15. Appendices
Green Smart User Manual 185
ENGLISH
"Filling in" this space with the soft tissue of the tongue can increase the quality of the
image by diminishing this radiolucent shadow. When directed to place the tongue on the
roof of the mouth, the pediatric patient is likely to press only the tip of the tongue against
the palate. While an adult patient can usually understand what is required when directed
to swallow and note the position of the tongue, a child may be directed to suck in the
cheeks, which results in pushing the tongue into a position flat against the palate.
7
Conclusion
In addition to these guidelines for producing error-free radiographic images for the
pediatric patient, panoramic machines should be evaluated periodically for accuracy.
Changes may occur over time to the focal trough that interferes with the diagnostic quality
of the machine.
6
If a decrease in image quality is noted in spite of following accurate
patient positioning steps, the panoramic x-ray machine should be inspected and the focal
trough recalibrated. The dental hygienist who is skilled in understanding panoramic
equipment operation and pediatric patient management is more likely to produce
radiographic images that result in higher diagnostic yields.
References
1. Public Health Service, Food and Drug Administration, American Dental Association Council on
Dental Benefits Program, Council on Dental Practice, Council on Scientific Affairs. The Selection of
Patients for Dental Radiographic Examinations. Washington, DC: United States Department of Health
and Human Services; 1987 (revised 2005):1-23.
2. Pinkham PS, Casamassimo, Fields HW, McTigue DJ, Nowak AJ. Pediatric Dentistry Infancy
through Adolescence. 4th ed. St. Louis: Elsevier Saunders; 2005:677.
3. Thomson EM. Panoramic radiographs and the pediatric patient. Dimensions of Dental Hygiene.
2008;6(2):26-29.
4. Rushton VE, Rout J. Panoramic Radiology. London: Quintessence Publishing Co Ltd; 2006:17, 84-
85.
5. Kullman L, Joseph B. Quality of digital panoramic radiography in a newly established dental school.
Swedish Dent Journal. 2006; 30: 165-170.
6. Akarslan ZZ, Erten H, Güngör K, et al. Common errors on panoramic radiographs taken in a dental
school. J Contemp Dent Pract. 2003;4:24-34.
7. Rushton VE, Horner K, Worthington HV. The quality of panoramic radiographs in a sample of
general dental practices. Br Dent J. 1999; 26: 630-633.
8. White SC, Heslop EW, Hollender LG, Mosier KM, Ruprecht A, Shrout MK. Parameters of radiologic
care: an official report of the American Academy of Oral and Maxillofacial Radiology. Oral Surg Oral
Med Oral Pathol. 2001;91:498-511.
9. McDonald RE, Avery DR, Dean JA. Dentistry for the Child and Adolescent. 8th ed. St. Louis:
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