Radiation Safety

The clinician should explain the procedural steps to the patient prior to machine entry and head positioning so that the patient can anticipate what will happen next and not be alarmed by the mechanical function of the panoramic machine. These instructions are important to prevent movement or head positioning errors that could result in a retake and additional patient radiation exposure.

The use of patient shielding during panoramic imaging procedures has been controversial for many years. Current evidence-based findings indicate that abdominal and thyroid shielding for diagnostic intraoral, panoramic, cephalometric, and CBCT imaging are no longer necessary.^3,16 Their use should be discontinued as a routine practice and as needed, federal, state, and local regulations and guidance requiring routine use of such shielding should be revised to reflect evidence-based recommendations.³ As seen in Figure 9, use of these shields can produce radiopaque artifacts by blocking the primary x-ray beam, obscuring anatomical structures, causing retakes, and increasing the radiation dose to the patient.^3,16 In addition, abdominal and thyroid shields do not protect the patient against internal radiation scatter.¹⁶

Figure 9. Panoramic Image with Midline Radiopaque Lead Apron Artifacts.

Figure 9. Panoramic Image with Midline Radiopaque Lead Apron Artifacts.