Radiology plays an essential part in dental health practice. Like in every other aspect of practice, clinicians who advise patients to undergo x-ray examinations must be aware of the nature of any possible harmful effects and of the risks involved. A satisfactory radiograph should be obtained with a minimum exposure to radiation of the patient, the clinician and other persons involved with the examination.
The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) has produced the Radiation Protection Series Publications https://www.arpansa.gov.au/regulation-and-licensing/regulatory-publications/radiation-protection-series .
The Code of Practice and Safety Guide for Radiation Protection in Dentistry (2005) https://www.arpansa.gov.au/sites/default/files/legacy/pubs/rps/rps10.pdf  Radiation Protection Series Publication No. 1 (ARPANSA 2002) page 51 and 52 recommends for:
“Protective drapes. Protective drapes do not protect against radiation scattered internally within the body and only provide significant protection in cases where the X-ray beam is directed towards structures outside the dento-maxillofacial area. Even in the latter case the use of a protective drape for gonadal protection could only be regarded as prudent for a small child or for a female patient who is, or may be, pregnant. Although it has been argued in the past that routine use of protective drapes for dental radiography could be justified to allay perceived patient anxiety, their routine use is unnecessary in view of the very low effective doses involved in properly conducted dental radiography. Protection of the thyroid may be relevant for some examinations (see section on children below).”
“Pregnancy. Radiation Protection Series Publication No. 1 (ARPANSA 2002) recommends that precautions be adopted in radiological procedures involving exposure to the lower abdomen and pelvic regions of women of reproductive capacity to ensure that the radiation dose received is as low as possible, and particular care should be taken to avoid the irradiation of the fetus whenever practicable. When radiography of an area remote from the foetus is needed, such as in dental radiography, this can be undertaken with negligible dose to the foetus at any time during pregnancy. Provision of a leaded drape is recommended when the X-ray beam is directed downwards towards the patient’s trunk, for instance when taking occlusal views of the maxilla. There is no need on radiation protection grounds to defer dental radiography during pregnancy.”
“Children. The various factors influencing the dose to adults also apply to children, but the shorter distances between the area irradiated and many of the organs in children will result in higher doses to those organs. This is particularly true for the gonads and the thyroid. In general, it must be remembered that some tissues in growing children are more sensitive to radiation than those of mature persons. Therefore, the need for radiography should be carefully assessed and appropriate protective measures such as leaded drapes and thyroid collars should be considered, particularly during occlusal views of the maxilla where the X-ray beam is directed vertically Radiation Protection Series No. 10 Safety Guide Radiation Protection in Dentistry 52 downwards towards the patient’s trunk. However, in the case of panoramic and cephalometric radiography the use of a thyroid collar is discouraged since it may physically interfere with the procedure and can often be detrimental to obtaining an adequate image.”
For practices undertaking radiography the EPA Radiation Standards epa.nsw.gov.au/your-environment/radiation/publications-and-consultation-docs are relevant to the owners and licensed users of ionising radiation apparatus. The Guideline sets out the minimum requirements for registration of diagnostic imaging apparatus, and promotes industry best practice in radiation safety to be implemented during the use of radiation apparatus for dental and maxillofacial purposes.
Cone beam computed tomography (CBCT) scanners are considered a dental apparatus and are covered by the ARPANSA Code of Practice, Radiation Protection in Dentistry (the Code). The Code is picked up in the IA24 licence condition for the use of CBCT. The relevant parts of the Code must be met by users of CBCT.
You will not find any mandatory requirements relating to providing lead protection for patients undergoing CBCT examinations. The Code recommends, but does not require, the use of thyroid and lead aprons for dental procedures. The Environment Protection Authority (EPA) does not require the use of lead protection for patients undergoing CBCT procedures. It is good, however, to have lead protection available for patients who request/feel the need for protection.
If protective lead aprons are used, then hangers must be provided to ensure that aprons can be hung to prevent cracking of the protective material.
The following link to the International Atomic Energy Agency, provides additional information as well as multiple references for further reading on the topic iaea.org/resources/rpop/health-professionals/dentistry/patients
ADA (federal) Practical Guide to Dental Radiology is another useful document:
Disclaimer:Â This is one of a series of Advisory Services information sheets created by ADA NSW. They are intended as general guides that highlight key pieces of information frequently requested. They do not set out to provide comprehensive information about a topic and they are not legal advice. Please be mindful that information provided in these resources can change after the publication date.
