Medical Forum / General / Dentistry / August 2005
X-Ray without a vest?
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nickw - 27 Aug 2005 18:23 GMT Hi,
On Thursday I had a dentist appointment with a new dentist. So of course they wanted to take a full mouth X-Ray. Thing is, after they did this and moved on to the "bite-wings" X-Rays, they put one of those lead vests on me; Now I realize they did not put the vest on me for the other full mouth X-Ray (the one where you sit in a box and the device moves around your head).
This is probably fairly normal, and probably happens all the time, but I'm just a bit worried. Do I have anything to be worried about having been exposed to an X-Ray for 15-30 seconds?
I've tried to read up on the subject, and even if it isn't horribly dangerous at this level, I'm still dissapointed. Apparently they are only supposed to take X-Rays only when necessary, and they failed to get the old X-Ray from my previous dentist (even though they asked for his contact information when I made the appointment, and informed me they would get all of my records). After they already took the X-Rays, the receptionist came in and said my other Doctor was sending over my records, including a full-mouth X-Ray from 2004. So this X-Ray shouldn't have been taken anyway, aside from the lead protection issue.
Thanks, Nick
Administrator - 27 Aug 2005 18:36 GMT The thing that goes around your head can put out a lot of x-rays, mor then taking bitewings. I am a computer guy, so when the pano or x-ra sensors stop working I get to fix it. I have talked to guys who g around the country installing pano's, (the box that circles around th head). I noticed when they were doing demo's and etc, that they staye far away from the pano. I asked them why and they said x-rays can b dangerous, and since they are always around pano's shooting x-rays they dont like the risk or probability. Just to be safe. I woul personally wear a lead apron when taking a pano, and bitewings
One night, I was tuning an x-ray sensor, and I took way too many x-ray of myself. I quit when my mouth started to feel weird. I noticed othe people can feel this weird feeling when taking a pano. They dont lik to do it more then once or twice
This is why I just want to play it safe, because I am not an expert o x-rays, but the guys who do seem to know more about x-rays seem to pla it safe also
Makes sense to me, at a lot of offices I work for the hygeinists sta clear when shooting the x-ray. They will stand behind a wall usually. now do the same thing, unless its me who is getting the x-ray
Maybe I am just paranoid
-- Administrato
Vaughn - 27 Aug 2005 19:05 GMT > One night, I was tuning an x-ray sensor, and I took way too many x-rays > of myself. I quit when my mouth started to feel weird. That is crazy! Aren't you supposed to use some type of a dummy for that? (Not a flame, I also did silly things with radiation when I was young. Most poeple to not realy understand their lack of immortality until their 30's)
> Makes sense to me, at a lot of offices I work for the hygeinists stay > clear when shooting the x-ray. They will stand behind a wall usually. I > now do the same thing, unless its me who is getting the x-ray. That makes sense because the hygienists are doing this all day/ every work day. The patient usually only gets one or two sets of x-rays a year. Big difference.
I never was offered a lead apron until I started with my present dentist, two partners who run a very nice shop.
Vaughn
Administrator - 28 Aug 2005 00:32 GMT Vaughn Wrote:
> > One night, I was tuning an x-ray sensor, and I took way too many > x-rays [quoted text clipped - 23 lines] > > Vaughn Yeah! I am staying away from x-rays for awhile.... I was worried but all I can do is pray.
 Signature Administrator
Joel344 - 28 Aug 2005 00:52 GMT Thyroid collars are an absolute requirement in Pennsylvania ....
-- Joel34
Jacob - 28 Aug 2005 12:16 GMT Now this is completely STUPID!! If you really are a computer guy and install and repair x-ray machines and panorex machines, I just don't believe that you would "take too many x-rays of myself" when tuning an x-ray sensor!!! That is about the dumbest thing I've EVER heard!!! If you are really serious and this really happened, then the last thing you should be doing is working on x-ray machines, as it is obvious that you know nothing about the potential problems with excess radiation!! Where is your brain???? I've never heard/read/seen anything/anyone so stupid!!!!
> The thing that goes around your head can put out a lot of x-rays, more > then taking bitewings. I am a computer guy, so when the pano or x-ray [quoted text clipped - 20 lines] > > Maybe I am just paranoid. Administrator - 28 Aug 2005 15:56 GMT You guys can be real a.sholes. I was 21 years old, and I am a damn goo pc tech\network administrator. X-Rays sensors and digital pano interface with computers so thats where I come into play. And lets se here I was 21 when I did that and I am still alive. What gets me is have already told you guys how dumb I thought it was, and you kee pressing the issue.
I am not a dentist, I never went through ANY x-ray training. Someon hands me a sensor and says, fix it
Something I doubt you could do yourself. I bet you have someone do al your computer work, dont you
Jacob Wrote:
> Now this is completely STUPID!! If you really are a computer guy an > install and repair x-ray machines and panorex machines, I just don' [quoted text clipped - 48 lines] > http://dentalcom.net/forum/member.php?userid= > > View this thread: http://dentalcom.net/forum/showthread.php?t=275 -- Administrato
A+ N+ MCP2000 Microsoft Certified Professional and Red Hat Linu Certified Technicia Justin Shafe Onsite Dental System Fort Worth, TX 817909422
' (http://tinyurl.com/5jhcs
Administrator - 28 Aug 2005 16:05 GMT Jacob, did you not read where I said I now stand behind a wall when messing with x-rays and how I prefer to not have x-rays done in awhile??? Duh.
Guys like you are why I made DentalCom.
 Signature Administrator
A+ N+ MCP2000 Microsoft Certified Professional and Red Hat Linux Certified Technician Justin Shafer Onsite Dental Systems Fort Worth, TX. 8179094222 ' ' (http://tinyurl.com/5jhcs)
W_B - 29 Aug 2005 17:46 GMT >You guys can be real a.sholes. Hey, hey, hey there... Calm down dude.
Don't judge us all from the response of one goofball.
--
W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com
Mark & Steven Bornfeld - 27 Aug 2005 18:52 GMT > Hi, > [quoted text clipped - 22 lines] > Thanks, > Nick You should have been given a lead apron. However, the x-ray dose of a panorex is generally less than a full series of x-rays. You shouldn't worry. However, if I were that dentist I'd worry if an inspector finds out. Don't be shy about asking for the apron. It was probably an oversight--one that shouldn't be made.
Steve
 Signature Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
nickw - 27 Aug 2005 18:59 GMT I certianly won't be shy about asking for the apron in the future, but in this case I was just un-informed and not thinking about what the tech should have been doing.
Do you think I should report this incident? At least to the dentist the tech was working for? I certainly wouldn't want this to be a regular practice at the office...
Thanks for the great information!
Mark & Steven Bornfeld - 27 Aug 2005 19:26 GMT > I certianly won't be shy about asking for the apron in the future, but > in this case I was just un-informed and not thinking about what the [quoted text clipped - 5 lines] > > Thanks for the great information! Yes--to the dentist. I wouldn't report to the state unless youi find out the error hasn't been corrected. You'll be doing the other patients (and the dentist) a big favor.
Steve
 Signature Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
Joel344 - 27 Aug 2005 19:36 GMT Big news guys., There are studies suggesting that with digital films th lead apron (or the other one) actually cause MORE radiation throug scatter. If anyone is interested, I will dig up the paper.
I still recommend the apron, less radiation or more radiation, becaus of patient perception.
Joel M. Eichen DD
-- Joel34
Mark & Steven Bornfeld - 27 Aug 2005 19:49 GMT > Big news guys., There are studies suggesting that with digital films the > lead apron (or the other one) actually cause MORE radiation through [quoted text clipped - 4 lines] > > Joel M. Eichen DDS How can something that blocks 100% of x-rays cause scatter?
Steve
 Signature Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
Joel344 - 27 Aug 2005 20:12 GMT Its the same reason why jewelry, tongue piercing barbells, and the like scatter radiation. Even a silver filling causes scatter. Yes it blocks the x-ray from reaching the film, but the x-ray is partially scattered (secondary radiation) through collision with the outer orbital electron shells.
 Signature Joel344
Joel344 - 27 Aug 2005 20:20 GMT Here is a pointer ......
Kawabe R, Nakada M, Suzuki S, Fujifuchi S, Sagami T, Nakada M, Wajima T, Togashi A, Kudo Y, Kashida Y. Related Articles, Links [Discussion "Is it necessary to attach a protective apron to the patient in the X-ray diagnosis?"] Nippon Hoshasen Gijutsu Gakkai Zasshi. 2004 Dec;60(12):1630-43. Japanese. No abstract available. PMID: 15614209 [PubMed - indexed for MEDLINE]
6: Kimura Y, Kobayashi T, Sasanuma K, Tsukamoto A, Kato H. Related Articles, Links [Round table discussion: is it necessary to attach a protective apron to the patient in the X-ray diagnosis?] Nippon Hoshasen Gijutsu Gakkai Zasshi. 2004 Dec;60(12):1620-9. Japanese. No abstract available. PMID: 15614208 [PubMed - indexed for MEDLINE]
 Signature Joel344
celtan - 27 Aug 2005 20:41 GMT > I certianly won't be shy about asking for the apron in the future, but > in this case I was just un-informed and not thinking about what the [quoted text clipped - 5 lines] > > Thanks for the great information! Taking a Full Mouth XR set exposes you to less radiation than a stroll at the beach during a cloudy afternoon. Now, if you are taking that exposure several times a day, five days a week, the effect is additive, and then there would be cause for concern. Otherwise, from the patient's perspective, it is not a problem.. The only exception is pregnant women during their first trimester, when the developing fetus is extremely sensitive to radiation.
Vaughn - 27 Aug 2005 21:44 GMT > Taking a Full Mouth XR set exposes you to less radiation than a stroll at the > beach during a cloudy afternoon. Not so! Actually, a conventional dental x-ray represents a rather large dose to the head area. See: http://www.adani.by/prod_securpersonal_xray.php
>Now, if you are taking that exposure several times a day, five days a week, the >effect is additive, and then there would be cause for concern. Otherwise, from >the patient's perspective, it is not a problem.. True
Regards; Vaughn
Steven Bornfeld - 28 Aug 2005 00:03 GMT >> I certianly won't be shy about asking for the apron in the future, but >> in this case I was just un-informed and not thinking about what the [quoted text clipped - 8 lines] > Taking a Full Mouth XR set exposes you to less radiation than a stroll > at the beach during a cloudy afternoon. That's a meaningless statement. The whole body dose of a full series of x-rays without a shield yields a rather high skin dose at the end of the cone (on the order of 1 rad) per exposure. I don't have the figures, but the dose unshielded to the thyroid is significant. The whole body dose is lower, but this ignores the relatively high exposure to some radiosensitive organs. While the OP has no real cause for concern IMO, taking a pollyanna attitude toward patient safety has a way of coming back to bite you in the a.s.
Steve
Now, if you are taking that
> exposure several times a day, five days a week, the effect is additive, > and then there would be cause for concern. Otherwise, from the > patient's perspective, it is not a problem.. The only exception is > pregnant women during their first trimester, when the developing fetus > is extremely sensitive to radiation.
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celtan - 30 Aug 2005 02:14 GMT Wrong. Studies made with the older 70kvp machines and using regular speed film show an exposure of 1 to 1.5 mrems per FMXR. You can get as muh as 5 mrems PER HOUR during a beach stroll at certain latitudes. And yet the girls at Ipanema look _very_ healthy to me...
Now a days we use 90 KVP and ultrafast film. It's true that radiation at the focusing point of the beam is locally much higher, which is why I don't take PAXRs of a graft site for the next 6 mos, but thyroid involvement is virtually nil.
Toots
Steven Bornfeld - 30 Aug 2005 04:01 GMT > Wrong. Studies made with the older 70kvp machines and using > regular speed film show an exposure of 1 to 1.5 mrems per FMXR. You can > get as muh as 5 mrems PER HOUR during a beach stroll at certain > latitudes. And yet the girls at Ipanema look _very_ healthy to me... Have you seen her lately?
Steve
> Now a days we use 90 KVP and ultrafast film. It's true that radiation > at the focusing point of the beam is locally much higher, which is why I [quoted text clipped - 8 lines] > Newsgroups > ----= East and West-Coast Server Farms - Total Privacy via Encryption =----
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celtan - 31 Aug 2005 05:23 GMT Oh, I wish...!
: )
>> Wrong. Studies made with the older 70kvp machines and using >> regular speed film show an exposure of 1 to 1.5 mrems per FMXR. You can [quoted text clipped - 18 lines] >> ----= East and West-Coast Server Farms - Total Privacy via Encryption >> =---- Joel344 - 30 Aug 2005 09:29 GMT Hi Celatan,
What you describe as 70 kVp and 90 kVp has to do with producing high contrast films and low contrast films, not mrems. Each type has a specilized use in dentistry.
You can substitute "image" for the word "films" if you are digital, however the principle is the same. A key to understanding this us to expose two similar x-ray fims to a step-wedge which is used to illustrate "contrast" variables, and to control dark room variation.
Steve Mancuso might chime in here, "What's a darkroom?" I would not be surprised.
Joel
celtan Wrote:
> Wrong. Studies made with the older 70kvp machines and using > regular speed film show an exposure of 1 to 1.5 mrems per FMXR. You [quoted text clipped - 16 lines] > ----= East and West-Coast Server Farms - Total Privacy via Encryption > =----
 Signature Joel344
Joel344 - 30 Aug 2005 09:32 GMT Step Wedge
.
[image:
http://www.dl-c.com/Velvia%20vs%20Provia%20100F/Step%20Wedge.jpg
]
.
 Signature Joel344
billkatz - 27 Aug 2005 21:32 GMT nickw Wrote:
> This is probably fairly normal, and probably happens all the time, but > I'm just a bit worried. Do I have anything to be worried about having > been exposed to an X-Ray for 15-30 seconds? The type apron used on a panorex series is commonly called a cape. Probably a good idea to request one in the future. Here's a visual reference --> http://www.kabdental.com/products/aprons_&_accesories.htm
 Signature billkatz
Joel344 - 27 Aug 2005 22:00 GMT Thanks Bill! Colorful, aren't they?
They have something else on the web page that is very useful for doin delicate endodontics on upper third molars ......
HERE
[image: http://www.kabdental.com/images/LA68.jpg]
.
billkatz Wrote:
> The type apron used on a panorex series is commonly called a cape > Probably a good idea to request one in the future. Here's a visua > reference --> > http://www.kabdental.com/products/aprons_&_accesories.ht -- Joel34
billkatz - 27 Aug 2005 22:28 GMT Joel344 Wrote:
> Thanks Bill! Colorful, aren't they? > [quoted text clipped - 6 lines] > > .. The camouflage pano cape is invaluable when deer hunting too. :)
All kidding aside, I wonder how many people use the thyroid collars and do they really do any good???
 Signature billkatz
Joel344 - 27 Aug 2005 22:28 GMT In Pennsylvania they inspect your set-up and you better have a thyroid collar .....
 Signature Joel344
Joel344 - 27 Aug 2005 22:32 GMT Hey Bill!
What cape?
.
[image http://www.angelfire.com/amiga/zorro_fl_fs/Zorro_Flaring_his_Cape___small[2].jpg]
.
-- Joel34
billkatz - 27 Aug 2005 22:32 GMT Joel344 Wrote:
> Hey Bill! > > What cape? > > .. Isn't that Sue's dentist???
 Signature billkatz
Joel344 - 27 Aug 2005 22:36 GMT It is .... it is also Halloween.
Those capes look comfortable for watching TV also ......
.
[image: http://www.kabdental.com/IMAGES/concept_DentApron.jpg]
.
 Signature Joel344
Joel344 - 27 Aug 2005 22:40 GMT Here is the government surplus ones that Pepsident Bush says is okay to stop bullets, but I do not believe him.
.
[image: http://www.kabdental.com/IMAGES/flow_xray_apron4.jpg]
..
 Signature Joel344
billkatz - 27 Aug 2005 23:05 GMT Joel344 Wrote:
> Here is the government surplus ones that Pepsident > Bush says is okay to stop bullets, but I do not believe him. > > ... Better than what we have now ;)
Back to the thyroid collars. I go to a LOT of dentist's offices an I've never seen one used. Is there a preexisting set of guidelines whe one is to be used? Hyper/hypothyroidism for example??
-- billkat
Steven Bornfeld - 28 Aug 2005 00:04 GMT > Joel344 Wrote: > [quoted text clipped - 8 lines] > I've never seen one used. Is there a preexisting set of guidelines when > one is to be used? Hyper/hypothyroidism for example??? Yeah. They should ALWAYS be used.
Steve
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George Chatzipetros - 28 Aug 2005 09:57 GMT Sorry Steve, but every radiography course I have recently attended says lead aprons are not only useless, but also potentially more dangerous due to scattering of the radiation. Check medline if you want. Some excepts: "A statistical comparison between unshielded and shielded conditions was performed. When the leaded apron and thyroid collar were used the absorbed dose to the pituitary gland was increased significantly (P < 0.05). Following this a second group, using a different dosimetry system and a male phantom repeated the experiment. In both cases, the shielded phantom received significantly higher dose to the pituitary region than the unshielded."
"A tissue-equivalent anthropomorphic human phantom was used with a lithium fluoride thermoluminescent dosimetry system to evaluate the radiation absorbed dose to the ovarian and testicular region during dental radiologic procedures. Measurements were made with and without personal lead shielding devices consisting of thyroid collar and apron of 0.25 mm lead thickness equivalence. The radiation absorbed dose with or without lead shielding did not differ significantly from control dosimeters in vertex occlusal and periapical views (p greater than 0.05). Personal lead shielding devices did reduce gonadal dose in the case of accidental exposure (p less than 0.05). A leaded apron of 0.25 mm lead thickness equivalent was permeable to radiation in direct exposure testing."
It's a thing of the past, no need to use it. Your E-speed film or digital radiography and well-serviced high-KV cone should be enough to provide safe radiography. I believe the chance for a stochastic effect occuring is something like 1-in-4,000,000. That's still a lot better than the chance of dying due to an undiagnosed carious lesion.
George
Joel344 - 28 Aug 2005 10:52 GMT The reference
Oral Surg Oral Med Oral Pathol. 1991 May;71(5):642-6. Related Articles, Links
The leaded apron revisited: does it reduce gonadal radiation dose in dental radiology?
Wood RE, Harris AM, van der Merwe EJ, Nortje CJ.
Ontario Cancer Institute, Princess Margaret Hospital, Toronto, Canada.
 Signature Joel344
George Chatzipetros - 28 Aug 2005 13:31 GMT Right Joel, there are a few more as well.
Vaughn - 28 Aug 2005 14:57 GMT > Sorry Steve, but every radiography course I have recently attended says > lead aprons are not only useless, but also potentially more dangerous [quoted text clipped - 7 lines] > shielded phantom received significantly higher dose to the pituitary > region than the unshielded." Interesting! But both of these studies seem to be sadly limited and can not possibly answer the research question they seem to be asking. I have not read the whole reference, but both of these experiments seem to be limited to a single organ while ignoring the rest of the patient. The real question (and ultimately the real answer) must address the entire patient and have an answer that is reduced to equivalent whole-body dose.
My (many decades ago) health physics training said that ANY shielding between the human body and the radiation emitter is a good thing. My personal experience using radiation instruments inside a hot reactor compartment supported everything I was taught. I pride myself on keeping an open mind, but I would need far more convincing scientific evidence before dispensing with any patient or practitioner shielding.
Vaughn
Steven Bornfeld - 28 Aug 2005 18:46 GMT > Sorry Steve, but every radiography course I have recently attended says > lead aprons are not only useless, but also potentially more dangerous [quoted text clipped - 28 lines] > > George This is shocking to me. My personal lead shield is tested by the NYC Board of health. It is NOT permeable to x-rays. I don't know the equivalent thickness of lead it is regulated to. Furthermore, while I can conceive of a refractive effect at the EDGE of the lead apron, I can certainly not explain a SCATTER effect (in the sense that I could explain it in sense of scatter from a closed cone. I would appreciate if you could explain this claim. Surely something so major as this would have been reported, and something so counter-intuitive would have received wide circulation. You must know that there are studies out there to support whatever position you wish to take. I would hesitate to jump on a report which on its face is so grossly self-serving. I am not saying that radiation to patients is a major health issue. I am concerned with the perception that the old mandate to keep patient x-ray exposure as low as possible given the anticipated clinical information not be thrown out the window.
Steve
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George Chatzipetros - 28 Aug 2005 19:09 GMT Steve, your collar is fine, it's just that lead aprons and thyroid collars are a thing of the past, like dycal under composites. They have been around or so long that everybody considers them "a good thing to do" and "the way to go".
Check this out: United Kingdom's Department of Health and National Radiological Protection Board have issued the following statement: 'There is no justification for the routine use of lead aprons for patients in dental radiology. Thyroid collars should only be used in those few cases where the thyroid may be in the primary beam. Lead aprons do not protect against radiation scattered internally within the body, and only provide a practicable degree of protection in the infrequently used vertex occlusal projection. Even in this case the use of the lead apron could only be regarded as prudent for a female patient who is, or may be, pregnant'. This was exactly what I was taught in a course last year from two radiology advisors. So unless you were standing behind a full lead screen, don't bet on the apron protecting you.
Steven Bornfeld - 28 Aug 2005 19:47 GMT > Steve, your collar is fine, it's just that lead aprons and thyroid > collars are a thing of the past, like dycal under composites. They have [quoted text clipped - 15 lines] > radiology advisors. So unless you were standing behind a full lead > screen, don't bet on the apron protecting you. I note the qualifier "radiation scattered internally within the body". To your knowledge, has this new information actually affected any regs in the US?
Steve
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George Chatzipetros - 28 Aug 2005 21:02 GMT You will have to check the current regs for your state, as I unerstans states will have different regs. To my limited knowledge, the use of lead aprons for dental radiography is not mandatory in many states.
George
billkatz - 28 Aug 2005 21:17 GMT We live in a litigious world. Use the vest because you 'luv them. :)
 Signature billkatz
Steven Bornfeld - 28 Aug 2005 20:07 GMT > Steve, your collar is fine, it's just that lead aprons and thyroid > collars are a thing of the past, like dycal under composites. They have [quoted text clipped - 15 lines] > radiology advisors. So unless you were standing behind a full lead > screen, don't bet on the apron protecting you. Note the following:
# There is no justification for the routine use of lead aprons for patients in dental radiography. Their use during panoramic radiography is positively discouraged.
http://www.latimes.com/services/site/premium/access-registered.intercept
There is certainly some interesting stuff out there. There is for example a suggestion that:
"the normal selection criteria for dental radiography do not need to be influenced by the possibility of a female patient being at any stage of pregnancy."
http://www.imagingsystms.com/html/radiation_studies.htm#Lead
Maybe this in fact is a British thing. In fact it contradicts everything I've ever heard about the subject. Of course, the lawyers here may have something to do with this. However, some of this is troublesome to me as well--esp. the graph purporting to show the "Dental Radiation Exposure Comparative". Equating random environmental radiation to direct beam exposure is difficult to do at best; in my experience it is only done as a means of allaying anxiety in the lay public. BTW, and not intending to say that dycal under resins is a bad thing, but in my experience there was far less postop sensitivity in those days. I wouldn't bet the farm that the pendulum won't swing back on the advisability of phosphoric acid etching in deep carious lesions.
Steve O
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Stove99pipe - 29 Aug 2005 02:32 GMT > BTW, and not intending to say that dycal under resins is a bad thing, > but in my experience there was far less postop sensitivity in those > days. I wouldn't bet the farm that the pendulum won't swing back on the > advisability of phosphoric acid etching in deep carious lesions. > > Steve I have been ClearFil'ing these types of lesions since I heard Ray Berlotti speak on sensitivity in dentin. With etch/prime and separate bonding (two bottle) systems like that, you may have a slightly weaker bond, but you have more than enough, and you will have less sensitivity. This is especially true if you wait at least 15 secs with the unit light moved away before you wipe, air dry and cure it. By waiting, you're getting a good penetration of bonding and producing the hybrid layer that freezes odontoblast endings and prevents sensitivity.
The only caveat with ClearFil is that you need an activator with dual and self cure filling or cementation material. This is also true with 5th generation bondings (such as SingleBond).
.... now, let's see... I'm getting 500$ from Kurraray and 275$ from 3M for saying that.....
Blattt SP
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Amatus Cremona - 29 Aug 2005 13:08 GMT > Maybe this in fact is a British thing. In fact it contradicts everything > I've ever heard about the subject. If the study was funded by the same people who fund the NHS, you have to wonder if they aren't just trying to make dental care cheaper rather than raise the rates of reimbursement from NHS. Sort of like the third molar study done by the NHS saying third molars do not need to be removed unless they are infected.
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Amatus
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> >> Steve, your collar is fine, it's just that lead aprons and thyroid [quoted text clipped - 49 lines] > Steve > O letsconnect - 29 Aug 2005 14:33 GMT Amatus Cremona Wrote:
> If the study was funded by the same people who fund the NHS, you hav > to wonder if they aren't just trying to make dental care cheaper rathe > than raise the rates of reimbursement from NHS. Sort of like the thir > molar study done by the NHS saying third molars do not need to b > removed unless they are infected.<dentaltwinnospam @earthlink.net="" I was under the impression that a recent Cochrane review came to similar conclusion re. third molars </dentaltwinnospam
-- letsconnec
Amatus Cremona - 29 Aug 2005 13:05 GMT > Steve, your collar is fine, it's just that lead aprons and thyroid > collars are a thing of the past, like dycal under composites. They have > been around or so long that everybody considers them "a good thing to > do" and "the way to go". You should continue to use a lead apron as the world expects it of us. The difference in x-ray exposure to the rest of the body (not counting the neck, is minimal with or without it. However, any radiation which strikes the outside of the apron will be reflected into the room. By this time, its energy will be so low that it probably would not be an issue a few inches away. Any radiation reflected off the inside of the lead apron (due to radiation which scatters off the inner body tissues), will be reflected back into the body. But, remember that the residual energy of this radiation will be extremely low. I think every lead apron should have an integral thyroid collar. I think every exposure should have a lead apron placed, simply because you will be blamed for any diseases which come up 20 years later if you don't.
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Amatus
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> Steve, your collar is fine, it's just that lead aprons and thyroid > collars are a thing of the past, like dycal under composites. They have [quoted text clipped - 15 lines] > radiology advisors. So unless you were standing behind a full lead > screen, don't bet on the apron protecting you. George Chatzipetros - 29 Aug 2005 17:24 GMT Read the literature Amatus. There is NO benefit when using an apron/collar. There is INCREASED radiation uptake of certain tissues (eg the pituitary gland) when you're using an apron/collar. If you want to continue using that is not beneficial but may well be harmful, go ahead. But in 20 years later you will be blamed for any diseases which come up if you did. I can almost see it in my mind if I try: Lawyer: "Dr Amatus, look at this study showing increased radiation uptake when using a lead apron. Why have you been using one for the past 20 years? My client lost all of his hair and has suffered extensive emotional damage! Now hand me over your house/pension.car etc". Don't you think it's time dentists got a spine and start practicing for the benefit of their patients instead of having knee-jerk reactions like that? Guys, lawyers are the worst spinsters and liars in the world. If you use an apron, they're gonna get you. If you don't use an apron, they're gonna get you. You can't win with them.
George
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