Prescription of Dental Radiographs

[Arne Petersson]

In Sweden, we have a debate since many years about what responsibilities
dental hygienists and dental assistants have to take and analyse
radiographs.  The law says that it is the dentist that is responsible for
the radiographic equipment and therefore, no dental hygienist or dental
assistant can work without a dentist in the background.
It is also clear that dental assistants can be delegated to take
radiographs when the dentist gives the order, but they have no right to
interpretate the radiographs.

For dental hygienists it is more complicated.  An ongoing governmental
investigation suggests that dental hygienists are able to take and
interpretate radiographs considering dental caries and marginal bone
destructions.  However, all radiographs taken by the dental hygienist must
be shown to a dentist for interpretation of other diseases.  The dental
hygienist must not decide on a new patient, if radiographs should be taken
or not.  This decision must be taken by a dentist.  Here comes a difficult
part.  Can a dental hygienist refer a patient for radiographic examination?
 In my opinion this is not possible in Sweden, because then the radiologist
has to make a clinical examination to be able to decide what radiographs
that should be taken and the extension of the examination is also depending
on the treatment that is to be suggested for the patient.
For patients that are coming for check-ups i.e. yearly, the dental
hygienist and dentist together decides what is suitable for the individual
patient and they may together decide that the dental hygienist can take
radiographs at the revision intervals.  In this case it might be possible
for the dental hygienist to refer the patient, but they would never do it,
because what they want is to take the full responsibility for the patient
and make as much as possible by there own.
As you understand this is a very hot issue in Sweden and the final decision
about the education and resposibilities for the dental hygienist is not
clear.  The radiologists in Sweden are against all delegation of diagnosis
from the dentist to other professions.
Arne Petersson
At 11:31 1997-11-25 -0800, you wrote:
>There is a little controversy going on here in BC, Canada, concerning
>whether dental hygienists should prescribe radiographs.  It is the position
>of the recently established BC College of Dental Hygienists that the
>training and experience of hygienists is sufficient to enable them to do
>this.  Some of us believe that it is the responsibility of whomever
>prescribes radiographs (or any other form of investigation) to undertake
>the direction of the consequent patient care.  Only a dental course would
>provide the background knowledge for this prescription.
>
>I am seeking information about the extent to which hygienists in other
>parts of the world are allowed to prescribe radiographs.
>
>                Colin.
>
Arne Petersson, DDS PhD
Department of Oral Radiology, Faculty of Odontology,
Lund University, Carl Gustafs v 34, S-214 21 Malmö,
Sweden tel 40-322007, telefax 40-322023
e-mail arne.petersson at odrtg.lu.se