Sir, I wonder if any of your members can help. As a dental student I was fortunate enough to be taught by Rita Mason and Professor G. Seward of The London Hospital. The technique of taking oblique lateral radiographs was well taught and often used for clarification of fine detail, where rotational tomograms had too much distortion or loss of information due to the focal trough or where the patient was unable to tolerate the periapical of lower third molars.

Having been a Senior Dental Officer in Special Care Dentistry since 1994 I have used this technique routinely where patients have been unable to tolerate/cooperate sufficiently for intra oral radiographs or a rotational tomogram. Or where the anatomy or physical posture of the patient also preludes the taking of the 'OPT' ie the patient with severe arthritis of the neck and TMJ with the neck fixed flexion and limited jaw opening. The patient with Parkinson/MS/Huntingdon's/Chorea etc who is unable to remain still due to involuntary spasms with tremors. The patient with Down's syndrome where neck and shoulders anatomy may cause difficulty. Or the patient under general anaesthesia who has been unable to cooperate prior to GA for radiographs. With oblique lateral radiographs the head is supported with vacuum pillows/sandbags and takes 0.20 seconds to take rather than the much lengthier OPT and consequently less exposure to radiation.

Latterly we have been unable to obtain films/cassettes/intensifying screens. The general comment is everything is now digital and these old fashioned techniques are no longer of use. These new wonderful techniques of CDCT and digital OPTs are super if you have full patient cooperation or an 'average' anatomy. If not, we are unable to use fully the diagnostic tools available to 'mainstream' patients and this can compromise our diagnosis and treatment planning for patients. Having worked in a unit where X-rays were not available under GA, and then became available, especially oblique laterals/bimolars I noticed significant difference in diagnosis and therefore treatment outcomes.

If any members know where we can obtain these I would be most grateful for the information. If no longer available how does that leave the most vulnerable members of our society regarding equality of outcome of care?