An audit of occipitomental radiographs

Abstract

Objectives: To audit the justification for and image quality of occipitomental (OM) radiographs obtained at a dental teaching hospital.

Methods: One hundred OM radiographs taken at Glasgow Dental Hospital and their associated request forms were analysed by two examiners retrospectively. Information recorded from the request form included the age and gender of the patient, requesting department, grade of requesting clinician, reason for the request and exposure factors. The radiographs were assessed for radiographic density, patient positioning, presence of abnormality and whether the maxillary sinuses were normal or not. It was then decided by reference to the clinical records if there had been an indication for taking the radiograph.

Results: The majority of the requests were from junior staff, most frequently for pain or sinusitis. Almost all were from the Departments of Oral Surgery, Oral Medicine or Dental Accident and Emergency (A&E). The technical quality of the radiographs was variable, especially with respect to superimposition of the petrous temporal bone. Over half of the cases had normal sinuses, no abnormality and no indication for the radiograph.

Conclusions: Many requests were inappropriate and the resultant radiographs had a low diagnostic yield. The technical quality of the radiographs was variable. Guidelines for clinicians for the prescription of OM radiographs were produced and the protocol for radiographic technique changed.