title: Application of segmented dental panoramic tomography among children: positive effect of continuing education in radiation protection.
abstract: Dental panoramic tomography is the most frequent examination among 7-12-year olds, according to the Radiation Safety and Nuclear Authority of Finland. At those ages, dental panoramic tomographs (DPTs) are mostly obtained for orthodontic reasons. Children's dose reduction by trimming the field size to the area of interest is important because of their high radiosensitivity. Yet, the majority of DPTs in this age group are still taken by using an adult programme and never by using a segmented programme. The purpose of the present study was to raise the awareness of dental staff with respect to children's radiation safety, to increase the application of segmented and child DPT programmes by further educating the whole dental team and to evaluate the outcome of the educational intervention.
  A five-step intervention programme, focusing on DPT field limitation possibilities, was carried out in community-based dental care as a part of mandatory continuing education in radiation protection. Application of segmented and child DPT programmes was thereafter prospectively followed up during a 1-year period and compared with our similar data from 2010 using a logistic regression analysis.
  Application of the child programme increased by 9% and the segmented programme by 2%, reaching statistical significance (odds ratios 1.68; 95% confidence interval 1.23-2.30; p-value < 0.001). The number of repeated exposures remained at an acceptable level. The segmented DPTs were most frequently taken from the maxillary lateral incisor-canine area.
  The educational intervention resulted in improvement of radiological practice in respect to radiation safety of children during dental panoramic tomography. Segmented and child DPT programmes can be applied successfully in dental practice for children.
authors.affiliation: 1 Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.|2 Department of Social Services and Health Care, City of Helsinki, Helsinki, Finland.
authors.forename: Elmira
authors.initials: E
authors.lastname: Pakbaznejad Esmaeili
authors.affiliation: 1 Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.|3 University Dental Clinic of City of Helsinki, Helsinki, Finland.
authors.forename: Janna
authors.initials: J
authors.lastname: Waltimo-Sirén
authors.affiliation: 2 Department of Social Services and Health Care, City of Helsinki, Helsinki, Finland.
authors.forename: Tuula
authors.initials: T
authors.lastname: Laatikainen
authors.affiliation: 4 Department of Public Health, University of Helsinki, Helsinki, Finland.
authors.forename: Jari
authors.initials: J
authors.lastname: Haukka
authors.affiliation: 1 Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.|3 University Dental Clinic of City of Helsinki, Helsinki, Finland.
authors.forename: Marja
authors.initials: M
authors.lastname: Ekholm
keywords: X-ray image; child; continuing education; panoramic radiography; radiation protection