Audit on reducing radiation exposure to patients

Taking radiographs is an essential part of most orthodontic examinations. It is however ethically inappropriate to expose a patient to radiation unless there is a clinical need for the information it will provide which will be of benefit to the patient. We noticed that a number of patients who were being referred to us for orthodontic treatment already had recent radiographs which may provide useful information and save us having to repeat the views.

An initial audit of 144 consecutively seen new patients showed that a significant number of them had panoral radiographs taken elsewhere within the previous 2 years. Only 31% of these had been sent with the referral. Having to request them and reschedule the patient for another appointment is obviously an inconvenience all round while repeating the radiograph could potentially expose the patient to unnecessary radiation exposure and contravene ethical guidelines.

We therefore modified our referral forms to specifically ask the question whether there was a panoral radiograph taken within the previous 2 years available and if so for it to be copied or sent as an original with the referral. We installed high quality scanning equipment in our practices so that radiographs could be easily copied and returned and also decided to routinely send copies of all panoral radiographs we take to the patient’s dentist in case the information is of use to them in the future.

A follow-up audit of another 144 consecutively seen new patients showed that 88% of available radiographs had been included with the referral. This was a big and very worthwhile improvement.