Intra 107

Radiographs in the Pediatric Patient

• In children, radiographs are useful in detecting conditions of the teeth and bones, in showing changes related to caries and trauma, and in evaluating growth and development.
• Explain the radiographic procedures you are about to perform in terms that the child can easily understand.
  For example, you can refer to the tubehead as a camera, the lead apron as a coat, and the radiograph as a picture. 
• Exposure factors (milliamperage, kilovoltage, time) must be reduced because of the smaller size of the pediatric patient.

XCP instruments can also be used for the pediatric patient, but the exposure time is reduced.

Radiographs for the Endodontic Patient

• It often is difficult to obtain accurate radiographs during endodontic (root canal) treatment because
  of the rubber dam clamp, endodontic instruments,
  or filling material extending from the tooth. 
• The Endoray II film holder can be used to aid in positioning the film during this portion of the root canal procedure. 
• This holder fits around a rubber dam clamp and allows space for endodontic instruments and filling materials to protrude from the tooth.   

Endoray II film holder.

The Patient Who Gags

• To help prevent the gag reflex, you must convey
  a confident attitude.
• In a patient with a hypersensitive gag reflex, you should expose the maxillary molars last. 
• When you place films in the maxillary posterior,
  do not slide them along the palate.
• There may be times when you will encounter a patient with an uncontrollable gag reflex. 
• When this occurs, you must use extraoral radiographs such as panoramic or lateral jaw radiographs. 

Tips For Mounting Radiographs

• Handle films only by the edges.
• Label and date the film mount before mounting the films. 
• Include the patient’s full name and date of exposure and the dentist’s name. 
• Work with clean, dry hands.
• Use a definite order for mounting films.
• Use the “smile” line to mount bite-wing radiographs. 

Things to remember:

Avoid “baby talk.” Use positive reinforcement with children. Always commend the child on a job well done. It’s important to move quickly; have all settings ready and remind child to hold still.

Demonstrate actions for the child before you begin. You may need to postpone films if the child is uncooperative.

Periapical film must be positioned to see 5mm past the apex of the tooth. The tooth should be centered on the film.

Extension near film is to protect the materials used for endodontic procedure.

Remind the patient to breathe through the nose. Commend the patient on a job well done. Move quickly; remove films immediately from the mouth.

What types of mounts are available? (Plastic, cardboard.) Always double check mount for errors.