In some recent work I had cause to consider radiology in dental practice. I had an interest in this through practice and an article I wrote when I first went to the bar in 2011. https://pubmed.ncbi.nlm.nih.gov/22376092/
I still see references to the ALARA principle – meaning as low as reasonably achievable.
That is no longer relevant in Australian health practice at least in relation to diagnostic radiology.
That phrase is no longer used in the code for diagnostic medical / dental radiology under Justification or Optimisation. The phrase ALARA references the superseded 2008 Code.
See here for the 2019 code. https://www.arpansa.gov.au/sites/default/files/medical-exposure-code-rps-c-5.pdf
The new code specifies as to optimisation:
2.2.2 Optimisation
Optimisation of protection is maximising the benefit-risk ratio of a medical exposure for that patient.
Radiation exposure must be minimised yet still sufficient to fulfil the clinical objective of the procedure, with account taken of relevant norms of acceptable image quality or therapeutic efficacy. Special attention is required for exposures of paediatric patients, for individuals undergoing health screening, for volunteersin medical research and where a fetus or breastfed infant may receive an incidental exposure.
Diagnostic reference levels (DRLs), which give an indication of levels of doses to patients for common procedures, are one method that can be used as an optimisation tool in medical imaging. Their purpose is to raise awareness of patient doses and prompt medical radiation facilities administering doses greater than the reference levels to review procedures and revise or justify as appropriate.
This justification is now a three tier process.
See here for the 2019 code. https://www.arpansa.gov.au/sites/default/files/medical-exposure-code-rps-c-5.pdf
