Open Contact Dental

Dentistry Through a Hygienist's Eyes

X-Ray Vision


Taking x-rays looks easy. Put film or sensor in a patient’s mouth. Have them bite. Step out of room to push a button. Take film/sensor out. Pretty simple.

Have you tried to make any type of diagnosis with a film/image that is under or over exposed? Don’t get me started on foreshortening and distortion. How about trying to get a clear interproximal view of a patient’s mouth who has a gallon of teeth and a half gallon of jaw. We’ve all spend time squinting and second guessing what we see because a film/image is less than adequate. Even after years of practice we can become victim to the dreaded “overlap”. Taking a perfect film takes practice, the patience of a good instructor and digital technology that shows us almost immediately that a retake needs to be done. Even with all that experience under our belts we still take films that are less than can be desired.

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Imagine this scenario…You see out of the corner, while wearing loupes and actively working with a patient, a young boy, about 9 years old, enter the room in which your panoramic X-ray machine resides. Imagine also seeing your office receptionist quietly walk out of the room, hearing the whirl of a panoramic image being exposed and seeing her emerge from around the wall to enter the room again.

What would you assumed happened? Would you assume that you employer just delegated a duty, authorized by your State Board to be performed by a licensed auxiliary, to the office receptionist? Upon investigating more you determine that yes, the receptionist, the person who answers the phone to schedule appointments, verifies insurance coverage and posts the checks, just positioned a patient and exposed a radiographic image.

In a healthier economic time – where patients are banging down the door for dental care – you would be able to do what you need to do. RUN, from this office. Unfortunately in this job market with jobs being too few and very far between you are forced to endure unethical behavior.

Your employer may be a nice, sweet man because he keeps the office environment light and friendly. He may know everything about his patients and keeps a smile on his face even when faced with stressful situations. The disregard for the laws of the State Board and amount of time and effort our colleagues endured to allow licensed auxiliaries the right to perform these duties is not very nice or sweet at all. Imagine if the nice guys are playing this way, what are the bad guys doing?

You want to use your voice and be an advocate for this patient and an advocate for all those licensed professionals whose rights are being ignored. You want to say: “Dr, you just showed unprofessional and unethical behavior by allowing a non licensed worker to perform duties that you know she is not licensed to perform. You have put your license on the line. I am reporting you to the State Board”. You would like to say to the receptionist, “Receptionist, you know you are not licensed. I hope you’ve gotten a raise to perform this illegal duty because the fine in our state is $5000 plus legal fees”. And to the state Board, “State Board, I have to report an unlicensed individual posing as a dental professional and a dentist who is delegating illegal acts to said person”.

Some say this is a victimless crime and that no one gets hurt. Our State Associations have fought hard for our rights to expose dental radiographs in a generally supervised setting (each State regulations vary). Employers who overlook the laws and regulations of their State are slowly allowing the rights and duties we have fought so hard to achieve to erode.

So what are we to do? Do we turn in our employer and co-workers who have been like family to us for years? Do we put ourselves into a position where we could be blacklisted among the dentists in our towns and never find employment again? Who congratulates us for getting our bosses fined and reprimanded? Do we feel good about turning in the unethical culprits?

I think the most important question is the one we ask ourselves. Are we perpetuating the cycle of unethical behavior by allowing it to go on and turning a blind’s eye to these actions? Only we can stop the unethical behavior of others by making It known that we see this behavior occurring. We need to stand up for our profession so that we can help it move upward.

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