“Just this once; it’s okay.”
Does that sound like your practice? You know, you have a gaggy, bouncy kid who’s just about to tongue-thrust their way out of having those radiographs taken, but here comes Amazing Assistant to help you get a diagnostically acceptable image. SCORE!
The problem is that this never happens “just once.” I’ve seen the same person holding sensors in patients’ mouths dozens of times, and that’s when it becomes a problem. Yes, radiation is safer now that we’ve dialed it down and collimators make sure that there’s nothing scattering beyond the focused beam, but that doesn’t mean that we should be flippant about limiting exposure to our patients and most importantly, ourselves.
My best friend from high school could tell you not to hold those films in people’s mouths, too. She was a dental technician in the Navy and also worked for years in pediatric dental offices and orthodontics as an assistant, calming nervous children, helping them to have good dental experiences, and when she was exposing radiographs, sometimes she admits that she would make it easier on everyone if she would stay with the child while the x-rays were beaming through her hand.
She doesn’t have to tell you not to hold the films, though. She can just show you why you shouldn’t:
This is her right hand. Several years ago when she was doing laundry her finger caught on the dryer and “snapped.” This is important, sort of like when your patient tells you exactly what they were eating when their tooth broke – don’t you pay that the most attention of all? Because it was the darn dryer that was the problem….(!) Let’s be serious, though. Like you, her doctor really didn’t care what broke her finger, he wanted to know why it broke.
Turns out that she had developed a giant cell tumor in the first (proximal) phalange of her ring finger that had eaten everything except a small sliver of bone and that was what had snapped. These are very, very rare in small bones like those found in our fingers; most osteoclastomas happen in the larger bones like femurs and such. Hmmm.
Even though the tumor was benign, because of the damage done, the possibility of regrowth and other factors, the decision was made for my friend to have her ring finger amputated. I would have had her flip you the bird for effect but she no longer has a middle finger either…! (think about it…!)
So she was fortunate enough to stay in dentistry as a patient care coordinator for a few more years as she recovered but is now working towards her master’s degree for speech pathology. While she doesn’t seem totally convinced that excessive radiation exposure caused her to lose her finger, she doesn’t count it out for even a second.
And neither do I.
Losing a finger may be anecdotal evidence about the dangers of radiation, but it’s enough for me to feel like enforcing what we already know to be true.
Please share this story with those you care about, even if it makes you feel like the Radiation Nazi.
Patricia Found Clark says
Thank you for sharing. It definitely is not worth sacrificing one’s health for a radiograph. People can live without a tooth, they sometimes don’t live once they have cancer.
Agreed. And it’s not too difficult to make the commitment to one’s self to be safe, no matter how much you want to say, “just this one time.”
I’ve seen peer pressure in an office to hold the sensor and it breaks my heart when someone doesn’t understand that when one small part of their body gets hit by radiation several times per day, every day, that it WILL add up.
Joe Tagliarini says
That’s the thing about radiation in the dentist’s office. It’s small enough that limited exposure isn’t going to harm you but 8 hours a day, 5 days a week for the next 30 years…well all those “just this once” moments add up to a lot.
Holding films is an absolute no-no nowadays! At uni we were shown plenty of photos in radiology lectures like that of the hand of your best friend from high school. I would never hold films or let any of my staff do that. However digital RGs and rectangular collimation is still not standard practise at my practice (s = verb; c = noun) so we still have some way to go. Love your blog cheers
Hoang Truong, DDS says
I will show this to my assistants and hygienists. Sometimes they stay in the room during x-rays. While it is helpful, I always remind them that their long-term health is just as important.
Thank you for sharing this informative post on the long-term and repeated exposure to dental x-rays.
Rick Lindquist says
So glad to see the radiation Nazi posting. It’s funny that term exists…not funny ha ha funny strange!
We all must be aware that damage from X-ray exposure is cumulative. Ohh just this once………it won’t hurt me. I’ve been doing this for years and no issues etc etc etc.
Distance is our friend. Dental X-rays are at a low level today. Good colimation, short exposure times. The issue this creates is folks get complacent. We often repeat the low dose mantra several times per day to patients.
Leaving the room is not truly necessary, what is necessary is distance and correct position. Be behind the generator, 2 meters behind it. Distance and avoidance of the primary beam will keep you safe.
Been taking and teaching dental X-ray for almost 40 years, no missing digits. Distance is our friend.
I’m going through this now. Seeing surgeon Friday. I worked in nursing homes with sometimes combative patients that certainly couldn’t hold the FMX themselves. I would hold the film and use a Nomad….I was required to get the FMX . I always figured I was done having children so no concern for my reproductive health. Didn’t consider the thumb!