What is the rationale for not exposing pregnant patients to unnecessary radiographs and what precautions should be taken if imaging is essential?

• A. Pregnant patients should be imaged as usual with no special precautions.
• B. Fetal sensitivity to radiation; minimize dose, shield, justify necessity, and use the lowest-dose modality.
• C. Only ultrasound should be used in pregnancy.
• D. Imaging should always be avoided entirely.

Answer: (B)

The central idea is to protect the developing fetus from radiation while still obtaining essential diagnostic information. Fetal tissues are more radiosensitive, so even small doses from dental radiographs warrant extra caution. Because of this sensitivity, any radiographic exam during pregnancy should be carefully justified and kept as low in dose as possible.

If imaging is essential, follow ALARA: justify the study with a clear clinical need, and use the lowest-dose technique feasible. This includes using digital sensors with fast exposure, tight collimation to limit the irradiated field, and aiming for the shortest exposure time to reduce scatter. Protect the abdomen with shielding when it does not interfere with the diagnostic task, to further reduce fetal exposure. Also strive to avoid repeats and consider alternatives that do not involve ionizing radiation, such as ultrasound or MRI, when appropriate for the clinical question.