child_xrayThe Image Gently® campaign has developed online educational and scientific materials to help dental professionals optimize radiation dose used in imaging exams performed on children. Image Gently has also produced downloadable materials to help parents ask more informed questions of their dental providers whenever scans are recommended for their children.

“Dentists use x-rays to diagnose disease or damage that isn’t visible during an exam. Children may require x-rays as an adjunct aid to diagnose dental decay or to assess growth and development for orthodontic treatment.” said Charles H. Norman III, DDS, president of the American Dental Association (ADA). “It’s important for dentists and parents to have meaningful conversations about children’s x-rays. I’m pleased that the ADA is part of the Image Gently Alliance, whose goals align with the ALARA or ‘as low as reasonably achievable’ principle, which the ADA has long advocated.”

Imaging can serve an important role in improved dental health. However, children are, in general, more sensitive to radiation than adults. As such, health care providers should reduce radiation dose used in children’s imaging and avoid unwarranted imaging. When dental imaging procedures are considered, dental providers are urged to:

  • Select x-rays for individual needs, not as a routine. Use x-rays only when essential for diagnosis and treatment—based on a review of the patient and their dental history.
  • Use the fastest image receptor available. When film x-ray is used, select “E”- or “F”-speed. Set exposure parameters as low as possible for diagnostic digital imaging.
  • Use cone-beam CT (CBCT) only when necessary. CBCT should be restricted in children to cases in which it is essential for diagnosis and treatment planning.
  • Collimate beam to area of interest. For intraoral x-rays, collimation should be rectangular to match recording area of detector. For extraoral x-rays, including cone-beam CT, restrict beam to the area needed for diagnosis.
  • Always use thyroid shield. The thyroid gland in children is particularly sensitive to radiation. Use of a properly positioned shield significantly reduces the dose to the thyroid.
  • Child-size the exposure time. Less exposure time needed for children as oral structures are smaller than in adults.

“The materials made available through the Image Gently campaign will help general and specialty dentists ‘child size’ their imaging techniques and provide even better and safer treatment to all patients, especially children,” said Alan G. Lurie, DDS, PhD, immediate past president of the American Academy of Oral and Maxillofacial Radiology. “To have North American and European dental societies involved in Image Gently sends a clear, strong message about the importance of this effort.”

The Image Gently campaign is conducted by the Alliance for Radiation Safety in Pediatric Imaging, founded by the Society for Pediatric Radiology, the American College of Radiology, the American Society of Radiologic Technologists, and the American Association of Physicists in Medicine. The campaign now encompasses more than 80 medical, surgical, dental, and other professional health care organizations serving more than a million providers worldwide.

“We are incredibly pleased that the major dental societies have opted to take part in Image Gently and take steps to ensure that the care they provide is as safe as possible. We encourage all dental professionals to take advantage of the materials on the Image Gently website and factor them into their clinical decision-making,” Marilyn Goske, MD, co-chair of the Alliance for Radiation Safety in Pediatric Imaging.

Image Gently alliance members in dentistry include the ADA; American Academy of Oral and Maxillofacial Radiology; American Association of Oral and Maxillofacial Surgeons; American Association of Endodontists; American Academy of Oral and Maxillofacial Pathology; American Academy of Pediatric Dentistry; American Academy of Periodontology; American Dental Education Association; Canadian Association of Oral and Maxillofacial Radiology; and the European Academy of DentoMaxilloFacial Radiology

Health care providers are urged to visit the Image Gently website and pledge to do their part to “child-size” the radiation dose used in children’s imaging.