Awareness of Radiation protection among Dental surgeons in south Chennai -A Questionnaire study
Anuradha G1, Pazhanivel K2
1Prof and Head, Department of Oral Medicine and Radiology, Madha Dental College and Hospital,
Chennai, Tamil Nadu.
2Post Graduate, Department of Oral Medicine and Radiology, Madha Dental College and Hospital,
Chennai, Tamil Nadu.
*Corresponding Author E-mail: anug77@yahoo.com
ABSTRACT:
Aim and Objectives: To assess the attitude and awareness about radiation protection among dental surgeons in south Chennai. Materials and Methods: The study participants comprised 150 dental practitioners (general and speciality) in south Chennai. The information was collected from each participant through structured questionnaires regarding attitude and awareness towards radiation protection. Pearson correlation coefficient test was used to assess the validity and reliability of questionnaire, and any P ≤ 0.05 was considered as statistically significant. Results: Of all the 150 dentists enrolled in the study, 69% dental surgeons considered X-ray films as a image receptor. However, majority of the dentists (73%) failed to acquire informed consent of the patient before prescribing dental radiograph. while Majority of dentists were unaware of position and distance rule (54%) and 46% were aware of the rule, it was also found that 59% dental surgeons did not use film holding device and only 41% used film holding device. Majority of them (59%) were aware of AERB certification and 41% were unaware of AERB, 15% of them hold the cone during exposure Conclusion: The current study shows the utmost need for further implementation of radiation protection principle among dental surgeons in south Chennai. Majority of them did not practice radiation protection procedures. Emphasis on radiation safety is mandatory for continuing professional education and development of radiographic selection criteria should be recommended.
KEYWORDS: Awareness, radiation protection, dental surgeons, Attitude.
Radiation hazards evaluation is very important in justifying and ensuring protection. With such evaluation, safe limits of radiation can be evaluated. Radiation exposure limits were introduced by the International Commission on Radiological Protection (ICRP), which was founded in 1928. In India, Atomic Energy Regulatory Board (AERB) is the competent authority. It implements safety provision by Atomic energy Act, 1962. It should be constantly monitored if the radiation protection comes foremost in radiography. The goal of radiation protection procedure is to minimize the exposure of the operator, office personnel, and patient during radiographic examination.
In dentistry, it is mainly used for diagnostic purposes, and in a dental set-up, usually the practicing dentist exposes, processes, and interprets the radiograph. Even though such exposure is less, it is critical to reduce exposure to the dental personnel and patients to prevent the harmful effects of radiation(1).
Biological hazards are classified based on occurrence probability into nonstochastic and stochastic effect (2). The radiographic examination carried out in all fields of medical services and dental services contributes the promotion of health, both individually and nationally. In dental practice radiographic examination plays an essential part though certain amount of radiation is delivered inevitably to the patients. It should be as low as reasonably achievable (ALARA). The practicing dentist differs from medical colleagues as he exposes, processes, and interprets the radiograph. Although exposure is minimal it is very important to reduce radiation to avoid the accumulated dose to the dentist in their lifetime.
MATERIALS AND METHODS:
A questionnaire study was carried out among 150 dental surgeons in south Chennai. A specially prepared structured questionnaire was used to assess the attitude and awareness about radiation protection among dental surgeons in south Chennai. The questionnaires could be returned by mail or in‑person. The dentists were informed about the anonymous processing of the questionnaires. A total of 15 questions were included. Statistical analysis was performed using Pearson correlation coefficient test to know the validity of the questionnaire and any P ≤ 0.05 was considered statistically significant.
RESULTS:
Of all the 150 dentists enrolled in the study, 69% dental surgeons considered X-ray films as a image receptor (figure 1). It was observed that 63% of dental surgeons made less than 5 exposure per day (figure 2). Majority (45%) of them use X -ray to view the periapical region (figure 3). Majority of dental surgeons sent the patient for CT or CBCT to view extension of cyst and tumour (34%), implant planning (30%), for endo and ortho treatment (26%) (figure 4).
However, majority of the dentists (73%) failed to acquire informed consent from the patient before prescribing dental radiograph. Majority of dentist were unaware of position and distance rule (54%) and 46% were aware of the rule. While 59% dental surgeons did not use film holding device only 41% use film holding device. Many dentists were aware of AERB certification (59%) and 41% were unaware of AERB. 15% of the dentists hold the cone during exposure (Figure 5).
Majority of dental surgeons (51%) were aware of the most commonly protected organ was the thyroid gland during dental X-ray exposure (figure 6). A less percentage of dentists (44%) used lead aprons and thyroid collars to cover their patients during radiographic examination while 50% did not use any protective measure during exposure (figure 7) and also less percentage of dentist (23%) use TLD badge as a personal monitoring device during X ray exposure (figure 8).
DISCUSSION:
The effect of ionizing radiation on living system is well known and well documented. The biologic interaction between ionizing radiation and living organism leads to changes in the electron level immediately within a fraction of seconds of exposure and persist for varied period of time Practitioners who administer ionizing radiation must be familiar with the magnitude of radiation exposure encountered in dentistry, the possible risk that such exposure entails, and the methods used to reduce doses. This information provides the necessary background for explaining the concerned patients the benefits and possible hazards involved with the use of X-rays(3).
In our present study majority of dental surgeons were using X-ray film as a image receptor only 13% of them were using digital sensor , which was consistent with the other studies conducted by İlgüy et al., [4] Math SY et al, [5] and Kaviani et al. [6] .73% dental surgeons did not take informed consent before taking radiographs, because majority of them were unaware of the importance of explaining the radiation risk and hazards to the patient.
ADA strongly recommends lead apron and thyroid collar, because lead aprons should be used to minimize patient exposure to radiation, but in our study only 44% dental surgeons use lead apron in their day to day practice. Similar study conducted by Asha et al in coorg, India [7] showed 40% dental surgeons wearing lead apron and in other study conducted by Amanpreet K, et al [8] in Lucknow 38.6% dentist were using lead apron.
Personal monitoring device were used to measure the exposure of operator or associated personal as a protective measure but 76% of dental surgeon did not use any Personal monitoring device which is not in accordance with the study done by Math SY et al.[5] and Kaviani et al.[6]. A strict adherence to what has been termed the position and distance rule is required to reduce the X-ray exposure to the dental surgeons according to which the operator should stand 6 feet from the patient at an angle of 90 to 135 degree to the central x ray of the x ray beam, but 46% of dental surgeon were aware of position distance rule in our study, other similar studies conducted by Asha et al[7] showed 34.4% dental surgeons following this rule.
Film holding device should be used because they improve the alignment of film thereby decreasing the unnecessary exposure and retake of film, but 41% of dental surgeons were only using film holding devices similar to the study conducted in Lucknow and Coorg India[7,8]
CONCLUSION:
The current study shows the utmost need for further implementation of radiation protection principles among dental surgeons in south Chennai. Majority of them did not practice radiation protection procedures. Emphasis on radiation safety is mandatory for continuing professional education, and development of radiographic selection criteria should be recommended.
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Received on 23.12.2019 Modified on 11.02.2020
Accepted on 08.04.2020 © RJPT All right reserved
Research J. Pharm. and Tech. 2021; 14(1):321-324.
DOI: 10.5958/0974-360X.2021.00059.7