Regardless of the use of digital or film-based panoramic imaging, the patient must be prepared properly prior to the procedure. The first step is to explain the general aspects of the procedure to the patient. The clinician will need to reinforce and coach the patient during the procedure. Additional pre-exposure instructions are necessary to avoid the production of unwanted artifacts and to ensure patient cooperation.
For intraoral radiography, the patient must be instructed to remove facial jewelry in the beam path (for instance, nose rings or large earrings), eyeglasses and intraoral prostheses. With panoramic imaging, all metallic objects from the head and neck region must be removed including those items described above (Figure 11). Examples include earrings, tongue rings, necklaces, napkin chains, barrettes, hairpins, intraoral prostheses and hearing aids must be removed. These items would produce radiopaque artifacts on the image if left in place during exposure. The clinician should take care to safely store these items and return them to the patient when the process is complete.
Figure 11. Removal of metallic head and neck objects.