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Dental Hygiene

PanX and dental impressions

05/19/2008

Question:

I have been searching for an answer to our patient`s question as to why our office requires a panx before doing dental impressions. I work for an office that does only dentures, partials, (acrylic & cast metal)extractions, relines and repairs. I know the obvious for extractions but my doctor says it is a Florida state law that we take xrays on a new patient even if the patient is edentulous and we are just making dentures. We explain to the patient that we are looking for cysts, signs of bone cancer etc., but some still argue. Is there a state (of Florida) or federal law that says we must take one? The doctor does not like me telling patients "It is his policy" even though I explained he has every right to set that policy and not treat patients who don`t comply. Can you help me know for sure? (By the way, I am from Ohio and was in the 2nd class of Expanded functions and passed my testing at OSU in July 1978!)

Answer:

I don't know of any state or federal requirements for taking specific films. The "Guidelines for Prescribing Dental Radiographs", endorsed by the ADA and other groups, identify the need for a panoramic film for edentulous patients and a combination of periapical films and panoramic for partially edentulous patients. This would be considered the standard of care for these patients. If pathology, impacted teeth, etc., are not identified prior to denture fabrication and a problem later develops which requires a surgical procedure, a new denture or at least a reline would be needed, increasing the overall expense to the patient. The benefit of disease detection from the panorex would also outweigh the risk of radiation exposure.

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Response by:

Constance R Kuntupis, RDH, MA Constance R Kuntupis, RDH, MA
Clinical Associate Professor of Dental Radiology
College of Dentistry
The Ohio State University