Article
A 25 year-old male patient was referred to our dental clinic for evaluation of his third molar, for which a Panoramic radiograph (PAN) was advised. The patient was instructed to take off all possible removable appliances in the head and neck region before a PAN could be taken. The patient was successfully positioned in the PAN unit as usual and instructions given to stand still until the scan was done. The door was closed, the dead man switch was held and the button pushed to expose the patient. It so happened that, instantly, the patient got a phone call (probably from his girlfriend) and he had no other option but receive to the call. We were literally seeing this event happen from the leaded glass window but, unfortunately, by the time we could communicate with the patient, the machine had already completed its rotation and it was too late to make an announcement. Within 2–3 seconds the panoramic image could be seen appearing on the computer screen with the image of the patient's phone in it (Figure 1). One could also see the iPhone symbol which was simply crazy. The ghost image of the mobile phone was evident on the right-hand side of the image. However, there was not much patient movement error in the radiograph since the patient followed the instructions strictly. The only thing we forgot to instruct the patient to do was not to receive any phone calls during the radiation exposure. The best way that we could have done this was to avoid the patient taking his mobile phone into the radiography room.
Explanation of the procedure to the patient would play an important role before we could take a PAN. Many patients may be unsure of what to expect and what will be happening. It is a good idea to demonstrate to the patient that the machine will move around their head. Also, to instruct the patient to close their eyes and breathe normally so that he/she doesn't follow the machine while it is rotating. It is mandatory that patients remove any possible objects in their head and neck region which could distort the PAN, resulting in the image being undiagnostic. Objects such as sunglasses, dentures, dental appliances, earrings, tongue piercings, necklaces, hair clips, hairpins, other facial piercings or any other metallic object in the head and neck region need to be removed. This reduces the production of ghost images. Apart from this, it is also extremely important to avoid patients taking their mobile phones into the radiography room in order to avoid such consequences that happened in our case.