Journal of Advanced Pharmaceutical Technology & Research

: 2022  |  Volume : 13  |  Issue : 5  |  Page : 12--15

Knowledge, attitude, and practice of lead aprons among dental practitioners and specialists

P Anushya, Maha Lakshmi Jayaraman 
 Department of Conservative Dentistry and Endodontics Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Science, Saveetha University, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. Maha Lakshmi Jayaraman
Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Science, Saveetha University, Chennai - 600 077, Tamil Nadu


In dentistry, radiographs are often used to diagnose and assess problems relating to oral conditions as well as for better treatment planning. Even though the radiation risk offered by X-rays is minimal, the absorption of this lower level radiation in the individual for a long time challenges a health concern. The aim of the study was to assess the knowledge, attitude and practice of lead aprons among dental practitioners and specialists in Tamil Nadu. A cross-sectional survey was performed around 100 dentists in Tamil Nadu, India, by framing standard questionnaires and collecting responses by online survey forms such as “Google Forms.” The statistical study was undertaken with SPSS version 22 and the Chi-square test was selected to determine the correlation. This study showed that lead aprons were regularly used by 63% of participants during radiation exposure. Thirty percent of participants were aware of radiation protection protocol but neglected to use lead aprons routinely (P = 0.113). About 91% of participants gave more preference for thyroid gland to protect it from dental radiation rather than other head-and-neck organs and 82% of them were using thyroid collars for patients during exposure (P = 0.671). Our survey shows that the usage of lead aprons is practiced strictly by dental practitioners under <5 years of clinical experience. However, dental practitioners and specialists were aware of radiation protective aprons but often neglected to use them in practice.

How to cite this article:
Anushya P, Jayaraman ML. Knowledge, attitude, and practice of lead aprons among dental practitioners and specialists.J Adv Pharm Technol Res 2022;13:12-15

How to cite this URL:
Anushya P, Jayaraman ML. Knowledge, attitude, and practice of lead aprons among dental practitioners and specialists. J Adv Pharm Technol Res [serial online] 2022 [cited 2023 Mar 25 ];13:12-15
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Full Text


Dental radiographs are valuable diagnostic tools for oral diseases. It aids the dentist in assessing the most appropriate treatment regimen for patients' dental status and plays an important role in dental practice.[1] When compared to medical practitioners, dental specialists are the ones who execute the most X-ray queries. X-rays are required for almost all dental treatments such as root canal treatment, extraction, and implant. An intraoral periapical radiograph is the most common radiological method conducted to test the teeth and their periapical region.[2] According to the Polish Sanitary Inspectorate, dental X-ray devices accounted for more than half of the approximately 15,000 devices in use in 2012.[3] These data suggest that dental radiography doses account for a substantial portion of the annualized dose from medicinal resources. Repeated exposure to cytotoxic materials has been indicated to induce prolonged cellular destruction, competitive cell growth, granulation tissue formation, and tumorigenesis.[4] As a result, both dental professionals and patients are more likely to be exposed to radiation and dentists should be conscious of various radiation safety procedures to reduce this risk. To mitigate these impacts, the As Low As Reasonably Achievable (ALARA) guideline should be followed.[5] Using appropriate equipment and the right methodology, unwanted radiation dose to clinician and patient could be reduced.

Radiation awareness among dental radiologists, medical students, and physicians of various specialties has been studied extensively. Dental practitioners who were trained about radiation protocol were more conscious than those who had not. Furmaniak et al. recommend that dental practitioners should be ready to tell patients about the potential risks associated with radiation.[6] Dentists who treat pediatricians should be conversant with the American Academy of Pediatric Dentistry radiation protocol and should use dose reduction techniques.[7],[8] When health-care personnel wears lead aprons and thyroid shields during procedures, their radiation exposure is reduced by half. Radiation dosage can be reduced using a variety of methods such as increased purification and voltage, lower current, and an average distance of 3 feet from X-rays.[9] Our team members have the extensive clinical knowledge and research skills which have resulted in publications of the highest quality.[10],[11],[12],[13],[14],[15],[16],[17],[18],[19],[20],[21],[22],[23],[24],[25],[26],[27],[28],[29] In the current survey, we attempted to evaluate dentists' awareness, perception, and validate the usage of lead aprons by conducting a study among general dental practitioners in Chennai.

 Materials and Methods

Study design

A cross-sectional survey was performed through online forms from February to April 2021 among dental practitioners and specialists.

Study subjects

A simple random sampling method was used to choose the individuals.

Inclusion criteria

All dentists and specialists who were interested in taking part in this research were included in this study.

Ethical considerations

The Institutional Review Board of Saveetha Dental College provided ethical permission for this study. The ethical approval number is IHEC/SDC/ENDO/161.

Study methods

Structured self-administered surveys with 14 questions encompassing sociodemographic information, knowledge, attitude, and perception were created. The questionnaire had a few open-ended questions and a mix of multiple-choice questions, and it was circulated through an online “Google Forms” in 2021 to 100 dental practitioners. Awareness, knowledge, attitude, and perception are the four outcome variables. Each output variable was collected as ordinal data, and the results were frequently verified for clarity, validity, competence, and accuracy.

Statistical assessment

SPSS IBM SPSS Version 22.0, Armonk, New York: IBM Corp was used to perform the database assessment. To summarize qualitative data, descriptive statistical analysis in percent was determined. The Chi-square test of independence was used to assess the database, which yielded a significant P = 0.05. Pie charts, bar graphs, and percentage tables were used to display the results.


In this survey, a total of 100 dental practitioners and specialists participated. Of the 100 participants, 49% were general dental practitioners, 21% of oral surgeons, 12% of periodontists, 7% of endodontists and prosthodontists, and 4% of pediatric dentists. The clinical experience of participants: 65% of participants were <5 years, 24% of participants were <15 years, and only 11% of participants were >20 years. For protection from radiation exposure, only 63% of participants were regularly using lead aprons and the remaining 16% of participants were occasional users as well as 21% of participants were rare users. Only 85% of participants stood 6 feet away from the X-ray source during radiation exposure. The majority of the participants (82%) were using thyroid collars for patients during exposure. When the participants were asked about the annual radiation dose limit for a dentist, 12 mSv were reported by 55% of participants, 250 mSv by 25% of participants, no limit was reported by 9% of participants, and the remaining 11% of participants were not aware about it.


In the present study, about 97% of participants were aware of radiation protection equipment, namely X-ray aprons, thyroid collars, and kilts. Recent findings reported that medical radiation workers were aware of radiation shielding garments but frequently refused to use thyroid collars and other equipment.[30] In this study, 63% of participants were regularly using lead aprons and 82% of participants were using thyroid collars for patients during radiation exposure. Similar to our study, 26% of dental students still wear lead aprons as protection to reduce radiation exposure to children during dental radiography. The cause for not wearing a lead apron is due to the lack of availability of a lead apron, as well as the apron's extra weight.[31]

In our findings, only 85% of participants stood 6 feet away from the X-ray source during dental radiography. The previous study reported that 70.5% of dentists stood behind the lead shield and 74% of them stood at a 6-foot distance from the radiation.[32] Many dental professionals were utterly unsure of the standing distance away from rays in the absence of a shield. Just 59% of respondents recognized how far they should stay away from radiation (<6 feet), and 56% were aware of proper angulation to prevent the direction of rays.[33]

The ALARA guideline is very important to avoid unwanted radiographs. It is fair to conclude that dentists who were unfamiliar with the concept would be unable to enforce the ALARA theory in practice. As a result, if the ALARA theory is not followed, patients should be exposed to excessive radiation.[34] One of the limitations of an investigation of this nature is the limited sample as well as response bias. Furthermore, each dental procedure involving X-ray radiation should be operated properly and also the rules of the International Commission on Radiological Protection should be enforced, to minimize unintended harm to health-care providers and patients.


Our survey revealed that the usage of lead aprons is practiced strictly by dental practitioners under <5 years of clinical experience. However, dental practitioners and specialists were aware of radiation protective aprons but often neglected to use them in practice. It is advised that dental professionals and practitioners be trained and reinforced to change their attitude toward radiation protection safety guidelines.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


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