Knowledge & Practice of Radiation Exposure Protection Protocols by Dentists Performing Endodontic Treatment in Pakistan


  •   Ramsha Kamran

  •   Kiran Saba

  •   Saima Azam


Dental radiography is an essential diagnostic tool in endodontics and one of the indispensable indicators of success. However, the potentially harmful effects of radiation cannot be overlooked. The aim of this survey was to assess knowledge, attitude and practice of radiation hazards and exposure protection techniques of dentists in Pakistan. A cross-sectional study was conducted using an online survey questionnaire. The questionnaire was distributed among all regions of Pakistan through social media and WhatsApp after carrying out the reliability analysis. Statistical analysis was performed using SPSS 20.0. Question wise analysis using frequencies and percentages was done. Association between the level of awareness with qualification and workplace setting was carried out using chi-square test and logistic regression analysis. The minimum required sample size calculated for this study was 335. A total of 341 dentists [performing endodontic treatment] participated and submitted the form from all regions of Pakistan. 65% of the dentists were aware with the ALARA principle. 40% were aware with the ICRP and NCRP guidelines. Only 27% were using lead apron and 71.8% had never used thyroid collar on the patient. Furthermore, a positive correlation was seen between the designation and awareness level and practice [p=0.01]. Similarly, a significant correlation p=0.01 was seen between awareness level/practice and workplace setting. The results of the present study can help design continual education programs at regular intervals at institutional and national level for strict observance of radiation protection guidelines with more emphasis on general practitioners and government hospitals.

Keywords: Dentists, endodontics, knowledge, X-Rays, Pakistan, radiation protection


Jones CG. A review of the history of US radiation protection regulations, recommendations, and standards. Health Physics. 2005; 88(2): 105-24.

Almohaimede AA, Bendahmash MW, Dhafr FM, Awwad AF, Al-Madi EM. Knowledge, attitude, and practice [KAP] of radiographic protection by dental undergraduate and endodontic postgraduate students, general practitioners, and endodontists. Int J Dent. 2020; 2020.

Binti Abd Rahman F, Gurunathan D, Vasantharajan MS. Knowledge, attitude and practice of radiation exposure protection for pediatric patients among undergraduate dental students. Biomed. Pharmacol. J. 2018; 11(2): 1143-51.

Ribeiro DA, De Oliveira G, De Castro GM, Angelieri F. Cytogenetic biomonitoring in patients exposed to dental X-rays: comparison between adults and children. Dentomaxillofac Radiol. 2008; 37(7): 404-7.

Lannucci MJ, Howerton LJ. Dental radiography: principles and techniques. 5th Ed. St. Louis: Elsevier; 2012: 12-20.

Rabhat MP, Sudhakar S, Kumar BP, Ramaraju. Knowledge, attitude and perception [KAP] of dental undergraduates and interns on radiographic protection-a questionnaire based cross-sectional study. J Adv Oral Res. 2011; 3(3): 45-50.

Mallya MS, Lam WNE. White and pharoah’s oral radiology principles and interpretation. 7th Ed. St. Louis: Elsevier; 2004: 25-46.

Frommer HH. Biological effects of radiation, in radiology for dental auxiliaries. 6thEd. St. Louis: Elsevier; 1996: 49-67.

Arnout EA, Jafar A. Awareness of biological hazards and radiation protection techniques of dental imaging-a questionnaire based cross-sectional study among Saudi dental students. J Dent Health Oral Disord Ther. 2014; 1(1): 1-7.

Amirzadeh, F, Tabatabaee SH. Evaluation of healthy behavior in radiation employees in hospitals of Shiraz. The Fourth International Cyberspace Conference on Ergonomics. 2005.

Basheer B, Albawardi KW, Alsanie SA, Alotaibi BM, Alanazi MM, Alfaifi HA, et al. Knowledge, attitudes and perception toward radiation hazards and protection among dental professionals in Riyadh, Kingdom of Saudi Arabia. Int. J. Med. Health Res. 2019; 8(9): 75-81.

Bushong CS. Radiologic science for technologists: Physics, Biology and Protection. 11th Ed. St Louis: Elsevier; 2017: 483-90.

Wenzel A, Gröndahl H. Direct digital radiography in the dental office. Int Dent J. 1995; 45: 27-34.

Parks ET, Williamson GF. Digital radiography: an overview. J Contemp Dent Pract. 2002; 3: 23-39.

Vilborn P, Uys A, Yakoob Z, Cronje T. Evaluation of radiation awareness among oral health care providers in South Africa. S. Afr. Dent. J. 2021; 76(3): 122-8.

Furmaniak KZ, Kołodziejska MA, Szopiński KT. Radiation awareness among dentists, radiographers and students. Dentomaxillofac Radiol. 2016; 45(8): 20160097.

Svenson B, Söderfeldt B, Gröndahl H. Knowledge of oral radiology among Swedish dentists. Dentomaxillofac Radiol. 1997; 26(4): 219-24.


How to Cite
Kamran, R., Saba, K., & Azam, S. (2022). Knowledge & Practice of Radiation Exposure Protection Protocols by Dentists Performing Endodontic Treatment in Pakistan. European Journal of Dental and Oral Health, 3(1), 27–32.