Dental radiography-prescribing practices: a nationwide survey of dental hygienists.
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abstract
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.
