Establishment of a local diagnostic reference level for dental intraoral bitewing X-rays

A state-based local diagnostic reference level (LDRL) for dental intraoral X-rays has been established. LDRL values of 2.0 mGy incident air kerma (IAK) and 57 mGy•cm² air kerma-area product (KAP) for an adult posterior bitewing X-ray were determined based on 811 X-ray units surveyed. This IAK LDRL value is greater than those established in several other nations and regions around the world in similar studies. Analyses of radiographic technique and equipment usage are included to provide broad guidance as to ways that imaging could be optimised, such as in the selection of exposure factors, collimators, image receptors, and X-ray unit models.