Big Sandy Community and Technical College

Course Syllabus

PS Number: 54493 Lecture 54494 Lab

Semester: Fall Year: 2015

Faculty Name: Kathy J. Miller, DMD Title: Instructor

Course Prefix and Number: DAH 135 Course Credit Hours: 2

Course Prerequisites: Admission into the Dental Assisting/Dental Hygiene Integrated Program and completion of program pre-requisites – Dental Hygiene: ENG 101 and BSL 110; Dental Assisting: BSL 107 or BSL 109 or HEA 110 or BSL 110 and BSL 111.

Course Title: Oral Radiology

Catalog Course Description: The theory and clinical practice of oral radiographic methods. History and development of x-radiation; properties and uses of x-radiation; radiation hygiene; exposing, processing and mounting of intra-oral and extra-oral

films; and identification of radiographic anatomic landmarks. Instructor Contact Information:

Campus Location: SCC Laurel North Building & Room: LN1 – Room 151

Office Hours: By appointment only

Office Phone Number: 606-877-1421 Ext 14978

Alternate Number:

Best Times to Call:

KCTCS Email: kmiller0156@kctcs.edu

Special Instructions:

Supervisor Contact Information:

Name: Eric Dixon, DMD

Campus Location: Prestonsburg Building & Room: Johnson – J113

Office Phone Number: 606-886-3863 ext 67352

KCTCS Email: edixon0001@kctcs.edu

Text and Supplies: Dental Radiology, Principles and Techniques by Iannucci/Howerton, fourth edition/ publisher-Elsevier ISBN 978-1-4377-1162-2

KCTCS General Education Competencies

Students should prepare for twenty-first century challenges by gaining: A. Knowledge of human cultures and the physical and natural worlds through study in the sciences and

mathematics, social sciences, humanities, histories, languages, and the arts. Method to Achieve Competency:

B. Intellectual and practical skills, including

inquiry and analysis

critical and creative thinking

written and oral communication

quantitative literacy

information literacy

teamwork and problem solving Method to Achieve Competency:

C. Personal and social responsibility, including

civic knowledge and engagement (local and global)

intercultural knowledge and competence

ethical reasoning and action

foundations and skills for lifelong learning Method to Achieve Competency:

D. Integrative and applied learning, including synthesis and advanced accomplishment across general and specialized skills.

Method to Achieve Competency:

Course Specific Competencies (Student Outcomes):

1. describe how x-rays are produced and their effect on radiographic film. 2. discuss biological effects of radiation. 3. discuss radiation hygiene. 4. discuss the geometric factors which affect the radiographic image. 5. demonstrate the ability to take acceptable intra-oral and extra-oral radiographs. 6. process dental radiographs. 7. mount dental radiographs.

8. demonstrate panoramic and computerized imaging techniques 9. demonstrate the ability to obtain an acceptable panoramic radiograph.

10. identify oral radiographic anatomic landmarks.

11. identify abnormal anatomy 12. understand and be able to determine need for radiographs 13. understand how the patient’s health history and status affects treatment 14. identify and discuss techniques and processing errors. 15. demonstrate the ability to chart radiographic findings. 16. understand the legal aspects of the patient chart and privacy 17. know and be able to implement proper infection control 18. be able to analyze and interpret radiographs 19. understand how and when referrals are needed

Lab Competencies (Student Outcomes): (Enter N/A if this does not apply.)

1. Physical properties of the dental x-ray machine 2. Radiation protection and monitoring 3. Film processing a. Darkroom b. Film mounting 4. Principles of exposure a. Film density b. Film contrast 5. Paralleling techniques a. Basic film instrument and PID positioning procedures practicum b. Interproximal techniques c. Special needs patients 6. Bisecting angle technique a. Basic film, instrument and cone positioning procedures practicum b. Interproximal technique c. Special needs patients 7. Radiologic findings a. Landmarks b. Technique and processing errors c. Pathological conditions 8. Mandibular and maxillary cross-sectional occlusal survey 9. Extraoral radiographic technique

Course Outline: 1. Introduction

A. History of x-radiation 1. Discovery of x-rays 2. Properties and characteristics of x-rays B. Concepts of matter 1. Atoms, molecules, compounds 2. Phases of matter C. Basic concepts of x-ray production 1. Sources of electrons 2. Wave radiation 3. Particulate radiation a. Bremsstrahlung radiation b. Characteristic radiation 4. Ionization

2. Physical properties and principles of exposure A. Physical properties of x-rays 1. How x-rays are produced 2. Effects on photographic film B. Main component of x-ray tube

1. Cathode, anode, filament, tungsten target, collimator, focusing cup, housing

2. Thermionic emission C. Exposure variables 1. Voltage 2. Amperage 3. Transformers 4. Timer a. Impulses b. Seconds 5. Target-film distance D. Differential absorption and formation of latent image 1. Radiolucent/radiopaque 2. Latent image 3. Primary radiation 4. Leakage, secondary, remnant, scatter radiation E. Density 1. Controlling factors 2. Influencing factors F. Contrast and detail 1. High vs. low-scale contrast 2. Controlling factors 3. Influencing factors 4. Fogging 5. Penumbra and umbra 6. Object-film distance G. Inverse square law

3. Radiation biology A. Direct effects 1. Classical scattering 2. Photoelectric effect 3. Compton effect B. Indirect effects 1. Free radicals 2. Molecule alterations C. Acute effects D. Chronic effects E. Units of radiation measurement 1. Unit of exposure 2. Absorbed dose 3. Dose equivalent

4. Radiation hygiene A. Patient protection 1. Collimation 2. Filtration 3. Exposure time 4. Kilovoltage 5. Lead apron and thyroid shield 6. Film speed and selection 7. Position indicating device 8. Intraoral technique

9. Processing technique 10. Selection criteria B. Operator protection 1. Methods for reducing exposure 2. Personnel monitoring 3. Maximum permissible dose 4. “Common sense” rules C. Dental radiological health 1. Cell/tissue effects a. Somatic cells b. Sex chromatin c. Ionization d. Dose rate e. Sensitivity

5. Processing A. Darkroom and darkroom chemistry 1. Required features of a darkroom 2. Darkroom equipment B. Composition of a film packet C. Chemical 1. Use and function of developer 2. Use and function of water 3. Use and function of fixer D. Safelight E. Manual processing 1. Preparing solutions 2. Preparing film rack 3. Procedures for proper processing F. Automatic processing 1. Preparing solutions 2. Procedures 3. Maintenance of equipment G. Errors 1. Exhausted solution 2. Static electricity 3. Under/over development 4. Under/over fixing 5. Bent film 6. Air bubbles 7. Incomplete washing 8. Reticulation 9. Light leaks 10. Fingerprints and scratching 11. Film fog

6. Mounting Procedures A. Types of mounts B. Procedures 1. Identification a. Anterior b. Posterior c. Bitewing

2. Placement C. Labeling

7. Intraoral techniques A. Paralleling 1. Basic principles a. Relationship of target, film and central ray b. Position indicating device (PID) length 2. Basic film, instrument and PID positioning a. Anterior films b. Posterior films c. Extension cone paralleling (XCP) devices and

their functions 3. Interproximal techniques B. Bisecting angle 1. Basic principles a. Film placement b. PID length c. Differences in images d. Common errors 2. Film holders, film and PID placement a. Anterior b. Posterior 3. Interproximal techniques C. Computer imaging technology D. Pedodontic E. Edentulous F. Occlusal radiograph 1. Exposure principles 2. Techniques for exposing films 3. Indications

8. Localization techniques A. Two films B. Buccal-object rule

9. Extraoral A. Panoramic radiography 1. Principles of panoramic radiography 2. Advantages and disadvantages of panoramic radiography 3. Types of machines 4. Radiographic anatomic landmarks 5. Common technique errors B. Alternative imaging systems and techniques 1. Computerized tomography (CT) 2. Magnetic resonance imaging (MRI) 3. Xeroradiography 4. Cephalometric 5. Subtraction radiography 6. Temporomandibular joint (TMJ) 7. Maxillary sinus

8. Lateral oblique

10. Radiographic anatomic landmarks A. Mandible B. Maxilla C. Radiolucent vs. radiopaque

11. Errors in film placement technique A. Angulation 1. Horizontal 2. Vertical B. Movement C. Double exposure D. Packet placement E. Film bending F. Exposed backward

12. The order of the course material may be altered to adjust for lab.

Lecture/Exam Schedule:

Chapter Title Page Date

2 Radiation Physics 8 8/19

3 Radiation Characteristics

Syllabus overview

26 8/19

4

5

Radiation Biology

Radiation Protection

34

45

8/26

6

Dental X-Ray Equipment

Lecture on Lab related issues (will always be on test)

57

8/26

Test 1 9/2

7 Dental X-Ray Film 63 9/9

8

9

Dental X-Ray Image Characteristics

Dental X-Ray Film Processing

76

86

9/9

16

17

18

Introduction to Radiographic Examination

Paralleling Technique

Bisecting Technique

152

155

180

9/16

19

28

Bite-Wing Technique

Film Mounting and Viewing

Lecture on lab related issues

210

345

9/23

Test 2 9/30

10 Quality Assurance in the Dental Office 111 10/7

11

12

Dental Rad. And the Dental Radiographer

Patient Relations and the Dental Radiographer

121

125

10/7

13

14

Patient Education and the Dental Radiographer

Legal Issues and the Dental Radiographer

Fall Break

130

135

10/7

10/14

15 Infection Control and the Dental Radiographer

140 10/21

27

20

Normal Anatomy: Intraoral Images

Exposure and Technique Errors

Lecture on lab issues

325

226

10/21

Test 3 10/28

20 & 27 Review of these chapters. Will also be on Test 4

Lecture on lab issues

Independent Reading of Chapter 32: ID of Foreign Bodies

383

10/28

And Chapter 35: Int. of Trauma and Pulpal and PA Lesions 426

33

34

Interpretation of Dental Caries

Interpretation of Periodontal Disease

402

412

11/4

Test 4 11/11

21 Occlusal and Localization Techniques 239 11/18

22 Panoramic Imaging 274 11/18

23 Extraoral Imaging

Independent reading of Chapter 24: Imaging of Patients with

Special Needs

274

290

11/18

25 Digital Imaging 301 11/25

29 Normal Anatomy: Panoramic Images 357 11/25

TEST 5 12/5

FINAL FINAL

WEEK

Course Structure: Power point presentations, lecture, internet and independent assignments will be utilized in this course. Due to the amount of material to be covered in this course, it is recommended that you read your textbook chapters before lecture in order to familiarize yourself with the material to be covered in lecture.

Technology/Media Component: Class is taught via interactive television video. An attempt will be given to give students, at least a 48-hour notice (not including Saturday and Sunday) via their KCTCS e-mail of assignment deadlines, exams, etc. Students are ultimately responsible for all tests, assignments, etc. deadlines even if notice is not given since exams are scheduled in the syllabus.

Service-Learning:

Course Requirements and Evaluation:

In order to continue in the DH Program, a final grade of “C” or better is required. A student who withdraws from, or earns a grade lower than “C” in a course, WILL BE DROPPED from the program. The lab portion and the lecture portion of the class must be passed independently of each other for an overall passing grade. Lecture: 5 exams worth 100 points each 500 pts. Lab: Techniques (see TASK) 400 pts Assign/Participation & Quizzes Absence will not be tolerated 100 pts. Quizzes are to be expected every class period Final exam: Comprehensive 200 pts. Total 1200 pts

Patient Selection: You are responsible for finding your own radiology patients. We realize this is not easy, but it can be done. I suggest friends, family, and children. Your patients, however, must legitimately demonstrate a need for the radiographs in order to be accepted as a radiology patient. Your patients must have an acceptable health history. Since your Full Mouth and Bitewing requirements are graded on the inclusion of root apices and interproximal contacts, your patient should have a full dentition (wisdom teeth may or may not be present). If you choose a patient with missing dentition, there will be an automatic loss of points because the teeth are not present and therefore cannot be graded. It is possible to fail the assignment before starting because of the number of missing teeth. Your lab instructor may opt to disallow a patient for these reasons. The Panoramic patient may have missing teeth but cannot be totally edentulous. Poor patient selection therefore has a direct influence on the grade of the assignment and is therefore part of the assignment. If 1st molars are missing but 2nd molars are present, ask the lab instructor. If 2nd molars are missing, you do not have a good candidate unless 3rd molars are present. Some lecture exams may be given during lab time as announced in lecture.

Lab Portion

Lab Grades DAH 135 1. Dexter Adult BW #1 film #2 digital if avail. Pass/fail You must pass to advance to the next lab. 2. Adult BW Patient 100 pts possible 3. Dexter Adult Full mouth 50 pts 4. Dexter Adult Bisecting Angle Full mouth Pass/fail 5. Adult Full Mouth patient 100 pts possible 6. Adult Full Mouth patient (digital if avail.) 100 pts possible 7. Panorex 50 pts 8. Occlusal 2 films Dexter pass/fail each a. Max. Topographical Ant. Occlusal b. Mand. Cross-sectional Different sites may vary the order and/or add additional activities. Some of these such as learning how the processor works are important for future assignments. Day to day assignments are at the discretion of the lab instructor. However, questions from the lab assignments will be on the written tests and/or quizzes so please note the assignments in the lecture portion of the syllabus. Lab activities will vary from the lab exercises but you will be

held responsible for the information in the exercise, not doing the actual lab.

Grading Policy: The scale below shows the relationship between your semester percent average and

the letter grade you will receive. Slight deviations from this scale are possible if they

seem advisable.

A= 94-100%

B= 86-93%

C= 78-85%

D= Cannot continue in the program with less than a C

E=

Attendance Policy: Attendance is required at all labs. Part of the time you will be exposing radiographs on manikins or working directly with patients. At other times you will be processing films, evaluating films, getting films graded, completing other lab assignments, etc. Therefore you are expected to be present during all of the hours of lab unless you have been personally excused on an individual basis by the lab instructor. I DO NOT GIVE MAKE-UPS FOR LAB ASSIGNMENTS. If a student is absent, that student will make-up missed assignments during an OPEN LAB period ONLY. A Passing grade in lab and lecture must be made independently of each other. A passing grade must be achieved in lecture before lab is even considered. Failure or an incomplete on any lab will cause a letter grade drop. Failure or incompletes on 2 labs will be failure for lab and thus failure for the course. You must pass lab and you must pass lecture to pass the course. Showing competency and passing the manikin labs must be ACCOMPLISHED BEFORE the actual patient lab may be attempted. After four attempts to pass or at the lab instructor’s discretion on the manikin portion or two attempts to pass or at the lab instructor’s discretion on a patient lab without passing, the student may apply for remediation with the instructor and travel to the instructor’s site for such remediation. Passing the lecture portion of the class is defined as having a 78% average or higher on the 5 tests and final. The other assignments are part of the overall grade but are not considered in this definition. Failure of 3 of the tests or 2 of the tests and the final is considered failure of the lecture portion regardless of the overall average. Passing this class means you are qualified and competent to take radiographs on the public and failing the exam portion means you are not qualified. Remember you must have an overall average of 78% or higher in all aspects of the course as well as a 78% or higher in lab and a 78% or higher in lab or a ‘C’ to continue in the program overall.

Missed Exam Policy: If a make-up exam is necessary, 5% will be automatically deducted. Make-up exams may be a different exam and format. Any missed quiz will result in a score of 0 for that quiz. No make-up quizzes will be allowed. Make-up exams will be given at the discretion of the instructor. It is the students responsibility to contact the instructor for scheduling the make-up exam. Students requiring a makeup exam must contact the instructor and any other appropriate instructor at each site in order to schedule their individual exam. Makeup exams, dates and times, within the makeup week will be assigned to the student by the instructor. If a student fails to contact an instructor in order to make arrangements for a makeup exam the student will receive a zero score for the exam.

Telephone policy:

Cell phones will not be tolerated in lecture, lab or clinical settings. You will be required to leave your phone in your locker or place them in a basket at the front of the classroom. If your phone is on you will be dismissed from class for the day and participation points will be adjusted. You will also attend a conference with a program faculty member and program coordinator for a documented reprimand. Repeated reprimands could result in dismissal from the program. If you need to be contacted due to an emergency you may be reached at one of the the following numbers; for Prestonsburg 606-886-6752, for London 606-877-1421 ext 14791 and for Lexington 859-246-6200 ext 56622.

Late Assignment Policy:

Withdrawal Policy: A student may withdraw from the class and receive a “W” grade at any time specified by the printed college guidelines. After the mid-term date through the end of class work (see Academic Calendar), this instructor will allow a student to withdraw only under extenuating circumstances, such as illness, accident, etc. The student must see the instructor

Additional information can be found at the following site: http://www.bigsandy.kctcs.edu/en/Academics/Office_Hours_Schedules_and_Syllabi.aspx

Syllabus Quiz (20 points)

DAH 135 Oral Radiology

1. I have read and understand and accept the terms of this syllabus.

_______________________________ __________________________

Student's Signature Date

_______________________________ ________________________

Dr. Kathy J. Miller Date

True or False

2. _____ Failure to attend and participate in lecture will result in loss of participation points in the

class.

3. ____ I understand I am to have the material to be covered in lecture read before lecture and it

may be on a quiz even if lecture has not covered it yet.

4. _____A failure or incomplete on any lab will cause a letter grade drop.

5. _____Failure or incomplete on any two labs will cause failure of the course.

6._____Failure of 3 lecture exams will result in failure of the class

7. _____There will be 5 tests, each worth 100 points each, a final worth 200 points, labs worth

500 total points, and various other quizzes and assignments worth 400 points total

8._____Patient selection has a direct effect on the possible lab scores and should be taken

seriously

9. _____ You are responsible for providing your own radiology patients.

10._____It is YOUR responsibility to contact the instructor for make-up exams and/or

remediation for lab failures.