Development of 10 principles of radiation protection in oral and maxillofacial radiology

Purpose: This study aimed to establish an expert consensus on a set of principles for radiation protection in oral and maxillofacial radiology in Korea. Although national and international guidelines exist, their practical application to dental radiology remains limited, with key clinical components not mandatorily enforced. Therefore, guidelines tailored specifically to dental radiology are necessary to ensure consistent and effective radiation safety. Materials and Methods: A modified Delphi method was utilized, involving 20 experts-7 specialists in oral and maxillofacial radiology and 13 in medical radiology. A Guideline Development Committee initially drafted the principles, which were refined over 3 rounds of email-based surveys. Panelists evaluated each principle using a 9-point Likert scale, with quantitative scores and qualitative feedback informing the revision process. Results: Consensus was reached on 10 principles, addressing radiographic justification, imaging scope limitations, pregnancy considerations, pediatric optimization, portable radiography, radiation dose monitoring and equipment operation. Final agreement scores approached 9.0, with standard deviations <= 0.7, confirming strong expert consensus. Conclusion: The finalized principles constitute a structured, evidence-based guideline aligned with international standards while addressing specific challenges unique to oral and maxillofacial radiology. They offer practical strategies to enhance patient safety and standardize radiographic decision-making. Further research should investigate their clinical implementation and recommend periodic updates to reflect evolving technologies.