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IRMER versus Insight

Colin Campbell
by Colin Campbell on 05/01/19 18:00


For those of you who aren’t dental, IRMER is an acronym in dentistry related to the laws of radiation protection and exposing patients to dangerous radiation.

All dentists have to be IRMER trained and we have a statutory responsibility to keep our IRMER training up to date.

When dentists take on board a CT scanner in their practice (CBCT) it’s becoming more and more unacceptable to be untrained in this area of work.

When I got my first CBCT in 2009 it was basically installed and we had 30 minutes with an engineer and we were off and running. It wasn’t much different in 2014 with the second one.

Nowadays in the dental market place, it’s become a bit more unacceptable to just ‘fly free’ when you buy a CBCT scanner because some of the radiation doses in these machines are quite significant and you should really know what you’re doing when you use it, and even more so when you look at the scans.

So, here comes the IRMER versus insight thing.

Insight is gained from purposeful practice and from looking at CBCT scans in a particular way and analysing them and applying that to the procedure you’re going to do together with retrospectively viewing things afterwards to continue to learn.

You don’t learn that on an IRMER course, you learn about the basics of radiation production and the damage of radiation but you don’t get insight into assessing CBCT scans over multiple platforms and how to use them in your practice to the patient’s best benefit.

As CBCTs have become commoditised so has the learning in CBCT. Lots of people want to provide education and information for the cheapest possible amount for the greatest possible number.

This doesn’t give you any sort of competency framework from which to work on when you return back to your practice.

It’s like the old two-day surgical restorative implant courses… smash, bang and away you go.

There is another way to do this.

You could choose a pathway that teaches you insight, purposeful practice and learning.

 It’s essential to get the IRMER done because we all have to be safe and we need to understand the difference between Dose Area Product and Effective dose and how that applies to how we buy a CBCT scanner and the harm, or not, that it inflicts upon our patients.

We need to understand and be trained in medical reporting and the anatomy that we can see on large volume CBCTs so that we can take that knowledge forwards as we purposefully practice reporting our own scans.

If we think though, that we’ll be any good at this and it will be any use if we get a scan done by someone else that is cheap and get someone else to ‘medically report it’ then we’re missing the point.

The value for the patient here is not the scan, the value for the patient is the interpretation of the scan and the person who has been trained to interpret that properly.

My background is in Oral Surgery and Implant Dentistry and I had to teach myself over time to functionally report CBCT scans because there was very little available to show me how to do that.

I met Michael Bornstein on my travels and he was able to show me how to medically report a CBCT scan.

Following on from that we built a course together but understood clearly that to make this a Master Class and to give people the insight into reporting the scans properly and effectively in their own practice for the benefit of their patients it has to be a competency-based framework. People have to be tested on their ability to report scans accurately based on the information they’re given during the training.

This is different to an IRMER course, entirely different. It’s also valuable to your patients and they realise that when you take the time to explain it to them.

You can find out more information about our next CBCT Master Class here


Blog Post Number: 1877


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Colin Campbell
Written by Colin Campbell
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