Occupational radiation exposure from handheld dental x-ray devices: A quantitative dosimetric study

Occupational radiation exposure from handheld dental radiographic devices may pose potential health risks. This study aims to quantitatively evaluate the occupational radiation dose from handheld dental radiographic devices, UAX-01 (Device A), HyperLight-G (Device B), and EzRay Air P (Device C) to the operator's critical anatomical regions.

An experimental dosimetric study was conducted using purposive sampling of three devices. Radiation was measured using calibrated TLD-100 dosimeters placed on a mannequin (simulating an operator) and a head and neck phantom used only to simulate patient scatter. Dosimeters were placed at the orbital surface, neck (thyroid level), chest (thoracic level), index fingers, and pelvic surface (gonadal level) to measure personal dose equivalent [Hp(0.07), Hp(10)] with and without shielding. Additionally, in vivo clinical dose evaluation for device A over 2 months with dosimeters placed at the chest and finger level for dentist and assistant in Erbil, Kurdistan region of Iraq. Personal dose equivalent was analyzed using SPSS, with statistical significance set at p ≤ 0.05.

The results showed significant differences in unshielded personal dose equivalent across devices and anatomical regions (p ≤ 0.05). UAX-01 had the highest mean exposure at most sites: right orbital surface (46.90 µSv), neck (thyroid level) (39.54 µSv), chest (thoracic level) (40.66 µSv), right hand (65.21 µSv), left hand (31.85 µSv), and pelvic surface (gonadal level) (58.65 µSv). The left orbit received the highest dose from HyperLight-G (26.68 µSv). Protective shielding significantly reduced radiation exposure in nearly all regions and devices (p < 0.001), with reductions ranging from 32.25% to 66.90%. An exception was the chest (thoracic level) with HyperLight-G, where the reduction was not significant (p = 0.184). Additionally, in vivo monitoring of device A (UAX-01) over 2 months revealed a cumulative personal dose equivalent Hp(0.07) =  16.76 mSv to the finger (sensor-holding hand) and Hp(10) = 1.98 mSv to the chest of the dentist, indicating substantial localized exposure during routine clinical use.

The study revealed that handheld dental x-ray devices-particularly the UAX-01-can expose operators to radiation levels that may exceed ICRP and NCRP occupational dose limits for the orbital surface, hands, and whole body when used without consistent protection. To mitigate these risks, health care providers should implement shielding, proper positioning, and sensor holders, while policymakers must enforce ALARA (as low as reasonably achievable)-based regulations and routine occupational dose monitoring.