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16. Appendices
PCT-90LH User Manual 191
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the empty space of the oral cavity between the dorsal surface of the tongue and the
palate, producing a radiolucent shadow that diminishes the diagnostic quality of the
radiograph (Figure 3).
"Filling in" this space with the soft tissue of the tongue can increase the quality of the
image by diminishing this radiolucent shadow. When directed to place the tongue on
the roof of the mouth, the pediatric patient is likely to press only the tip of the tongue
against the palate. While an adult patient can usually understand what is required
when directed to swallow and note the position of the tongue, a child may be directed
to suck in the cheeks, which results in pushing the tongue into a position flat against
the palate.
7
Conclusion
In addition to these guidelines for producing error-free radiographic images for the
pediatric patient, panoramic machines should be evaluated periodically for accuracy.
Changes may occur over time to the focal trough that interfere with the diagnostic
quality of the machine.
6
If a decrease in image quality is noted in spite of following
accurate patient positioning steps, the panoramic x-ray machine should be inspected
and the focal trough recalibrated. The dental hygienist who is skilled in understanding
panoramic equipment operation and pediatric patient management is more likely to
produce radiographic images that result in higher diagnostic yields.
References
1. Public Health Service, Food and Drug Administration, American Dental Association Council on
Dental Benefit Program, Council on Dental Practice, Council on Scientific Affairs. The Selection
of Patients for Dental Radiographic Examinations. Washington, DC: United States Department of
Health and Human Services; 1987 (revised 2005):1-23.
2. Pinkham PS, Casamassimo, Fields HW, McTigue DJ, Nowak AJ. Pediatric Dentistry Infancy
through Adolescence. 4th ed. St. Louis: Elsevier Saunders; 2005:677.
3. Thomson EM. Panoramic radiographs and the pediatric patient. Dimensions of Dental Hygiene.
2008;6(2):26-29.
4. Rushton VE, Rout J. Panoramic Radiology. London: Quintessence Publishing Co Ltd; 2006:17,
84-85.
5. Kullman L, Joseph B. Quality of digital panoramic radiography in a newly established dental
school. Swedish Dent Journ. 2006; 30: 165-170.
6. Akarslan ZZ, Erten H, Güngör K, et al. Common errors on panoramic radiographs taken in a
dental school. J Contemp Dent Pract. 2003;4:24-34.
7. Rushton VE, Horner K, Worthington HV. The quality of panoramic radiographs in a sample of