Radiation Protection Legislation & Guidance

In addition to our regulations there are two sets of dedicated legislation and professional guidelines governing the use of dental X-ray equipment.

Ionising Radiation (Medical Exposure) Regulations 2000/2018 [IRMER2000/2018] relate specifically to protection of the patient.
Ionising Radiations Regulations 2017 [IRR2017] relate to the protection of workers and the public.

*Guidance notes for dental practitioners on the safe use of X-ray equipment (Public Health England and Faculty of General Dental Practice).

All practices should consider the following:

How do you put arrangements for radiation protection into practice?
Have you consulted a radiation protection adviser (RPA) and medical physics expert (MPE)? *The same person may fulfil both roles.
Have you registered with HSE? Where is your certificate?
Have you documented the arrangements for radiation protection, for example, in a radiation file or folder?
Do you quality assure/performance test the radiography equipment?
Is the X-ray equipment maintained or serviced by an appropriate person? This could be the organisation which installed the equipment
Does an appropriately trained staff member do a walk about visual inspection of X-ray sets to identify any safety faults?
Which staff are involved in taking X-rays and are they trained?
Have staff been trained according to current professional guidelines?

[Source] https://www.cqc.org.uk/guidance-providers/dentists/dental-mythbuster-3-dental-radiography-x-rays

Statutory Law

In addition to the general requirements of the Health and Safety at Work etc. Act 1974, and the Management of Health and Safety Regulations 1999, the following specific legislation applies:

[a] Ionising Radiations Regulations 2017 (IRR17);

[b] Ionising Radiation (Medical Exposures) Regulations 2017 (IRMER17)

(HSE, 2020) [PM77 – Equipment used in connection with medical exposure]

The legal protocols are as follows:

Critical Examination [CE]

This demonstrates that the x-ray unit is electrically, mechanically and radiologically safe, and that the environment that the x-ray unit has been installed in is safe for the operator and other personnel working at the practice.

Acceptance Test [AT]

This demonstrates that the x-ray unit operates in accordance with manufacturer specifications (*) and also measures patient radiation doses to ensure complete compliance (IRMER17).

These tests are ordinarily completed simultaneously [CEAT]. They are both undertaken at the point of installation and following any major maintenance procedure that might affect the output of the x-ray unit (IRR17).

Routine Test [RT] Quality Assurance [QA] Performance Test [PT]

This test includes all parts of the imaging chain and ensures that the performance of your x-ray equipment is fully optimised.

The procedure is undertaken triennially (3yrs) for standard intra-oral, panoramic and panoramic/cephalometric x-ray units.

* CBCT & Hand-held units are required to undergo annual routine tests.

Planned Preventative Maintenance [PPM]

(*) Manufacturers recommend that machinery should undergo an annual electro-mechanical inspection as part of their service guarantee.