Dental X-Ray Safety Checklist: Radiation Protection & Calibration
Ensure patient and staff safety with our Dental X-Ray Safety Checklist! Covering radiation protection, equipment calibration, and protocol adherence, this essential guide helps dental practices minimize risk and maintain compliance. Download now for a safer, more confident X-ray experience.
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Pre-Procedure Checks
Ensuring equipment readiness and personnel understanding of safety protocols before X-ray exposure.
Last Equipment Calibration Date
Tube Current (mA) Setting
Kilovoltage (kVp) Setting
Exposure Time Setting
Collimation Check
Digital Receptor Check
Image Processing Software Status
Patient Preparation
Verifying patient shielding, positioning, and consent regarding radiation exposure.
Pregnancy Status?
Approximate Gestational Age (if applicable)
Patient Communication Regarding Radiation Concerns?
Details of Patient Concerns (if any)
Appropriate Shielding Applied?
Consent Form (if applicable)
Patient Acknowledgement
Equipment Calibration & Testing
Validating the accuracy and safety of X-ray equipment through regular calibration and quality control measures.
Tube Current (mA) Reading
Kilovoltage (kVp) Setting
Exposure Time (seconds)
Detector Type
Calibration Date
Calibration Time
Output Reading (mR)
Calibration Status
Shielding & Protective Barriers
Confirming adequate shielding for patients and personnel during exposure.
Lead Apron Thickness (for patient)
Thyroid Shield Used?
Gonadal Shield Used (if applicable)?
Distance from X-ray Unit (feet)
Barrier Integrity Verified?
Comments on Shielding/Barriers (e.g., repairs needed)
Exposure Parameters
Reviewing and documenting exposure settings (mA, kVp, time) for optimal image quality with minimal radiation dose.
kVp (Kilovoltage Peak)
mA (MilliAmperes)
Exposure Time (Seconds)
Image Receptor Type
Collimation Technique
Notes on Exposure Settings (e.g., adjustments made, rationale)
Date of Parameter Validation
Personnel Safety & Monitoring
Ensuring personnel are properly trained, wear appropriate protective gear, and are monitored for radiation exposure.
Last Radiation Exposure Badge Reading (mSv)
Date of Last Radiation Safety Training
Radiation Safety Role (e.g., Radiation Safety Officer)
PPE Utilized During Exposure
Notes on Individual Radiation Exposure Concerns
Date of Next Scheduled Radiation Safety Review
Record Keeping & Documentation
Maintaining accurate records of equipment maintenance, calibration, and personnel monitoring.
Calibration Date
Exposure Meter Reading (mR)
Notes on Calibration Procedure
Calibration Certificate (PDF)
Last Personnel Radiation Monitoring Date
Personnel Exposure Dose (mSv)
Equipment Maintenance Log Reviewed?
Emergency Procedures
Reviewing and ensuring accessibility of emergency protocols related to radiation incidents.
Contact Information for Radiation Safety Officer (RSO)
Emergency Contact Information (Police, Fire, Hazmat)
Dose Limits for Personnel (mSv/year)
Procedure for Reporting Radiation Incidents
Date of Last Emergency Drill
Time of Last Emergency Drill
Steps Taken During Radiation Incident
Photos/Documentation of Incident (if applicable)
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