[Dose and image quality in intraoral radiography]

The technique factors when performing intraoral X-ray exposures must be selected in such a way that sufficient diagnostic information is obtained at a reasonable patient dose. The Danish National Institute of Radiation Hygiene has performed a study comprising 32 dental X-ray sets. The mean value of the skin dose for a maxillary molar was 9.6 mGy and the value for the dental colleges 7.0 mGy. For a mandibular incisor the corresponding doses were 7.7 mGy and 3.6 mGy. After the conclusion of the mentioned study it has been part of the institute's inspection procedure for dental X-ray sets to measure patient skin doses. 243 measurements were performed and the mean value of the entrance skin dose was 6.5 mGy and the dose interval was 0.7-57 mGy. All doses are normalised to speed class D film. At 16% of the inspected sets films of speed class E were used. The remainder used class D films. The spread in doses cannot be explained by variation in equipment parameters alone but is to a high degree due to a combination of inappropriate film processing and exposure time. Interviews with staff in dental clinics confirm that films are frequently processed until the desired density is obtained by visual estimation. It is shown that the skin dose when using film of speed class D can be kept below 7 mGy for a mandibular incisor. Concluding is stated that film processing shall be performed in accordance with specifications from the manufacturer of the developer. Film of speed class E must be used. Finally must the exposure time be graduated according to the object exposed.