Evaluation of radiation awareness among oral health care providers in South Africa
The aim of this study was to assess the awareness of oral health care providers and dental students regarding radiation safety, protection and legislation pertaining to dental radiography in South Africa. An online questionnaire consisting of 20 structured multiple-choice questions was distributed among final year students and oral health care providers. The mean, median, standard deviation (SD) and frequencies were determined statistically to compare the number of correct answers for each responder group. In total, 189 questionnaires were analysed. The average number of correct answers was 11.6 out of 20 (58%) for all responders. Dental students presented with the highest percentage (66%) of correct answers. Higher radiation awareness was evident among the respondents who had undertaken continued education courses. Radiation awareness among oral health care providers in South Africa needs improvement. Greater emphasis should be placed on dental radiology courses to increase the knowledge and awareness. However, there is no officially established benchmark of radiation awareness in South Africa.
2. White SC, Pharoah MJ. Oral Radiology: Principles and Interpretation. 7th ed: Mosby. 2014.
3. Svenson B, Ståhlnacke K, Karlsson R, Fält A. Dentists’ use of digital radiographic techniques: Part II - extraoral radiography: a questionnaire study of Swedish dentists. Acta Odontologica Scandinavica. Informa UK Limited. Nov 13, 2018; 77(2): 150-7. Available from:http://dx.doi.org/10.1080/00016357.2018.152 5763.
4. Rushton VE, Horner K, Worthington HV. Screening panoramic radiology of adults in general dental practice: radiological findings. British Dental Journal [Internet]. Springer. Science and Business Media LLC; 2001 May; 190(9): 495-501. Available from: http://dx.doi.org/10.1038/sj.bdj.4801014
5. Chalkley M, Listl S. First do no harm - The impact of financial incentives on dental X-rays. Journal of Health Economics Elsevier BV. 2018 Mar; 58: 1-9. Available from: http://dx.doi.org/ 10.1016/j.jhealeco.2017.12.005
6. Granlund C, Thilander-Klang A, Ylhan B, Lofthag-Hansen S, Ekestubbe A. Absorbed organ and effective doses from digital intra-oral and panoramic radiography applying the ICRP 103 recommendations for effective dose estimations. The British Journal of Radiology. British Institute of Radiology; 2016 Oct; 89(1066): 20151052. Available from: http://dx.doi.org/10.1259/bjr.20151052
7. Sources and Effects of Ionizing Radiation, United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) 2000 Report, Volume I. United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) Reports. UN; 2000 Oct 13: Available from: http://dx.doi.org/10.18356/49c437f9-en.
8. Republic of South Africa. National Health Act No. 61. 2003; 869.
9. Horner K, Islam M, Flygare L, Tsiklakis K, Whaites E. Basic principles for use of dental cone beam computed tomography: consensus guidelines of the European Academy of Dental and Maxillofacial Radiology. Dentomaxillofacial Radiology. British Institute of Radiology; 2009 May; 38(4): 187-95. Available from: http://dx.doi.org/10.1259/dmfr/74941012.
10. European Commission. Radiation Protection No 172 Cone Beam Computer Tomography for Dental and Maxillofacial Radiology. (Evidence-Based Guidelines) Directorate-General for Energy. Directorate D - Nuclear Energy Unit D4 - Radiation Protection. Luxembourg. 2012. Available from: http://dx.doi.org/10.2768/21874.
11. Svenson B, Soderfeldt B, Grondahl HG. Analysis of Dentists' Attitudes Towards Risks in Oral Radiology. Dentomaxillofac Radiol. 1996; 25(3): 151-6. Available from: https://doi.org/10.1259/dmfr.25.3.9084264.
12. Furmaniak KZ, Kołodziejska MA, Szopinski KT. Radiation awareness among dentists, radiographers and students. Dentomaxillofacial Radiology. British Institute of Radiology Oct, 2016; 45(8): 20160097. Available from: http://dx.doi.org/10.1259/dmfr.20160097.
13. Jacobs R, Vanderstappen M, Bogaerts R, Gijbels F. Attitude of the Belgian dentist population towards radiation protection. Dentomaxillofacial Radiology. British Institute of Radiology. Sep, 2004; 33(5): 334-9. Available from: http://dx.doi.org/10.1259/dmfr/22185511.
14. Brown J, Jacobs R, Levring Jäghagen E, Lindh C, Baksi G, Schulze D, et al. Basic training requirements for the use of dental CBCT by dentists: a position paper prepared by the European Academy of DentoMaxilloFacial Radiology. Dentomaxillofacial Radiology. British Institute of Radiology. Jan, 2014; 43(1): 20130291. Available from: http://dx.doi.org/10.1259/dmfr.20130291.
15. Levetown M. Communicating With Children and Families: From Everyday Interactions to Skill in Conveying Distressing Information. Pediatrics. American Academy of Pediatrics (AAP). May 1, 2008; 121(5): e1441-60. Available from: http://dx.doi.org/10.1542/peds.2008-0565.
16. Oikarinen HT, Perttu AM, Mahajan HM, Ukkola LH, Tervonen OA, Jussila A-LI, et al. Parents’ received and expected information about their child’s radiation exposure during radiographic examinations. Pediatric Radiology. SpringerScience and Business Media LLC. Nov 13, 2018; 49(2):155-61. Available from: http://dx.doi.org/10.1007/s00-247-018-4300-z.
17. National Department of Health. Republic of South Africa. Directorate Radiation Control unit. Code of Practice for Users of Medical X-Ray Equipment. 2015. Available from: https://sites.google.com/site/radiationcontroldoh/.
18. Noffke CE, Snyman AM. South African Legislation for Radiation Control in Dentistry: A Review. SADJ. 2007; 62(10): 438,40, 42-5. Available from: https://journals.co.za/content/sada/62/10/EJC158948.
19. Noffke CE, Van der Linde A, Farman AG. Responsible use of cone beam computed tomography: minimising medicolegal risks: clinical. South African Dental Journal. Jul 1 2013;68(6): 256-9. Available from: https://journals.co.za/content/sada/68/6/EJC141199.
20. Shahab S, Kavosi A, Nazarinia H, Mehralizadeh S, Mohammadpour M, Emami M. Compliance of Iranian dentists with safety standards of oral radiology. Dentomaxillofacial Radiology. British Institute of Radiology. Feb, 2012; 41(2): 159-64. Available from: http://dx.doi.org/10.1259/dmfr/29207955.
21. R Core Team. R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing, Vienna, Austria. 2018. Available from: https://www.R-project.org/.
22. Bhayat A, Chikte U. Human Resources for Oral Health Care in South Africa: A 2018 Update. International Journal of Environmental Research and Public Health. MDPI AG; May 14,2019; 16(10): 1668. Available from: http://dx.doi.org/10.3390/ijerph16101668.
23. Awosan K. Knowledge of Radiation Hazards, Radiation Protection Practices and Clinical Profile of Health Workers in a Teaching Hospital in Northern Nigeria. Journal Of Clinical And Diagnostic Research. JCDR Research and Publications; 2016. Available from: http://dx.doi.org/10.7860/jcdr/2016/20398.8394.
24. An S-Y, Lee K-M, Lee J-S. Korean dentists’ perceptions and attitudes regarding radiation safety and protection. Dentomaxillofacial Radiology. British Institute of Radiology. Jan 31, 2018;20170228. Available from: http://dx.doi.org/10.1259/dmfr.20170228.
25. Wright B. Contemporary medico-legal dental radiology. Australian Dental Journal. Wiley; Feb 29, 2012; 57: 9-15. Available from: http://dx.doi.org/10.1111/j.1834-7819.2011.01653.x.
26. Abdelkarim A, Jerrold L. Clinical considerations and potential liability associated with the use of ionizing radiation in orthodontics. American Journal of Orthodontics and Dentofacial Orthopedics. Elsevier BV; Jul, 2018; 154(1): 15-25. Available from: http://dx.doi.org/10.1016/j.ajodo.2018.01.005.
27. National Council on Radiation Protection and Measurements (NCRP). Radiation Protection in Dentistry. Bethesda, Md: NCRP. NCRP Report No. 145. 2003. Available from: https://ncrponline.org/publications/reports/ncrp-reports-145/.
28. Ihle IR, Neibling E, Albrecht K, Treston H, Sholapurkar A. Investigation of radiation- protection knowledge, attitudes, and practices of North Queensland dentists. Journal of Investigative and Clinical Dentistry. Wiley; Dec 2018; 12: e12374. Available from: http://dx.doi.org/10.1111/jicd.12374.
29. ICRP. Recommendations of the International Commission on Radiological Protection. ICRP Publication 60. Ann. ICRP 21. 1990; (1-3). Available from: https://www.icrp.org/publication.asp?id=ICRP%20Publication%2060.
30. European Commission. Radiation Protection Report 136: European Guidelines on Radiation Protection in Dental Radiology: The Safe Use of Radiographs in Dental Practice Directorate-General for Energy and Transport; Nuclear Safety and Safeguards; Brussels; Luxembourg. 2004. Available from: https://op.europa.eu/en/publication-detail/-/publication/ea20b522-883e-11e5-b8b7-01aa75ed71a1.
31. ADA Oral Health Topics. X-Rays. Key Points. June 3, 2018. Available from: https://www.ada.org/en/member-center/oralhealth-topics/x-rays.
32. Lintag K, Bruhn AM, Tolle SL, Diawara N. Radiation Safety Practices of Dental Hygienists in the United States. J DentHyg. 2019; 93(4): 14-23. Available from: https://digitalcommons.odu.edu/cgi/viewcontent.cgi?article=1042&context=dent alhygiene_fac_pubs.
33. Kim Y-J, Cha ES, Lee WJ. Occupational radiation procedures and doses in South Korean dentists. Community Dentistry and Oral Epidemiology. Wiley; May 5, 2016; 44(5):476-84. Available from: http://dx.doi.org/10.1111/cdoe.12237.
34. Kelaranta A, Ekholm M, Toroi P, Kortesniemi M. Radiation exposure to foetus and breasts from dental X-ray examinations: effect of lead shields. Dentomaxillofacial Radiology. British Institute of Radiology; Jan 2016; 45(1): 20150095. Available from: http://dx.doi.org/10.1259/dmfr.20150095.
35. Miles DA. Radiographic Imaging for the Dental Team. 4th ed. St. Louis: Saunders. 2009.
36. Lurie AG. Doses, Benefits, Safety, and Risks in Oral and Maxillofacial Diagnostic Imaging. Health Physics. Ovid Technologies (Wolters Kluwer Health); 2019 Feb; 116 (2): 163-9.Available from: http://dx.doi.org/10.1097/hp.000000000000 1030.
37. ICRP. Recommendations of the International Commission on Radiological Protection. ICRP Publication 26. Ann. ICRP.1977; 1 (3). Available from: https://www.icrp.org/publication.asp?id=ICRP%20Publication%2026.
38. ICRP. Recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Ann. ICRP. 2007; 37(2-4): 1-332. Available from: https://www.icrp.org/publication.asp?id=ICRP%20Publication%20103.
39. Theodorakou C, Walker A, Horner K, Pauwels R, Bogaerts R, Jacobs Dds R, et al. Estimation of paediatric organ and effective doses from dental cone beam CT using anthropomorphic phantoms. The British Journal of Radiology. British Institute of Radiology; Feb 2012; 85(1010):153-60. Available from: http://dx.doi.org/10.1259/bjr/19389412.
40. ICRP. Pregnancy and Medical Radiation. ICRP Publication 84. Ann. ICRP. 2000; 30 (1). Available from: https://www.icrp.org/publication.asp?id=ICRP%20Publication%2084.
41. Health Professions Council South Africa. Ethical Guidelines for Good Practice in the Health Care Professions. Guidelines on the Keeping of Patient Records. Booklet 9. Pretoria 2008. Available from: https://www.hpcsa.co.za/Uploads/Professional_Practice/Ethics_Booklet.pdf
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright for all articles is retained by the author/s of the individual articles.