Desired Outcome: To promptly take quality x-rays the first time and to limit the exposure for the patient. To efficiently develop, mount, and place the x-rays on the view box for the doctor to view prior to the treatment.
Measurement: Minimal exposures to patients and staff by consistently achieving quality radiographs. Number of times x-rays need to be retaken.
The doctor examines the patient and usually orders a BWX and Pano x-ray and/or additional P.A.’s of visual decay or sensitive teeth. An x-ray of the problem area is taken for emergency toothaches. If the patient is uncooperative or has a gag reflex, take as many as possible, at least a Pano. Orthodontic referrals typically are for Pano and anterior PA’s or FMX (full mouth x-rays): 14 PAs and 4 BWXs, depending on the size and age of the patient.
1. Question female patients if there is any suspicion or chance they could be pregnant and place the lead apron on the patient.
2. Lay out the necessary film (usually 2-4 films) based on the size of the mouth.
3. Select the choice technique, Bite Wing tabs vs. Rinn Holder and take the appropriate x-ray.
4. Remove the lead apron from the patient and escort the patient back to the operatory.
1. Check the temperature gauge to ensure it is below 30° and label the appropriate mount.
2. Shut and lock the darkroom door and turn off the lights, except for the red light.
3. BWX, PA’s, and PAN’s
A. With gloved hands, pull apart the plastic, lead foil, and black paper and drop out the x-ray film.
B. Discard the lead foil wrappers in the proper OSHA receptacle and the plastic wrappers in the trash.
C. Remove your gloves and put the film through the developing machine.
D. Be sure the x-rays have entered the machine before opening the door.
4. Panalipse (pano).
A. With gloved hands, release the buttons on the film carrier and remove the panalipse film.
B. Remove your gloves and place the film through the developing machine.
C. Place the new unexposed panalipse film in the cassette.
D. Be sure the x-ray has totally entered the processor before opening the door.
E. Wipe off the film carrier and other contaminated areas and place the film carrier back in the Panalipse.
1. Periapicals (PA's) and bitewings (BWX's) and full mouth x-rays (FMX)
A. Get the appropriate posterior or anterior mount from the darkroom shelf.
B. Label the mount with patient's name, doctor’s name, doctor’s license number, and the date.
C. Remove the x-ray from the top of the developer and place it in the mount with the bubble facing out.
A. Type the labeling information into the x-ray unit computer so that it appears on the film when processed.
B. If labeling by hand, write the information on a white label and place it on the left hand edge of film.
C. Trim the x-ray so it will fit in the patient's chart.
1. Remove the x-ray from the mount.
2. Align the x-ray the duplication machine.
3. Push the “view” button to activate the light.
4. Close and lock the darkroom.
5. Select and trim the duplication film to size.
6. Lay the film over the x-rays with the dark side up.
7. Push the “duplicate” switch.
8. Close the lid and push the button. (An orange light should appear.)
9. Remove the films and run through the processor.
10. Do not open the door until the entire film enters the processor. (When you hear a “click”, the x-ray has gone completely through.)
11. When the light goes off, remove the films and return the original to the mount.
Samples from Standard Operating Procedures for
(Contains over 470 pages + software)