Dental Radiography Chapter 10 Quality Assurance in the Dental Office

Basic elements of a quality administration program

Description of the plan assignment of duties monitoring schedule maintenance schedule record-keeping log plan for evaluation and revision in-service training

Processing Equipment

Must be monitored daily. Thermometer and timer must be checked for accuracy. Temperature and level of water bath must be monitored. Water circulation, solution level, replenishment system must be monitored. Each day two films should be processed in the auto processor.

Screen-Film Contact Test

Steps: 1. Load the cassette, insert one film between the screens and close. 2. Place test object- wire mesh test object on top of the loaded cassette. 3. Position the PID- perpendicular to cassette 4. Expose cassette 5. Process the film 6. View- on a viewbox in a dimly lit room at a distance of 6 ft Results: Adequate Contact- If wire mesh image seen on the film exhibits a uniform density, good screen-film contact has taken place. Inadequate Contact- If wire mesh image seen on the film exhibits varying densities, poor sreen-film contact has ten place. Must repair or replace cassette.

Light Leak Test

Steps: 1. Prepare the darkroom-Close the darkroom door, and turn off all lights, including safelight 2. Examine the darkroom-observe the areas around the door, seams of walls and ceiling, vents, and the keyhole. Results: No light leaks-if darkroom is light-tight, no visible light is seen, proceed with processing. Light leaks- If leaks are seen, eliminate with weather stripping or black tape before proceeding.

Safelighting Test (Coin Test)

Steps: 1. Prepare the darkroom-turn off all lights including safelight 2. Prepare the film- unwrap one unexposed film, place it on flat surface at least 4 feet from the safelight. place coin on top of the film. 3. Turn on safelight- allow film and coin to be exposed to the safelight for 3-4 minutes. 4. Process the film- Remove the coin, and process the film. Results: Proper Safelighting- no visible image is seen on the processed film, proceed with processing. Improper safelighting- image of the coin and a fogged background appear on the processed film, safelight is not safe with that type of film. Must use film manufacturer's recommended safelight filters and bulb wattage.

Clearing Test

Steps: 1. Prepare the film- unwrap one film and immediately place it in the fixer solution 2. Check the film for clearing- measure the amount of time the film takes to clear Results: Fast clearing-if film clears in 2 minutres, the fixer is of adquate strenth. Slow clearing- if the film is not completely clear after 2 minutes, reimmerse in fixer solution. If film does not completely clear in 3-4 minues, fixer is depleted. Must be replaced.

Fresh Film Test

Steps: 1. Prepare the film Unwrap one unexposed film from a newly opened box. 2. Process the film. Use fresh chemicals to process the film. Results: Fresh-clear, slight blue tint Fogged-film is expired, has been improperly stored, or exposed to radiation. Do not use.

True

T/F- A cassette holder should be periodically examined for the presence of any dirt or scratches.

Processing Solutions

The most critical component of film processing quality control is the monitoring of the processing solutions. Processing solutions must be replenished daily. Should be evaluated each day before any patient films are processed.

Stepwedge Radiographs

a device constructed of layered aluminum steps to absorb varying amounts of x-rays

viewbox

illuminator, light source that is used to view processed films. Should be periodically examined for the presence of dirt on the Plexiglas surface and any discoloration. Surface should be wiped clean every week. Permanently discolored plexiglas and blacked flourescent bulbs must be replaced.

Quality Administration

management of the quality assurance plan in the dental office

Normalizing Device

monitors developer strength and film density

Darkroom lighting

must be checked for light-tightness every month, and proper safelighting every 6 months.

Reference Radiograph

one that is processed under ideal conditions and then used to compare the film densities of radiographs that are processed daily.

Quality Assurance

special procedures that are used to ensure the production of high-quality diagnostic images.

Quality Control Test

specific tests that are used to maintain and monitor dental x-ray units, supplies, film processing, and digital imaging equipment.

the dentist

who is ultimately responsible for the diagnostic quality of all dental images exposed in his or her office, regardless of who actually exposes the images.