Radiation Exposure and Frequency of Dental, Bitewing and Occlusal Radiographs in Children and Adolescents

GND
1175894842
ORCID
0000-0001-5646-7919
Affiliation
Section Preventive Dentistry and Pediatric Dentistry, Department of Orthodontics, Jena University Hospital, 07743 Jena, Germany
Schüler, Ina Manuela;
GND
1042166463
Affiliation
Department of Orthodontics, Jena University Hospital, 07743 Jena, Germany
Hennig, Christoph-Ludwig;
GND
1294471473
Affiliation
Section of Pediatric Radiology, Department of Radiology, Jena University Hospital, 07747 Jena, Germany
Buschek, Rika;
GND
1308231164
Affiliation
Section of Pediatric Radiology, Department of Radiology, Jena University Hospital, 07747 Jena, Germany
Scherbaum, Rebecca;
GND
131607596
Affiliation
Department of Orthodontics, Jena University Hospital, 07743 Jena, Germany
Jacobs, Collin;
GND
130181064
Affiliation
Radiation Protection, Centre for Health and Safety Management, Jena University Hospital, 07747 Jena, Germany
Scheithauer, Marcel;
GND
120904551
Affiliation
Section of Pediatric Radiology, Department of Radiology, Jena University Hospital, 07747 Jena, Germany
Mentzel, Hans-Joachim

Dental radiographs are valuable diagnostic aids for oral healthcare, but exposure to ionizing radiation carries health risks, especially in children due to their high radio-sensitivity. Valid reference values for intraoral radiographs in children and adolescents are still missing. This study aimed to investigate the radiation dose values and underlying justifications of dental, bitewing and occlusal X-rays in children and adolescents. Data from routinely executed intraoral radiographs between 2002 and 2020 with conventional and digital tube-heads were extracted from the Radiology Information System. The effective exposure was calculated from technical parameters and statistical tests performed. A total number of 4455 intraoral (3128 dental, 903 bitewing and 424 occlusal) radiographs were investigated. For dental and bitewing radiographs, the dose area product (DAP) was 2.57 cGy × cm 2 and the effective dose (ED) 0.77 µSv. For occlusal radiographs, the DAP was 7.43 cGy × cm 2 and the ED 2.22 µSv. Overall, 70.2% of all intraoral radiographs were dental, 20.3% bitewing and 9.5% occlusal radiographs. The most frequent indication for intraoral radiographs was trauma (28.7%), followed by caries (22.7%) and apical diagnostics (22.7%). Moreover, 59.7% of all intraoral radiographs were taken in boys, especially for trauma (66.5%) and endodontics (67.2%) ( p ≤ 0.00). Girls were significantly more frequently X-rayed for caries diagnostics than boys (28.1% vs. 19.1%, p ≤ 0.00). The average ED of 0.77 µSv for intraoral dental and bitewing radiographs in this study was within the range of other reported values. The technical parameters of the X-ray devices were found at the lowest recommended levels to best limit the radiation exposure and to assure acceptable diagnostic efficacy. Intraoral radiographs were performed predominantly for trauma, caries and apical diagnostics—reflecting general recommendations for the use of X-rays in children. For improved quality assurance and radiation protection, further studies are necessary to determine the meaningful dose reference level (DRL) for children.

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