On Feb. 27, 2024, CDPHE issued interpretation on shielding for dental imaging. None of this is new information or guidance, however, due to the increased number of articles on this topic nationally, the department issued guidance. (In January of 2020 the Colorado Board of Health adopted the requirements in place now related to the use of protective apparel or shielding (lead or lead equivalent aprons and other material) while performing radiographic exams.)
Regulatory Requirements: 6 CCR 1007-1, Part 6 of the Rules and Regulations Pertaining to Radiation Control has two instances that apply to the use of protective apparel specific dental imaging.
- Part 6, Section 6.3.3.7: Beam collimation, positioning, and shielding of radiosensitive organs from the useful beam that will not interfere with the imaging or medical procedure, or is contraindicated for radiation safety reasons, shall be used to reduce radiation exposure to the patient whenever possible.
- Part 6, Section 6.7.2.3(1): Intraoral and panoramic dental x-ray systems shall meet the following requirements: The useful x-ray beam shall be limited to the area of clinical interest.
- Part 6, Section 6.7.3.4: Excluding cases in which shielding would interfere with the diagnostic procedure, thyroid shielding shall be required for pediatric patients when performing intraoral imaging.
In general, the current requirement no longer requires the use of protective apparel or other shielding material to shield radiosensitive organs from the useful beam in those situations in which the shielding itself may compromise the diagnostic efficacy of the exam and result in an increase in the patient’s radiation dose due to repeat imaging needs or when using automatic exposure control which may drastically increase the x-ray output.
Specific to dental x-ray imaging:
- Thyroid shielding is required for pediatric patients when performing intraoral imaging, unless the shielding interferes with the specific diagnostic procedure being performed. An example of this may be certain panoramic imaging procedures.
- In all dental imaging procedures, the rule requires that the useful beam is limited to the area of clinical interest. As a result, with the exception of the thyroid shielding requirement for pediatric patients, there is no regulatory requirement to use shielding such as full body aprons or other lead or lead equivalent devices to shield radiosensitive organs or other portions of the patient during dental x-ray imaging.
Any questions or comments regarding this document should be addressed to the X-Ray Certification Unit at 303-692-3448, or by sending an email to: cdphe.hmxraycomments@state.co.us.
The information above is also available at https://cdphe.colorado.gov/hm/xray-guidance-and-policy