Sir, panoramic radiography (PR) is used worldwide for the screening of oral and maxillofacial diseases. One of the main considerations, before PR, is the removal of the patient's personal objects (piercings, glasses etc). To our knowledge, there are no studies that focus on this aspect, especially in private dental surgeries, and so we evaluated the presence of radiopaque objects in PR made by dentists.

All PR performed by dentists at the Dental Clinic of Brescia from 2005 to 2015 were evaluated to detect foreign objects. A total of 1,584 PR were reviewed by two calibrated clinicians, and in 43 cases (2.7 %) radiopaque objects were detected: piercings (22 cases), earrings (14), glasses (7). These numbers are almost embarrassing. When metal jewellery is present during radiographic examination, it may prevent visualisation of normal anatomy and/or pathologic findings (Fig. 1). Dentists should be strongly advised to remove any objects in the head area and oral cavity from patients before X-ray exposure. Non-diagnostic images may lead to retakes, with an increase of the patient's ionising radiation exposure.

Figure 1: Personal objects in panoramic radiographs
figure 1

a) glasses b) earrings c) earrings d) lingual piercing

Full size image