Dental Radiology Syllabus for 2013-2014
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Instructor Information

Office Location

West Campus Jones Hall 125

Office Hours

As listed on my office door.

Course Information

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Course

DHYG-1304-003 Dental Radiology

Prerequisites

Course Description

Fundamentals of oral radiography, including techniques, interpretation, quality assurance and ethics.

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Department Expectations

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Hours

(3 sem hrs; 2 lec, 4 lab)

Class Type

On Campus Course

Syllabus Information

Textbooks

Required Course Textbooks

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Students MUST have the current edition of all required textbooks and must bring textbooks to all scheduled class sessions.

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1.         Dental Radiography:  Principles and Techniques, 4th ed., Joen M. Iannucci, Laura Jansen Howerton, W.B. Saunders Company.

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2.         Amarillo College Dental Hygiene Program Manual  2012 -2013

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 Recommended Course Textbook  (Board Review Book of choice.  Example book listed below)

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1.         Mosby's Comprehensive Review of Dental Hygiene, 4th ed., Michele Darby, Mosby Publishing Company. 

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Supplies

\ Course Supply List

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  1. \ Library Card for AC and/or city library
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  3. \ Computer and Internet Access, printer, print cartridges
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  5. \ Index cards – if preferred for note taking, Sh

    Student Performance

    Instructor Objectives for the Course

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    Chapter objectives will coordinate with the materials presented in lecture, handouts, reading assignments, and examinations.  Learning the objectives will be required of the student in order to be successful in the completion of the written and practical examinations and in laboratory exercises. Given the course textbooks, personal notes, handouts, and other course materials, the student should:

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    1.         Learn the terminology, facts, theories, methods, and principles, associated with dental radiology as outlined in the daily objectives and in the course schedule.

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    2.         Apply the knowledge learned to a laboratory simulation or clinical patient.

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    3.         Evaluate the learning experiences as measured by the course objectives.

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    The student will know that these goals have been successfully completed if after evaluated by course instructor, a minimal grade of 75 or greater is earned.

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    Unit I Objectives:  Ch. 1, 2, 3, 4, 5 & 22

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    Ch. 1 - Radiation History

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    •          Be able to define and differentiate between the basic terms that pertain to dentistry and x-radiation.
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    •          Summarize the importance of dental radiographs.
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    •          Explain the various uses of dental radiographs.
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    •          Summarize the discovery of x-radiation and the pioneers that contributed to its progression in dentistry.
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    •          List the highlights in the history of x-ray equipment, film and dental radiographic techniques.
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    Ch. 2 - Radiation Physics

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    •          Be able to define the key words associated with radiation physics.
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    •          Identify the structure of the atom.
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    •          Describe the process of ionization.
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    •          Discuss the difference between radiation and radioactivity.
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    •          Name and define the two types of ionizing radiation.  Give examples of each type.
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    •          Define electromagnetic radiation.  List the common characteristics shared by all energies of the electromagnetic spectrum.
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    •          Explain the properties of velocity, wavelength, and frequency as they are related to the wave concept.
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    •          Define x-radiation.  List the properties of x-radiation. 
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    •          Identify the components of the x-ray machine and explain their functions.
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    •          Be able to label the parts of the dental x-ray tubehead and the dental x-ray tube.
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    •          Describe the step by step process of how dental x-rays are produced.
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    •          Explain the two types of x-rays that are produced in the x-ray tube. 
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    •          Define the terms of primary, secondary, and scatter as they are used to describe x-radiation.
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    •          List and describe the possible interactions of x-rays with matter.
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    Ch. 3 - Radiation Characteristics

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    •         Be able to define the key words associated with radiation characteristics.
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    •         Describe the effect that the kilovoltage peak has on the quality of the x-ray beam.
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    •         Describe how milliamperage influences the quantity of the x-ray beam. 
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    •         Identify the range of kilovoltage and milliamperage required for dental radiography.
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    •         Describe how increasing and decreasing exposure factors affect the density and contrast of the film.
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    •         State the rules governing kilovoltage, milliamperage, distance, and exposure time that are used when changing exposure variables.
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    •         Describe how kilovoltage, milliamperage, exposure time, and source-to-film distance influences the intensity of the x-ray beam.
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    •         Calculate an example of radiation intensity using the Inverse Square Law.
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    •         Explain how the half-value layer determines the penetrating quality of the x-ray beam.
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    Ch. 4 - Radiation Biology

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    •          Be able to define the key words associated with radiation biology.
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    •          Describe the mechanisms, theories, and sequence of radiation injury.
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    •          Define and discuss the dose-response curve and radiation injury.
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    •          List the determining factors for radiation injury.
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    •          Discuss the short-term and long-term effects, and the somatic and genetic effects of radiation exposure.
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    •          Describe the effects of radiation exposure on cells, tissues, and organs.
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    •          Identify the relative sensitivity of a given tissue to x-radiation.
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    •          Define the units of measurement used in radiation exposure.
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    •          List common sources of radiation exposure.
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    •          Discuss risk and risk estimates for radiation exposure.
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    •          Discuss dental radiation and exposure risks.
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    •          Discuss the risk versus benefit of dental radiographs.
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    Ch. 5 - Radiation Protection

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    •          Be able to define the key words associated with radiation protection.
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    •          Describe in detail the basics of patient protection prior to x-ray exposure.
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    •          Describe the different types of filtration and state the recommended total filtration for dental x-ray machines operation above and below 70 kVp
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    •          Describe the collimator used in dental x-ray machines and state the recommended diameter of the useful beam at the patient’s skin.
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    •          List six ways to protect the patient from excess radiation during x-ray exposure.
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    •          Describe the importance of film handling the processing after patient exposure to x-rays.
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    •          Discuss operator protection in terms of adequate distance, shielding, and avoidance of the usefulbeam.
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    •          Describe personnel and equipment monitoring devices used to detect radiation.
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    •          Discuss radiation exposure guidelines, including radiation safety legislation, MPD, MAD, and ALARA.
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    •          Discuss with the dental patient what radiation protection steps will be used before, during, and after x-ray exposure.
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    Ch. 22 - Panoramic Imaging

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    •          Be able to define the key words associated with panoramic imaging.
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    •          Describe the purpose and uses of panoramic imaging.
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    •          Describe the fundamentals of panoramic imaging.
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    •          Describe the equipment used in panoramic imaging.
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    •          Describe the patient preparations, equipment preparations, and patient positioning procedures needed before exposing a panoramic projection.
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    •          Identify the patient preparation and positioning errors seen on panoramic images.
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    •          Discuss the causes of patient preparation and positioning errors and the necessary measures needed to correct such errors.
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    •          Discuss the advantages and disadvantages of panoramic imaging.
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    Unit II Objectives:  Ch. 7, 8, 19, 9, 10, 11, 12, 13, 14 & 15

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    Ch. 7 - Dental X-ray Film

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    •          Describe in detail film composition and latent image formation.
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    •          List and describe the different types of x-ray film used in dentistry.
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    •          Define intraoral film and describe intraoral film packaging.
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    •          Identify the types and sizes of intraoral film available.
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    •          Discuss film speed.
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    •          Discuss the differences between intraoral film and extraoral film.
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    •          Describe the difference between screen and nonscreen films.
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    •          Describe the use of intensifying screens and cassettes.
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    •          Describe duplicating film.
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    •          Discuss proper film storage and protection.
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    Ch. 8 - Dental X-ray Image Characteristics

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    •          Differentiate between radiolucent and radiopaque areas on a dental radiograph.
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    •          Describe a diagnostic dental radiograph.
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    •          List the two visual characteristics of the radiographic image.
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    •          List the factors that influence film density and contrast.
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    •          Discuss the difference between high and low contrast.
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    •          Describe film contrast and subject contrast.
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    •          Describe the difference between short-scale and long-scale contrast.
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    •          Identify images of high contrast, low contrast, no contrast, short-scale contrast, and long-scale contrast.
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    •          Describe a stepwedge.
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    •          List the three geometric characteristics of the radiographic image.
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    •          List the factors that influence sharpness, magnification, and distortion
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    Ch. 19 - Bite-Wing Technique

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    •          Describe the purpose and use of the bite-wing film.
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    •          Describe the appearance of opened and overlapped contact areas on a dental radiograph.
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    •          State the basic principles of the bite-wing technique.
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    •          List the two ways a film can be stabilized in the bite-wing technique and identify which one is recommended for bite-wing exposures.
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    •          List the four film sizes that can be used in the bite-wing technique and identify which film size is recommended for exposures in the adult patient.
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    •          Describe correct and incorrect horizontal angulation.
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    •          Describe the difference between positive and negative vertical angulation.
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    •          State the recommended vertical angulation for all bite-wing exposures.
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    •          State the basic rules for the bite-wing technique.
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    •          Describe the patient and equipment preparations that are necessary before using the bite-wing technique.
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    •          Discuss the exposure sequence for a complete mouth radiographic series (CMRS) that includes both periapical and bite-wing exposures.
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    •          Describe the premolar and molar bite-wing film placements.
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    •          Describe the purpose an use of vertical bite-wings.  List the number of exposures and the size of film used in the vertical bite-wing technique.
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    Ch. 9 - Dental X-ray film Processing

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    •          Describe in detail how a latent image becomes a visible image.
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    •          List and discuss the five steps of film processing.
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    •          List and describe the four basic ingredients of the developer solution.
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    •          List and describe the four basic ingredients of the fixer solution.
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    •          Discuss the location, size, lighting, and equipment requirements necessary for the darkroom.
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    •          Discuss safelighting.
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    •          Discuss the parts of the processing tanks, master tank, and lid.
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    •          List and describe the equipment needed for manual film processing.
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    •          List and discuss the step-by-step procedures for manual film processing.
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    •          Describe the care and maintenance of the processing solutions, equipment, and equipment accessories used in manual film processing.
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    •          Discuss the advantages of automatic film processing.
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    •          List and identify the component parts of the automatic film processor.
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    •          Describe the mechanism of automatic film processing.
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    •          List and discuss the step-by-step procedures used for automatic film processing.
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    •          Describe the care and maintenance of the automatic film processor and automatic processing solutions.
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    •          Discuss the equipment requirements and step-by-step procedures used for film duplication.
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    •          Describe film processing problems that result from time and temperature errors.
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    •          Describe film processing problems that result from chemical contamination errors.
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    •          Describe film processing problems that result from film handling errors.
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    •          Describe film processing problems that result from lighting errors.
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    Ch. 10 - Quality Assurance in the Dental Office

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    •          List quality control tests and quality administration procedures that should be included in the quality assurance plan.
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    •          Discuss the purpose and frequency of testing dental x-ray machines.
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    •          Describe the tests used to check for fresh film and adequate film-screen contact.  Discuss the frequency of testing and the interpretation of test results.
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    •          Describe the test used to check for darkroom light leaks and proper safelighting.  Discuss the frequency of testing and the interpretation of test results.
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    •          Describe the test used to check the automatic processor.  Discuss the frequency of testing and the interpretation of test results.
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    •          List three tests used to check the strength of the developer solution.
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    •          Describe the preparation of the reference radiograph and the standard stepwedge radiograph. Discuss the use of these radiographs to compare film           densities and to monitor the strength of developer solution.
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    •          Describe the test used to check the strength of the fixer.  Discuss the frequency of testing and the interpretation of test results.
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    •          Discuss the basic elements of a quality administration plan.
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    •          Detail the importance of operator competence in dental radiographic procedures.
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    Ch. 11 - Dental Radiographs and the Dental Radiographer

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    •          Discuss the importance of dental radiographs.
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    •          List the uses of dental radiographs.
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    •          Discuss the benefits of dental radiographs.
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    •          List examples of common dental conditions that may be evident on a dental radiograph.
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    •          Discuss the knowledge and skill requirements of the dental radiographer.
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    •          List the responsibilities that may be assigned to the dental radiographer.
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    •          Discuss the professional goals of the dental radiographer.
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    Ch. 12 - Patient Relations and the Dental Radiographer

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    •          Discuss verbal, nonverbal, and listening skills and explain how each can be used to enhance communication.
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    •          Discuss how facilitative skills can be used to enhance patient trust
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    •          Define a relationship of trust between the dental professional and the patient.
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    •          Discuss the importance of the first impressions, Chairside manner, and attitude and explain how each can enhance patient relations.
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    Ch. 13 - Patient Education and the Dental radiographer

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    •         Summarize the importance of educating patients about dental radiographs.
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    •         List the three methods that can be used by the dental radiographer to educate patients about dental radiographs.
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    •         Answer common patient questions about the need for dental radiographs, x-ray exposure, the safety of dental x-rays, digital imaging, and other                          miscellaneous concerns. 
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    Ch. 14 - Legal Issues and the Dental radiographer

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    •          Define the key terms associated with legal issues.
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    •          List the federal and state regulations affecting the useof dental x-ray equipment.
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    •          Describe the general application of federal and stateregulations as they affect the dental auxiliary.
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    •          Describe the licensure requirements for exposingdental radiographs.
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    •          Define the legal concept of informed consent.
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    •          Describe how to obtain informed consent from apatient.
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    •          Discuss the legal significance of the dental record.
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    •          Describe the legal implications of patient refusal tohave dental x-radiation.
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    •          Discuss how confidentiality laws affect the informationin the dental record.
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    •          Describe the patient’s rights with regard to the dentalrecord.
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    Ch. 15 - Infection Control and the Dental Radiographer

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    •           Define the key terms listed.
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    •           Describe the rationale for infection control.
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    •           Describe three possible routes of disease transmission.
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    •           Describe the conditions that must be present for diseasetransmission to occur.
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    •           Discuss protective attire and barrier techniques, handwashing and care of hands, sterilization or disinfectionof instruments, and the cleaning and disi                 disinfection of the dental unit and environmental surfaces.
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    •           Detail infection control procedures necessary beforex-ray exposure.
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    •           Detail infection control procedures necessary duringx-ray exposure.
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    •           Detail infection control procedures necessary after xrayexposure.
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    •           Detail infection control procedures necessary forprocessing.
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    •           Discuss film handling in the darkroom with andwithout barrier envelopes.
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    •           Discuss film handling without barrier envelopesusing the daylight loader of an automatic processor.
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    Unit III Objectives: Ch. 18, 20, 21, 23, 24, 25 & 26

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    Ch. 18 - Bisecting Technique

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    •          State the rule of isometry.
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    •          State the basic principles of the bisecting technique and illustrate the location of the film, tooth imaginary bisector, central ray, and position-indicating            device (PID).    
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    •          List the film holders that can be used with the bisecting technique.
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    •          Describe the finger-holding method of film stabilization.
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    •          List the disadvantages of the finger-holding method.
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    •          Describe the film size used with the bisecting technique.
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    •          Describe correct and incorrect horizontal angulation.
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    •          Describe correct and incorrect vertical angulation.
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    •          State each of the recommended vertical angulation ranges used for periapical exposures in the bisecting technique.
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    •          State the basic rules of the bisecting technique.
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    •          Describe the patient and equipment preparations necessary prior to using the bisecting technique.
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    •          Discuss the exposure sequence used for the 14 periapical film placements used in the bisecting technique.
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    •          Describe each of the 14 periapical film placements recommended for use with the bisecting technique.
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    •          List the advantages and disadvantages of the bisecting technique.
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    Ch. 20 - Exposure and technique Errors

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    •          Identify and describe the appearance of the following film exposure errors: unexposed film, film exposed to light, underexposed film, and overexposed film.
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    •          Describe horizontal and vertical angulation.
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    •          Identify and describe the appearance of the following periapical technique errors: incorrect horizontal angulation, incorrect vertical angulation                              (foreshortened images and elongated images), and incorrect beam alignment (cone-cut images).
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    •          Describe and identify proper film placement for bite-wing radiographs.
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    •          Identify and describe the appearance of the following bite-wing technique errors:  incorrect horizontal angulation, incorrect vertical angulation, and incorrect          indicating device (PID) alignment (cone-cut images).
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    •          Identify and describe the appearance of the following miscellaneous technique errors: film bending, film creasing, phalangioma, double exposure,                       movement, and reversed film.
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    Ch. 21 - Occlusal and Localization Techniques

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    •          Describe the purpose of the occlusal examination.
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    •          List the uses of the occlusal examination.
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    •          Describe the patient and equipment preparations necessary prior to using the occlusal technique.
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    •          State the recommended vertical angulations for the following maxillary occlusal projections: topographic, lateral (right or left), and pediatric.
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    •          State the recommended vertical angulations for the following mandibular occlusal projections: topographic, cross-sectional, and pediatric.
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    •          State the purpose of localization techniques.
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    •          Describe the buccal object rule.
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    •          Describe the right-angle technique.
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    •          List the patient and equipment preparations that are necessary prior to using the buccal object rule or the right-angle technique.
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    •          Describe the film placements for the buccal object rule and compare the resulting radiographs.
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    •          Describe the film placements for the right-angle technique and compare the resulting radiographs.
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    Ch. 23 - Extraoral Radiography

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    •          Describe the purpose and uses of Extraoral radiography.
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    •          Describe the equipment used in Extraoral radiography.
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    •          Detail the equipment and patient preparations necessary prior to exposing an Extraoral film.
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    •          Identify the specific purpose of each of the Extraoral film projections.
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    • .        Describe the head position, film placement and beam alignment for each of the following Extraoral films: lateral jaw projection – body of the mandible,           lateral  jaw projection – ramus of the mandible, lateral cephalometric projection, posteroanterior projection, Waters projection, submentovertex projection           reverse Towne projection, and transcranial projection.
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    Ch. 24 - Imaging of Patients with Special Needs

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    •          List the areas of the oral cavity that are most likely to elicit the gag reflex when stimulated.
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    •          List two precipitating factors responsible for initiating the gag reflex.
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    •          Describe how to control the gag reflex using operator attitude, patient and equipment preparations, exposure sequencing, film placement and technique,            and helpful hints.
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    •          Describe common physical disabilities and what modifications in technique may be necessary during the radiographic examination.
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    •          Describe common developmental disabilities and what modifications in technique may be necessary during the radiographic examination.
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    •          List helpful hints that can be used when treating a person with a disability.
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    •          Describe the prescribing of dental radiographs, patient and equipment preparations, recommended techniques, and patient management as they pertain to &nbs

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