Abstract
<h3>Background</h3> There is substantial evidence for a cumulative dose-related response to ionizing radiation in the form of cancer development years after initial exposure. Therefore, this study focused on effective dose (E), a quantity with direct correlations to biologic risk from dental x-ray exposures. <h3>Objectives</h3> The purpose of this study was to measure doses and calculate (E) from adult full-mouth examinations (FMXs) by using handheld and conventional wall-mounted x-ray sources with both circular and rectangular collimation (RC). <h3>Materials and Methods</h3> A human tissue-equivalent phantom and optically stimulated luminescent dosimeters were used to measure dose from simulated FMXs (n = 18) at 24 head/neck tissue sites. The parameters were 70 kV/7 mA (0.84 mAs and 1.34 mAs) for Conventional Circular and RC handheld device; 60 kV/2.5 mA (2.16 mAs) for NOMAD Circular and RC handheld device; and 60 kV/2.0 mA (1.98 mAs) for Xray2 Go Circular (XTG) handheld device. Analysis of variance (ANOVA) and Tukey's HSD ("honest significant difference") statistics demonstrated significant relationships. <h3>Results</h3> The FMX E (µSv) values were: NOMAD RC (6.9); XTG (16.7); NOMAD Circular (17.4); and Conventional Circular (26.3). For circular techniques, the handheld device E was significantly lower than the conventional unit for both devices (<i>P</i> < .0001). With RC, E was significantly lower than all circular techniques (<i>P</i> < .0001). Significant differences in E were found for all modality combinations except NOMAD Circular and XTG (<i>P</i> = .8329). Operator groin exposure was significantly higher (60%–90%) than thyroid, chest, and trigger hand exposures, which were indistinguishable from ambient background levels, for all handheld modalities (<i>P</i> < .0001). <h3>Discussion</h3> Handheld device E was at least 34% less than conventional circular and as much as 74% less with the use of RC. Operator exposure to the groin can increase significantly from overangulating the handheld sources; however, the addition of RC can reduce this exposure by as much as 76%.
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