THE NEXTDDS Blog

Tips for Taking Proper Digital Radiographs

Posted by Dr. Patrice Smith on Wed, Jan 06, 2016 @ 12:00 PM

digital-radiographpy.pngThere is no doubt that the introduction of digital radiography has proved to be one of the most important new advances in the dental profession. Not only is it less labor intensive, it allows for saved time, diagnostic proficiency, and reduced radiation exposure.

Radiographs are an integral part of any dental practice and care must be taken to ensure they are of good diagnostic quality. They are taken just as one would take conventional x-rays, with the difference being the incorporation of a digital sensor. The digital sensor allows images to be propagated almost instantaneously on a monitor or screen, but is more rigid than conventional film, thus patient comfort is a big concern.

Tips for Better Radiographs

Here are a few tips and videos (for the visually inclined) on how to properly and comfortably take digital radiographs:

  • For the maxillary anterior segment: Using a rolling scoop motion, place the sensor into the patient’s mouth with the distal portion against the palate. Center the bite block on the maxillary central incisor teeth and ensure the sensor is placed parallel to the long axis of the teeth. Move the cable of the sensor to one side and have the patient bite down unto the bite block. Once stability is achieved, you can go ahead and press the exposure button. THE NEXTDDS shows here a helpful video on placement of the digital sensor for maxillary anterior teeth.

  • For the mandibular anterior segment: This is where things get a bit uncomfortable for the patient. To make taking x-rays in this segment more bearable, ask the patient to place the tip of his or her tongue to the lingual of the mandibular incisor teeth. Using a rolling scoop motion, place the sensor atop the tongue and roll into an upright position. The tongue will act as a cushion for the sensitive soft tissue and/or any tori that may be present. Center the bite block on the mandibular central incisors and ensure the sensor is placed parallel to the long axis of the teeth. Move the cable out of the way and ask the patient to bite down. Once stability is achieved, and press the exposure button.

  • For the posterior maxillary segment: Retracting the cheek (with your finger or instrument), guide the sensor into the patient's mouth between the maxillary central incisors and along the midline of the palate. Guide the sensor back until it is level with the desired posterior teeth, whether premolars or molars. At this point, angle the sensor slightly past the midline of the mouth so that the apices of the roots can be captured. Move the cable out of the way and have the patient bite on the bite block. Once stability is achieved, go ahead and press the exposure button. See here and here for instructional videos depicting placement of the digital sensor for the maxillary posterior teeth.

  • For the posterior mandibular segment: Taking these x-rays can be uncomfortable for the patient. You may want to use gauze or foam cushion that's compatible with digital sensors to aid in patient comfort. Retracting the cheek (with your finger or instrument), guide the sensor into the patient’s mouth between the tongue and the teeth at a 45-degree angle. Slowly guide the sensor back until it is level with the desired posterior teeth, whether premolars or molars. Move the cable out of the way and have the patient bite on the bite block. Once stability is achieved, go ahead and press the exposure button. See here and here for short videos on placement of the digital sensor for the mandibular posterior teeth.

  • Horizontal Bitewings: Retracting the cheek (with your finger or instrument), guide the sensor into the patient’s mouth, and place it between the tongue and the teeth with the tab resting on the teeth. Once it is level with the desired teeth and the cable is moved out of the way, have the patient slowly bite down. As the patient is biting down, swing the apparatus toward the lateral incisor. Swinging the apparatus toward the lateral incisor and adjusting the angulation will allow for open contacts on the radiograph so that any interproximal caries or anomaly can be easily seen. Click here for THE NEXTDDS video demonstrating placement of the digital sensor for horizontal bitewings.

  • Vertical Bitewings: Taking vertical bitewings can be uncomfortable for the patient. Here too you may want to use gauze or cushion (i.e., one that's compatible with digital sensors) to aid in patient comfort. Retracting the cheek with your finger or instrument, place the sensor into the patient’s mouth horizontally. Once the sensor is past the central incisors, roll into a vertical position and place against the posterior teeth. Ensure the cone of the x-ray source is parallel with the holder and is directed at the center of the ring. Move the cable out of the way and have the patient bite on the bite block--as shown on this instructional vldeo. Once stability is achieved, go ahead and press the exposure button.   

Following these tips will help in taking radiographs of good diagnostic quality. Keep in mind that digital sensors come in different sizes to accommodate different size mouths, and you may have to adjust accordingly. Of course, every patient is different and you may have to make further adjustments or incorporate different things to get desired results. Either way, the bottom line is: Ensure patient comfort; take x-rays that are of good diagnostic quality.

Find more videos and information on digital radiography and diagnostic imaging within THE NEXTDDS educational platform for dental students. Enrollment is completely free to dental students!

Find more helpful information by enrolling in THE NEXTDDS

Tags: radiographs, x-rays, digital radiographs,

Latest Posts

Posts by category