Assessing quality

This is a clinical audit to assess the quality of bitewing radiographs taken during dental examinations at Farm Street Dental Practice.

Radiography is a useful tool in aiding in diagnosis of dental diseases. Bitewings are mainly taken for caries diagnosis and also can be used to identify alveolar bone levels. At Farm Street, digital radiography is used to reduce radiation dose to the patients. Furthermore as many patients are of high caries risk, bitewings are taken regularly at the practice. I wanted to analyse the image quality of radiographs as I felt it was an important topic to regularly audit and ensure that radiographs are not repeated and radiation dose to the patient is kept as low as possible. This is in accordance with the European guidelines on radiation protection that the radiation dose to the patient should be as low as reasonably practicable (the ALARP principle).

Guidelines by the National Radiological Board have been produced to help practitioners apply the ALARP principle. Methods of dose reduction include factors related to the X-ray equipment such as filtration, collimation, image receptor, voltage, method of X-ray generation. Also there are patient factors such as patient preparation, and careful positioning and beam aligning devices. Quality assurance programmes and use of selection criteria for different radiographs further ensure the radiation dose is kept to the minimum.