-ray beam size; and radiation output, measured as the entrance surface dose in milliGray (mGy) for intra-oral sets and dose-area product (DAP), measured in mGy.cm(2) for panoramic sets. Physical checks, including mechanical stability, were also included as part of the testing process.
The Health and Safety Executive has expressed concern about the poor standards of compliance with the regulations during inspections at dental practices. Thirty-five percent of intra-oral sets exceeded the UK adult diagnostic reference level on at least one setting, as did 61% of those with child dose settings. There is a clear advantage of digital radiography and rectangular collimation in dose terms, with the mean dose from digital sets 59% that of film-based sets and a rectangular collimator 76% that of circular collimators. The data shows the unrealised potential for dose saving in many digital sets and also marked differences in dose between sets.
Provision of radiation protection advice to over 150 general dental practitioners raised a number of issues on the design of surgeries with X-ray equipment and critical examination testing. There is also considerable variation in advice given on the need (or lack of need) for room shielding. Where no radiation protection adviser (RPA) or medical physics expert (MPE) appointment has been made, there is often a very low level of compliance with legislative requirements. The active involvement of an RPA/MPE and continuing education on radiation protection issues has the potential to reduce radiation doses significantly further in many dental practices.
阐述作者在提供辐射防护顾问（RPA）/医学物理专家（MPE）服务以及关键检查/辐射质量保证（QA）测试方面的经验，以证明 X 射线设备对现有指南的合规性以及牙科实践对现有法规的合规性存在持续变化。
从对 915 台口腔内 X 射线设备和 124 台全景设备进行的一系列关键检查和常规三年辐射 QA 测试中收集数据。数据是使用可追溯校准的 Unfors Xi 仪表对设备进行直接测量的结果。测试涵盖了峰值千伏（kVp）的测量；过滤；定时器的准确性和一致性；X 射线束的大小；以及辐射输出，以口腔内设备的入口表面剂量（毫戈瑞（mGy））和全景设备的剂量面积乘积（DAP）（以毫戈瑞·厘米 2 （mGy·cm 2 ））表示。机械稳定性等物理检查也包括在测试过程中。
健康与安全执行局（HSE）在对牙科实践的检查中对法规合规标准差表示关注。至少有 35%的口腔内设备在至少一个设置上超过了英国成人诊断参考水平，而有儿童剂量设置的设备中则有 61%超过了该水平。在剂量方面，数字射线照相术和矩形准直具有明显的优势，数字设备的平均剂量是胶片设备的 59%，而圆形准直器的平均剂量是圆形准直器的 76%。数据显示，许多数字设备在剂量节约方面具有未实现的潜力，并且设备之间的剂量差异也很大。
为 150 多名普通牙科医生提供辐射防护建议，引发了一些关于 X 射线设备和关键检查测试的手术设计问题。在是否需要（或不需要）房间屏蔽方面，也存在很大的差异。在没有任命辐射防护顾问（RPA）或医学物理专家（MPE）的情况下，对立法要求的合规性往往非常低。RPA/MPE 的积极参与以及辐射防护问题的继续教育有可能进一步大大降低许多牙科实践中的辐射剂量。
