Sir, I note with interest the paper on clinical governance by Mistry.1 Mistry used the audit of image quality of dental radiographs as an example of an audit. She mentioned the guidance from the Faculty of General Dental Practice (UK) was that no less than 70% of radiographs should be categorised as grade 1 and no more than 10% should be categorised as grade 3.2 However, the targets for the subjective image quality rating were changed last year. Therefore, the target figures quoted by Mistry were out of date.1
“For digital imaging, no less than 95% of dental radiographs should be rated as 'A' and no greater than 5% as 'N'”
Since the second edition of Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment was published in October 2020, the use of three-point scale for the subjective quality rating of dental radiographs has been replaced by a two-point scale. The images are now rated either 'diagnostically acceptable' ('A') or 'not acceptable' ('N'). For digital imaging, no less than 95% of dental radiographs should be rated as 'A' and no greater than 5% as 'N'. For film imaging, the targets are slightly lower - no less than 90% should be rated as 'A' and no greater than 10% as 'N'. The use of a two-point scale is now recommended for all forms of dental radiography and dental cone-beam computed tomography imaging.3
C. A. Yeung, Bothwell, UK
Mistry B. Clinical Governance: A simple guide. BDJ Student 2021; 28: 11.
Faculty of General Dental Practice (UK). Selection Criteria for Dental Radiography. 9.2 Ideas for audit - developing local guidelines. February 2018. Available at: https://www.fgdp.org.uk/selection-criteria-dental-radiography/92-ideas-audit-%E2%80%93-developing-local-guidelines (accessed May 2021).
Public Health England (PHE) and Faculty of General Dental Practice (UK) [FGDP (UK)]. Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment. 2nd ed. London: PHE and FGDP (UK), 2020.
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Yeung, A. Quality ratings of dental radiographs. BDJ Student 28, 6 (2021). https://doi.org/10.1038/s41406-021-0256-9