title: Quality assessment of orthodontic radiography in children.
abstract: Numbers of dental panoramic tomographs (DPTs) and lateral cephalometric radiographs (LCRs) outweigh other radiographic examinations in 7- to 12-year-old Finns. Orthodontists and general practitioners (GPs) involved in orthodontics hold therefore the highest responsibility of the exposure of children to ionising radiation with its risks. Against this background, lack of reports on the quality of orthodontic radiography is surprising. The purpose of our study was to shed some light and draw the awareness of the orthodontic community on the subject by analyzing the quality of orthodontic radiography in Oral Healthcare Department of City of Helsinki, in the capital of Finland.
  
  
  
  We analyzed randomly selected 241 patient files with DPTs and 118 patient files with LCRs of 7- to 12-year-olds for the indications of radiography, quality of referrals, status of interpretation, and number of failed radiographs.
  
  
  
  The majority of DPTs (95%) and all LCRs had been ordered for orthodontic reasons. Of the DPTs, 60% were ordered by GPs, and of the LCRs, 64% by orthodontists. The referrals were adequate for most DPTs (78%) and LCRs (73%), orthodontists being responsible for the majority of inadequate referrals. Of the DPTs, 80% had been interpreted. Of the LCRs, 65% lacked interpretation, but 67% had been analysed cephalometrically. Failed radiographs, leading to repeated exposure, were found in 2-3%.
  
  
  
  The quality assessment revealed that orthodontic radiography may not completely fulfill the criteria of good practice. Our results stress further need of continuing education in radiation protection among both orthodontists and GPs involved in orthodontics.
authors.affiliation: *Oral Radiology, Department of Oral and Maxillofacial Diseases, University of Helsinki, elmira.pakbaznejad@helsinki.fi.|**Oral Healthcare Department of City of Helsinki.
authors.forename: Elmira
authors.initials: E
authors.lastname: Pakbaznejad Esmaeili
authors.affiliation: *Oral Radiology, Department of Oral and Maxillofacial Diseases, University of Helsinki.|***University Dental Clinic of City of Helsinki.
authors.forename: Marja
authors.initials: M
authors.lastname: Ekholm
authors.affiliation: ****Department of Public Health, University of Helsinki.
authors.forename: Jari
authors.initials: J
authors.lastname: Haukka
authors.affiliation: ***University Dental Clinic of City of Helsinki.|*****Orthodontics, Department of Oral and Maxillofacial Diseases, University of Helsinki, Finland.
authors.forename: Janna
authors.initials: J
authors.lastname: Waltimo-Sirén
mesh_terms: D017677:Age Distribution; D002508:Cephalometry / Q000379:methods / Q000592:standards; D002648:Child; D004522:Educational Status; D005260:Female; D005387:Finland; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D009970:Orthodontics / Q000193:education / Q000592:standards*; D011785:Quality Assurance, Health Care; D011835:Radiation Protection; D011862:Radiography, Panoramic / Q000379:methods / Q000592:standards*; D011897:Random Allocation; D012017:Referral and Consultation / Q000592:standards; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards*