benn at DENTAL.UFL.EDU
Thu Feb 15 15:57:24 PST 2001
As an immigrant I too had to have a chest x-ray. However, what is not generally known is that the INS are very concerned only to allow in people who are kind. Hence they x-ray you to check you have a good heart.....:-)
Dr. Douglas K. Benn,
Professor of Radiology & Director of Oral Diagnostic Systems,
Dept. Oral and Maxillofacial Surgery & Diagnostic Sciences,
University of Florida College of Dentistry,
Gainesville, FL 32610-0414,
Tel: (352) 392 5210.
Fax: (352) 392 2507
Email: benn at dental.ufl.edu
See website: http://oralsurgery.dental.ufl.edu for our presentation
"How to heal tooth decay and avoid fillings"
Personal website: http://www.dental.ufl.edu/benncv.htm
>>> agfarm01 at LOUISVILLE.EDU 02/15/01 02:59PM >>>
One of the requirements when I emigrated to the USA was an "adnministrative" chest radiograph, presumably used to protect the US population against admitting a person who could spread disease or become a burdon to the tax payer. I do not view aging a person (within a reasonable range of certainty) using radiographs as being any different from the chest radiograph that I received.
I agree in part with Julian's points, but not entirely. First, I do not believe that aging a person by dental and hand-wrist radiographs is practicing medicine. These are techniques used very frequently by Orthodontists. I do not believe that this is specialist work for a physician - or for an OM Radiologist. Second, there is a diagnostic element, namely the approximate aging of a patient who seeks to remain in the USA. Is the alternative immediate deportation? When age is a legal factor what better means are available for establishing the information in a relatively safe and convenient manner?
Certainly, the issues of appropriate collimation and using more suited receptors should be addressed. A panoramic radiograph and traditional hand-wrist films would be more appropriate than the direct-exposure emulsion films being employed. If recent radiographs are already available and can be authoritatively linked to the person under evaluation then there should be no need to make a new exposure. I would much prefer to see this procedure carried out by a dentist rather than a INS officer. I would suggest that the radiographs taken are also used for diagnostic purposes - i.e. when a panoramic film is exposed it should be interpreted and a copy of the film plus the report given to the person under evaluation for future use when seeking dental treatment.
Just some "off the cuff" thoughts to stir considered debate.
Allan G. Farman
>>> Lurie at NSO.UCHC.EDU 02/15/01 01:45PM >>>
Hi Julian and EC members,
I agree with all the points you have raised. I think it would be
appropriate for the Executive Council of the Academy to formulate a response
at the ad interim meeting next week and send it to the INS and the ADA.
> From: Gibbs, S Julian
> Reply To: Oral Radiology Discussion Group
> Sent: Thursday, February 15, 2001 12:28 PM
> To: ORADLIST at listserv.ucla.edu
> Subject: Action?
> The Feb. 5 issue of the ADA NEWS carries, on p. 18, an
> article about a dentist in New York who is assisting the
> Immigration and Naturalization Service in establishing the
> age of illegal immigrants. Illegal adults, age 18 or over,
> must establish fear of persecution if deported, while
> juveniles are allowed to remain.
> The dentist helps establish age from radiographs of third
> molars and wrists. From the article, he appears to violate
> several principles of sound radiologic practice:
> 1. Administrative use of radiation, for a purpose other
> than health benefit to the patient. In this case, there
> may be no other means to establish age. However, both
> third molar development and epiphyseal closure of radius,
> ulna, and phalanges are subject to considerable variation.
> We all know that bone age, dental age, and chronologic age
> do not always agree.
> 2. Fastest image receptor feasible. He is using occlusal
> film for wrist radiographs. High-speed screen-film systems
> are quite adequate for "bone age" films of the wrist, at a
> small fraction of the exposure required for occlusal films.
> Several films are required for anatomic coverage.
> 3. Collimation of the beam to the area of interest, or
> size of image receptor. A photograph shows the dental
> tubehead crudely aligned with the hand, with PID tip at
> least 30 cm from image receptor, a single occlusal film
> located under the phalanges.
> He also may be practicing medicine without a license.
> My question: should we, especially the appropriate AAOMR
> committee, write a letter to the editor pointing out these
> S. Julian Gibbs, DDS, PhD Voice: 615-322-1477
> Professor, Emeritus FAX: 615-322-1474
> Dept. of Radiology & Radiological Sciences
> Vanderbilt University Medical Center
> 209 Oxford House
> Nashville TN 37232-4245 Email:j.gibbs at vanderbilt.edu
> The American Republic will endure until the day Congress
> discovers that it can bribe the Public with the Public's money."
> Alexis de Tocqueville
> Democracy in America
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