Dr Krisztin Csom What are we protecting Patient

Dr. Krisztián Csomó

What are we protecting? � � Patient Ourselves Colleagues Environment

The 3 bases of radiation protetcion � Reasonable � Benefit � Optimization � ALARA � > Risk (As Low As Reasonably Achievable) Dose limitation

Equipment Service and controll Dentist and staff ALARA Staff protection Patient protection

Dentist and staff � Protect yourself! � Distance protection � Protecting wall � Never hold the film in your own hands!!!!!!

Distance protection � � The intensity of radiation is in reverse proportion to the distance squared Useable in places where only a few pictures are made (max 50 per week) The minimal distance is 2 meters (preferably 3 m) The person accompanying a minor can’t be pregnant, or under 18, also has to wear a protecting suit!

Protecting wall � The best option: Protected cabin � The wall can be made of: brick concrete Lead between wooden plates � In case of low circulation: protecting wall � At least 1. 5 m from the focus of the X-ray machine � At least 2 m high � At least 0. 7 mm lead-equivalent � At eye-level: 600 cm 2 1 mm lead-equivalent leadglass window

Licensing � � Standardized, given by the Hungarian health and safety board (ANTSZ). It is PROHIBITED to take an X-ray without a permit!

What protects the patient protects the staff as well � � � The X-ray image must be justified The person taking the picture must be well trained, must have adequate skills and not take unnecessary repeats The chosen technique must: � � � � � Be quick Have the lowest achievable radiation dose Be targeted Be able to be stored for future reference Filmholder Headchair Sensitive film – digital radiography Knowing the limits of our patient – anatomical as well as mental limits Lead apron Use of a tube of adequate geometry

Equipment We have to choose: � Which is the most ideal X-ray machine for our purposes � What is our purpose: � The lowest achievable radiation dose � The highest achievable image quality � � A lower dose of diffuse radiation can usually be achieved using modern equipment How does the digital system help?

Radiation protection in regards of digital radiography � � � The radiation dose is lower comparing intraoral images Can be stored electronically, images are easily multiplied and thereby no need for re-takes The benefits of the software: � No need for re-takes Over- or underexposed images can be salvaged The contrast and the definition can be modified

Maintenance and control � � � Optimal localization Maintenance every 2 years (the program is able to measure this) Radiation and electric insulation needs to be controlled regularly � The � exposition value needs to be standardized Keep track of the amortization!

Always monitor your own radiation exposure! � It is very important to know the dose you have been exposed to considering the stochastic effetcts!

Protection quantities � � Type of exposure Effective quantity Occupational 20 m. Sv/year Residential 1 m. Sv/year Equivalent quantity Eye-lens 15 m. Sv/year Skin 50 m. Sv/year Minors are not allowed to work in a radiating environment Pregnant colleague! The fetus is entitled to the residential levels of exposure!

Control of the occupational exposure � � � 1. Measuring 2. Registration, summarization, control (every 3 months) 3. Protection measurements

Measuring � � � Termoluminescent-dosimeter (TLD) (Film dosimeter) Must be worn at all times while at work!!!

Thank you for your attention!