• RPII Website
• RPII Code of Practice
• Statutory Instrument 478 of 2002
• Statutory Instrument 303 of 2007

Extracts from the faculty of General Dental Practitioners (UK) and the Royal College of Surgeons of England good practice guidelines-

The new patient to the practice
"Research has shown that intra-oral (bitewing and periapical) radiography is superior to panoramic radiography for the diagnosis of common dental pathology (caries, periodontal and periapical pathology)……"(page 20, section 2.2.1)

The edentulous patient
"In the absence of any clinical signs or symptoms there is no justification for any radiographic examination unless implant treatment is planned. Where clinical examination identifies the possible presence of an abnormality, such as a possible retained root, then an intra-oral radiograph is the appropriate radiographic examination."(Page 20, section 2.2.2)

Trauma
"If there is clinical evidence of a bony fracture it is probably more appropriate for a dentist to refer the patient for a complete radiographic examination at the hospital where treatment will be performed……For simple dental trauma, intra-oral radiography will provide greater diagnostic detail (than panoramic)" (Page 22, section 2.2.5)

Temporomandibular joint (TMJ) problems
"A study of patients with symptoms and signs related to the TMJ region found that panoramic radiography provided little or no information that influenced diagnosis or patient management in the majority of cases examined. (Page 23, section 2.2.6)

Suggested selection criteria for panoramic radiography

• Where a bony lesion or unerupted tooth is of a size or position that precludes its complete demonstration on intra-oral radiographs
• In the case of a grossly neglected mouth, with significant numbers of clinically-determined carious lesions and periapical pathology, along with established periodontal disease (other than simple gingivitis) and where there is pocketing greater than 6mm in depth
• For the assessment of wisdom teeth prior to planned surgical intervention. Routine radiography of unerupted third molars is not recommended
• As part of an orthodontic assessment where there is a clinical need to know the state of the dentition and the presence/absence of teeth. The use of clinical criteria to select patients rather than routine screening of patients is essential

Panoramic radiographs should only be taken in the presence of specific clinical signs and symptoms. There is no justification for review panoramic radiography at arbitrary time intervals.

All patients must have a clinical history taken prior to panoramic radiography. When radiographs are clinically indicated, intra-oral radiographs should be considered first because of better detail and lower radiation doses." (page 23, section 2.2.7)