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Contingency Plans For Radiation Exposure in Dental Radiography

Explore contingency plans for radiation exposure in dental radiography with incident reports from the Othea dental website.

Where a dental practice’s radiation risk assessment identifies that a reasonably foreseeable incident or accident could occur during the use of their dental X-ray equipment, regulation 13 of IRR17 requires contingency plans to be prepared.

The aim of these contingency plans is to restrict radiation exposure arising from the incident or accident by providing a predetermined course of action to be taken, tailored to each accident scenario.

In reality, there are a limited number of incidents or accidents that can occur with dental X-ray equipment and, in the event of an accident, radiation exposure can usually be averted by switching off the X-ray set.

The Othea website provides a useful database of incidents and accidents that have occurred while working with ionising radiation in a wide range of workplaces (industrial, research, and medical). Details of an incident involving an intra-oral X-ray set in the UK have been recorded on this website and an extract is given below.

Screenshot of the Othea website

Screenshot of a report of a UK incident - this details radiation injuries received by a newly installed dental x-ray set, which has not been installed correctly

To read the rest of the report on this incident go to: Othea dental incident.

Contingency Plans

The contingency plans must be included in a dental practice’s local rules and brought to the attention of all those staffs who could be involved.

Contingency plans should identify such things as:

  • Who is responsible for putting the plan into effect
  • What immediate actions and mitigations are necessary
  • Who to contact to assist in determining the seriousness of the situation

Training and Rehearsal

Staff who could be required to implement the contingency plans or carry out any of the actions in the plan should be given appropriate training. In practice, this training could be given in-house as part of training in the local rules.

IRR17 also requires that contingency plans are rehearsed at regular intervals. A brief summary of the outcomes of rehearsals should be made and if any problems in executing the plan were noted, the required corrective actions should be implemented as soon as possible.

Actions and Investigations

If an incident or accident occurs and a contingency plan is implemented, the cause of the incident or accident should be noted and a ‘lessons-learned’ analysis carried out to determine whether any measures could be put in place to prevent a recurrence, or minimise the effects of a similar incident. A dental practice should consult its RPA as soon as possible after the incident or accident; the RPA will be able to assist in the analysis and will advise on the extent of the investigation and any notifications that are required. Step 1.10 in week 1 of the course covers the actions to take if the investigation shows that any person received a dose greater than the practice’s dose investigation level or in excess of a dose limit.

IRR17 requires the employer to make a written record of the incident or accident and the subsequent analysis; this should be kept for at least two years from the date of the analysis.

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Dental Radiography: Radiation Protection in Dental Practice

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