Muzzin Kathleen B, Flint Diane J, Schneiderman Emet
Gen Dent. 2019 Mar-Apr;67(2):38-53.
Potential harm from ionizing radiation has led to the development of guidelines to protect patients and practitioners from unnecessary radiation exposure; however, these guidelines may or may not be followed in practice. This study surveyed US dental hygienists with regard to radiology policies in the workplace. The survey, consisting of 62 knowledge and practice items regarding use of dental radiography, was based on the 2012 publication by the American Dental Association (ADA) and the US Food and Drug Administration (FDA): Dental Radiographic Examinations: Recommendations for Patient Selection and Limiting Radiation Exposure. The survey link was emailed to 10,000 subscribers of the Dimensions of Dental Hygiene magazine and posted on the magazine's Facebook page. Five hundred seventeen dental hygienists completed the survey. Data analysis included descriptive statistics, cross-tabulations, and chi-square analyses. Approximately 45.9% of respondents reported that the dentist determined the need for radiography, and 41.8% reported that the decision was made by the dental hygienist. The majority of respondents (82.4%) reported that there were times when a clinical examination was not performed before imaging, and 69.9% reported that images had been ordered on the basis of a set time interval. Approximately 35.6% reported that images had been requested on the basis of the patient's insurance reimbursement. For adult recall patients with no clinical caries and low caries risk, general and corporate dental practices made bitewing radiographs more frequently (every 12 months) compared with educational institutions (P < 0.05). In the case of children and adolescent recall patients without caries and with low caries risk, for children, corporate dental practices made bitewing radiographs more frequently (every 6 months) than educational institutions (P < 0.05); for adolescent patients, corporate and general dental practices preferred to make bitewing images every 12 months, whereas educational institutions preferred to make bitewing images every 18 months (P < 0.05). The findings suggest that some dental practices are not strictly following the ADA/FDA guidelines with regard to frequency of radiographic exposures.
电离辐射的潜在危害促使人们制定了相关准则，以保护患者和从业者免受不必要的辐射暴露；然而，在实际操作中这些准则可能并未得到遵循。本研究针对美国牙科保健员在工作场所的放射学政策展开了调查。该调查包含62个关于牙科放射摄影使用的知识和实践项目，其依据是美国牙科协会（ADA）和美国食品药品监督管理局（FDA）2012年发布的《牙科放射检查：患者选择及限制辐射暴露的建议》。调查问卷链接通过电子邮件发送给了《牙科保健维度》杂志的10000名订阅者，并发布在该杂志的脸书页面上。517名牙科保健员完成了调查。数据分析包括描述性统计、交叉制表和卡方分析。约45.9%的受访者表示由牙医决定是否需要进行放射摄影，41.8%的受访者称由牙科保健员做出这一决定。大多数受访者（82.4%）表示有时在进行影像检查前未进行临床检查，69.9%的受访者称影像检查是根据设定的时间间隔安排的。约35.6%的受访者表示影像检查是根据患者的保险赔付情况要求进行的。对于无临床龋齿且龋齿风险较低的成年复诊患者，综合牙科诊所和企业牙科诊所比教育机构更频繁地进行咬合翼片放射摄影（每12个月一次）（P<0.05）。对于无龋齿且龋齿风险较低的儿童和青少年复诊患者，对于儿童，企业牙科诊所比教育机构更频繁地进行咬合翼片放射摄影（每6个月一次）（P<0.05）；对于青少年患者，企业和综合牙科诊所倾向于每12个月进行一次咬合翼片影像检查，而教育机构则倾向于每18个月进行一次（P<0.05）。研究结果表明，一些牙科诊所并未严格遵循ADA/FDA关于放射摄影曝光频率的准则。
