chapter 10

Key terms

Quality administration: The management of the quality assurance plan in the dental office.

Quality assurance: Special procedures used to ensure the production of high-quality, diagnostic
radiographs.
Normalizing device: A dental radiographic normalizing and monitoring device can be used to
monitor developer strength and film density.
Quality control tests: Specific tests designed to maintain and monitor dental x-ray
equipment, supplies, and film processing
reference Radiograph: : A reference radiograph is one that is processed under ideal conditions and
then used to compare the film densities of radiographs that are processed daily.
Stepwedge: A device constructed of uniform-layered thicknesses of an x-ray absorbing
material, usually aluminum; different steps absorb varying amounts of x-rays and are used to
demonstrate film densities and contrast scales
Viewbox: A light source used to view dental radiographs (also called the illuminator)

A quality assurance plan ensures the production of high quality radiographs and includes both quality
control tests and quality administration procedures.
Quality control tests are used to monitor dental x-ray equipment, supplies, and film
processing. The following quality control tests are recommended:

1. X-ray machines. Dental x-ray machines should be tested for minor malfunctions, output
variations, collimation problems, tubehead drift, timing errors, and inaccurate kilovoltage and
milliamperage readings. These tests should be performed once a year.

2. X-ray film. The fresh film test can be used to determine whether dental x-ray film is fresh and has
been properly stored and protected. This test should be performed each time a new box of film
is opened.
Fresh film appears clear with a slight blue tint
3. Screens and cassettes. Cassettes should be examined every month for adequate closure,
light leaks, and warping. The film-to-screen contact test can be used to determine the adequacy
of contact. This test should be performed periodically. More frequent testing is required if the
screens and cassettes are used often.
Viewing Equipment>>The surface of the viewbox should be wiped clean every week.


4. Darkroom lighting. The light leak test can be used to evaluate the darkroom for light leaks every
month.
The safelighting test (coin test) can be used to check for proper safelighting conditions and
should be performed every 6 months.
Only after the light-tightness of the darkroom has been established can the safelighting be
checked.
5. Processing equipment.
Manual and automatic processing equipment must be carefully maintained and monitored daily
for potential problems. With manual processing techniques, thermometer and timer must be
accurate, and temperature and level of the water bath, developer, and fixer solutions must be
checked.
Automatic processor test films can be used to check the functioning of the automatic
processor. These tests and checks must be performed daily.

6. Processing solutions.
The developer strength can be monitored by a reference radiograph, stepwedge
radiographs, or a normalizing device.
The fixer solution can be checked by performing a clearing test.
Fixer of adequate strength> the film should be cleared in 2 minutes.
These tests must be performed daily.
The processing solutions must be replenished daily and changed every 3 to 4 weeks as
recommended by the manufacturer.

Reference radiograph : A reference radiograph is one that is processed under ideal
conditions and then used to compare the film densities of radiographs that are processed
daily.
Normalizing device: A dental radiographic normalizing and monitoring device can be used
to monitor developer strength and film density.


Quality administration procedures include a description of the quality assurance plan, the
assignment of duties, a monitoring schedule, a maintenance schedule, record-keeping logs, a
plan for evaluation and revision, and in-service training.

The dentist is ultimately responsible for the overall quality assurance plan. In addition, the
dentist is responsible for the diagnostic quality of all radiographs, regardless of who exposes and
processes the films.
To ensure the production of diagnostic radiographs, the dentist depends on the skill of
competent dental radiographers who are competent in both exposure and processing
techniques.