Establishment of Local DRLs for Adult and Pediatric Patients in Intraoral Radiography at South African Oral Health Care Center

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ABSTRACT

  • 1Mashinini S,
  • 2Nyathi M ,
  • 3Rajbaran-Singh S
  • 1Department of Medical physics, School of Medicine, Sefako Makgatho Health Sciences University, Garankua
  • 2Department of Medical physics, School of Medicine, Sefako Makgatho Health Sciences University, Garankua
  • 3Department of Maxillofacial and Oral Radiology, School of Dentistry, Sefako Makgatho Health Sciences University, Garankua

Background

Dental radiography utilizes X-rays to obtain images of teeth, jaws, and surrounding tissues for diagnosis, treatment planning and monitoring of oral conditions. While radiographs provide significant clinical benefits, there is concern that exposure to X-rays, a form of ionizing radiation increases the risk of cancer. To mitigate risks, the International Commission on Radiological Protection advocates implementation of diagnostic reference levels (DRLs). DRLs are an optimization tool that identifies doses that are either too high or low that are not commensurate with the clinical objective. This study aimed at establishment of DRLs for adult and pediatric patients undergoing intraoral radiography at a South African (SA) Oral Health Care Centre.

Method

Six intraoral x-ray units were selected for dose measurements. Patient Entrance Dose (PED) measurements were taken using a RaySafe X2 Survey Meter with an X-ray sensor calibrated for intraoral energies. Three measurements per X-ray unit were taken for both adult and pediatric mandibular and maxillary molars with each X-ray unit set at 70 kV, 7 mA. For each unit, the dose area product (DAP) was calculated using the formula:

DAP = Exposed area (A) × Dose at the end of the cone (PED).

The 75th percentile of the median DAP values for each X-ray unit were proposed as DRLs.

Result

The proposed intraoral DRLs were 1.16 mGy (adult mandibular), 1.35 mGy (adult maxillary), 0.70 mGy (pediatric mandibular) and 0.85 mGy (pediatric maxillary). SA adult mandibular and maxillary DRLs are lower than Cyprus and Indian DRLs. Furthermore, SA pediatric mandibular and auxiliary molars are lower than Cyprus pediatric DRLs.

Conclusion

Proposed intraoral DRLs for adult patients are higher than those of children. Establishing DRLs is a crucial step towards ensuring patient safety in dental care in SA. Established DRLs provides a benchmark for future dose optimization efforts.
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PRESENTING AUTHOR

Mr. Sello Mashinini, MSc Medicine (Medical Physics)

MSc Student, Sefako Makgatho Health Sciences University

I am currently pursuing a Master’s degree in Medical Physics at Sefako Makgatho Health Sciences University, where I have acquired a solid foundation in radiation therapy, imaging techniques, and radiation protection principles. Through coursework and laboratory experiences during my Honors degree in Medical Physics, I have developed a keen understanding of the theoretical aspects of medical physics.
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