Thursday, February 8, 2024

ADA Guidelines Recently Released Advise No Need for Lead Apron and Thyroid Collar


Recently, the ADA Council on Scientific Affairs has released a new scientific paper regarding radiation use in dentistry.

The council, as expected, advises a minimal use of x-ray, stating that things like proper angulation, eliminating retakes, and using the lowest possible dosages to achieve necessary image are intrinsic to the safety of patients.  This comes as no surprise as for years they have advocated for the ALARA principle (As Low As Reasonably Achievable) when taking radiographs.

The truly newsworthy item from the report deals with lead shielding of patients.  Since the advent of digital sensors and rectangular collimation, many have wondered about the true "need" for lead shielding when taking radiographs.  The amount of radiation used to achieve a reasonable image has decreased almost exponentially since digital sensors became common place.  Rectangular collimation works to focus the beam to a very tight dimension which means that 'scatter' from the beam is practically eliminated.  These two breakthroughs have been combined to greatly decrease the actual amount of radiation needed as well as keeping the beam focused to only the area needed for the image.

In my work as Chief Dental Editor for Dental Products Report, I've gotten a chance over the past two decades to speak to quite a few Board Certified Oral and Maxillofacial Radiologists about the subject of shielding patients.  Not one ever told me that shielding was necessary, in fact everyone of them stated that their personal opinion, based on their knowledge, was that the time had passed where shields were absolutely imperative to ensure patient safety.

Now comes word, direct from the ADA that both thyroid collars and the thoracic/abdominal drape can be discontinued.

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