1. Essentials of Dental Radiography for Dental Assistants and Hygienists CHAPTER Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson NINTH EDITION Quality Assurance in Dental Radiography 19

2. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Objectives Define the key words Explain the relationship between quality assurance and quality control List the steps of a quality assurance program Explain the role a competent radiographer plays in quality assurance List the four objectives of quality control tests

3. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Objectives Make a step-wedge with cardboard and lead foil and demonstrate how to use it List two tests the radiographer can use to monitor a dental x-ray machine Explain the use of the coin test to monitor darkroom safelighting Describe how to test for light leaks in the darkroom

4. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Objectives Explain the use of a reference film to test processing chemistry Explain the use of the fresh-film test to monitor the quality of a box of film Describe quality control tests for radiographic viewing equipment Advocate the use of quality assurance to produce diagnostic-quality radiographs with minimal radiation exposure

5. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Key Words Coin test Fresh film test Light-tight Quality assurance Quality control Reference film Step-wedge

6. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Introduction Quality assurance is defined as the planning, implementation, and evaluation of procedures used to produce high-quality radiographs with maximum diagnostic information (yield) while minimizing radiation exposure.

7. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Introduction Establishing a quality control program for radiographic procedures helps to increase the quality of radiographs produced and decrease the incidence of retake radiographs. Quality assurance includes both quality administration procedures and quality control techniques.

8. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson TABLE 19-1 Quality Assurance Includes Both Quality Administration and Quality Control

9. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Quality Administration Procedures Needs assessment Written plan Authority and responsibilities Monitoring and maintenance schedules Log and periodic evaluation

10. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson TABLE 19-2 Suggested Time Intervals for Performing Quality Control Tests

11. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Competence of the Radiographer Essential to a quality assurance program is the ability of the radiographer. Retakes result in unnecessary radiation exposure to the patient and lost time for both the patient and the practice. The radiographer must be competent not only in exposing, processing, and mounting dental radiographs, but also in identifying when errors occur.

12. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Quality Control The objectives of quality control include: –Maintain a high standard of image quality. –Identify problems before image quality is compromised. –Keep patient and occupational exposures to a minimum. –Reduce the occurrence of retake radiographs.

13. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Quality Control Dental x-ray machine monitoring Darkroom monitoring Processing system monitoring X-ray film monitoring

14. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson BOX 19-1 Quality Control Tests for Dental X-ray Machines

15. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson PROCEDURE 19-1 Assembling a step-wedge

16. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Figure 19-1 Step-wedge. (A) Commercially made step-wedge. (B) Step-wedge made from discarded sheets of lead foil from intraoral film packets.

17. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Figure 19-2 Sketch of a step-wedge. A step-wedge is useful in making visual comparisons for quality control.

18. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson PROCEDURE 19-2 Procedure for x-ray machine output consistency test

19. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Figure 19-3 Correct position of tube head when not in use. Extension arm folded, tube head and PID aimed at the floor.

20. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson PROCEDURE 19-3 Coin test for safelight adequacy

21. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson PROCEDURE 19-4 Reference film to monitor processing solutions

22. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Figure 19-4 Dental radiographic quality control device. Available from x-ray QC [formerly Dental Radiographic Devices], www.xrayqc.com.

23. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Review: Chapter Summary Quality assurance is defined as the planning, implementation, and evaluation of procedures used to produce high-quality radiographs with maximum diagnostic information (yield) while minimizing radiation exposure. Quality assurance includes both quality administration procedures and quality control techniques.

24. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Review: Chapter Summary The five steps to a quality administration program are (1) assess needs, (2) develop a written plan, (3) assign authority and responsibilities, (4) develop monitoring and maintenance schedules, and (5) use a log and evaluations to check on the program.

25. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Review: Chapter Summary The key to producing the highest quality diagnostic radiographs with the lowest possible radiation exposure is operator competence. Quality control is defined as a series of tests to ensure that the radiographic system is functioning properly and that the radiographs produced are of an acceptable level of quality.

26. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Recall: Study Questions General Chapter Review

27. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Reflect: Case Study The practice where you work needs to update their radiographic quality control plan. Currently the basic plan mentions the need to test the x-ray machine and monitor the darkroom and processing systems. Applying what you have learned in this chapter, develop a quality control plan for your practice. Include the following:

28. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Reflect: Case Study 1.List of equipment you think the practice should be testing 2.The name of the test needed 3.Recommended time interval for performing the test 4.Name of the person assigned to perform the test

29. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Reflect: Case Study 5.A description of what a failed test and a successful test would look like 6.The action required if a failed test results

30. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Reflect: Case Study Then prepare the following documents that your practice would use to assist the quality assurance plan: 1.A detailed, step-by-step procedure that someone could follow to perform each of the tests you have recommended 2.Forms to keep a log of the outcomes for each of the tests you recommended

31. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Relate: Laboratory Application Proceed to Chapter 19, Laboratory Application, to complete this activity.