Dental Records in a Digital Age

3 months ago

𝗗𝗲𝗻𝘁𝗮𝗹 𝗣𝗿𝗮𝗰𝘁𝗶𝗰𝗲 𝗖𝗕𝗩𝗧/𝗖𝗕𝗖𝗧 𝗥𝗶𝘀𝗸 𝗠𝗮𝗻𝗮𝗴𝗲𝗺𝗲𝗻𝘁It is generally accepted that dentists recording CBVT- particularly large volume CBVT datasets- have responsibility for the interpretation of all data, not just the area of interest. (Dentists who record OPG radiographs must take responsibility for all non-dental diagnosis from such images or alternatively have them assessed on referral by an oral radiologist or medical radiologist and include this cost in their estimate of fees to the patient (see Aust Dent J2012 Mar:57 Suppl 1:9-15. doi: 10.1111j.1834-7819.2011.01653.x.)Practitioners frequently use a CBVT dataset to ’construct’ an OPG.If this construction is based on a full volume dataset, it is arguable that there may be pathology not detected by a general dentist who has training for the use of machine that they use.In Western Australia, Section 36 of the Radiation Safety Act 1975 provides for the Radiological Council to impose conditions, restrictions or limitations on a licence, exemption, or registration. In Western Australia, the standard condition of registration for the purpose of Radiology – Dental, requires that: “as soon as practicable, all CBCT images are reported on by an Australian Health Practitioner Regulation Agency registered medical radiologist or dento-maxillofacial radiologist”. It is probably therefore prudent, if not a legal requirement, in other states that practitioners recording CBVT data sets give consideration to having all of the datasets reviewed by an appropriate radiologist to reduce a failure to diagnose risk. Such reports would then need to be communicated to the patients as a matter of course. ... See MoreSee Less

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Brad Wright - Barrister

4 months ago

In some recent work I had cause to consider radiology in dental practice. I had an interest in this through practice and an article I wrote when I first went to the bar in 2011. pubmed.ncbi.nlm.nih.gov/22376092/I still see references to the ALARA principle - meaning as low as reasonably achievable.That is no longer relevant in Australian health practice at least in relation to diagnostic radiology.That phrase is no longer used in the code for diagnostic medical / dental radiology under Justification or Optimisation. The phrase ALARA references the superseded 2008 Code.See here for the 2019 code. www.arpansa.gov.au/sites/default/files/medical-exposure-code-rps-c-5.pdf The new code specifies as to optimisation:2.2.2 OptimisationOptimisation of protection is maximising the benefit-risk ratio of a medical exposure for that patient.Radiation exposure must be minimised yet still sufficient to fulfil the clinical objective of the procedure, with account taken of relevant norms of acceptable image quality or therapeutic efficacy. Special attention is required for exposures of paediatric patients, for individuals undergoing health screening, for volunteersin medical research and where a fetus or breastfed infant may receive an incidental exposure.Diagnostic reference levels (DRLs), which give an indication of levels of doses to patients for common procedures, are one method that can be used as an optimisation tool in medical imaging. Their purpose is to raise awareness of patient doses and prompt medical radiation facilities administering doses greater than the reference levels to review procedures and revise or justify as appropriate.This justification is now a three tier process.See here for the 2019 code. www.arpansa.gov.au/sites/default/files/medical-exposure-code-rps-c-5.pdf ... See MoreSee Less

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Brad Wright - Barrister

6 months ago

When Giles Coren is good, he is absolutely fantastic. This is an example. ... See MoreSee Less

I’m leavin’ it… how McDonald’s got deplorable

www.thetimes.com

In the 1970s you’d find all-American razzle-dazzle and tasty food in the golden arches. Now the chain symbolises US decline

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