Routine Tests
Routine performance tests are essentially similar in content to the acceptance test however the emphasis is on the results of technical tests and how these compare with previous tests. The ‘Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment’ [1] recommend that routine tests are carried out at least every 3 years, and annually if the assessed representative patient doses exceed the diagnostic reference levels (DRLs), targets for image quality are not met, or the quality assurance programme identifies another significant performance weakness. In addition, routine tests must be carried out following any major maintenance procedure. Annual routine testing is recommended for hand-held intra-oral x-ray equipment in all cases and cone beam computed tomography x-ray equipment where no suitable Quality Assurance test object is available [1,2].
An external medical physics expert (MPE) can be engaged to conduct these tests. Alternatively, test kits can be obtained from your Radiation Protection Adviser (RPA).
Ensure that routine tests are carried out as part of your practice’s quality assurance programme and following any major maintenance.
Compare the results of each routine test to previous tests in order to identify any trends that suggest deterioration in the performance of the x-ray equipment.
Keep records of routine tests in the Radiation Protection File, and act on any recommendations (see X-ray Machine Routine Testing and Maintenance Record template).
Radiation Safety Assessment
The assessment includes measurement of the representative patient dose and testing of any control measures (e.g. safety features and warning devices) to restrict the exposure of staff and others. Safety testing may be carried out as part of the routine test.
Ensure that radiation safety assessment is carried out at least every 3 years, or more often if this is indicated from the results of previous testing, and that any recommendations are acted on.
Consult the Radiation Protection Adviser (RPA) with respect to all aspects of these tests.
Retain the records of these tests in the Radiation Protection File, and act on any recommendations.
Maintenance
Maintenance of x-ray equipment and related auxiliary equipment should be carried out in accordance with the manufacturer’s instructions and must be carried out by a qualified person.
Keep a record of maintenance, including any defects found and their repair, for each item of x-ray equipment and any relevant auxiliary equipment (see X-ray Machine Routine Testing and Maintenance Record template).
Ensure that the service engineer provides a written report which details any changes that may affect radiation dose or image quality following maintenance and consult your RPA or MPE if required.
Routine Surveillance
In-house surveillance of features of x-ray equipment that could affect the radiation safety of patients and staff should be carried out as part of the routine use of the equipment. This includes checking the functioning of the warning systems and exposure switch, and for intra-oral x-ray machines, functioning of the counterbalance, and condition of the arm, tube head and wall mounting.
Keep a record of routine surveillance, including any actions required (see X-ray Machine Routine Surveillance Check Record template).
The condition of phosphor plates, digital sensors and displays should also be assessed and the checks recorded (see Quality Assurance of Image Processing and Viewing Facilities).
Sources of information
- Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment. (2nd edition) (2020) Faculty of General Dental Practice (UK)
- Guidance on the Safe Use of Hand-held Dental X-ray Equipment. (2016) Public Health England