Dental Radiography and IR(ME)R training
This training ensures everyone in our practice who refers for, justifies, or takes dental X-rays does so safely, lawfully, and to a high standard. It covers the two key regulations: IRR17 which protects staff and the public, and IR(ME)R which protects patients during exposures. You will learn the duty holder roles, the three governing principles, and how to apply them in daily practice so patients receive only the radiographs they genuinely need at the lowest reasonable dose.
What This Training Covers
A clear, practical grounding in dental radiography and ir(me)r.
This training ensures everyone in our practice who refers for, justifies, or takes dental X-rays does so safely, lawfully, and to a high standard. It covers the two key regulations: IRR17 which protects staff and the public, and IR(ME)R which protects patients during exposures. You will learn the duty holder roles, the three governing principles, and how to apply them in daily practice so patients receive only the radiographs they genuinely need at the lowest reasonable dose.
Learning Outcomes
By the end, your staff will be able to:
What Your Team Will Learn
A closer look at the dental radiography and ir(me)r module.
The module is built in short, practical sections. Each one teaches a part of the topic, then applies it to a real care scenario and checks understanding before moving on.
Two Regulations, Two Purposes
Dental radiography is governed by two distinct sets of regulations that are easily confused but serve different purposes. IRR17 (Ionising Radiations Regulations 2017) is enforced by the Health and Safety Executive and protects workers and members of the public from radiation exposure. IR(ME)R (Ionising Radiation Medical Exposure Regulations 2017) is enforced by the Care Quality Commission in England and protects the patient during the exposure itself. Understanding which regulation applies to which situation is essential for safe and legal practice.
Duty Holder Roles Under IR(ME)R
IR(ME)R creates four duty holder roles, each with clear legal responsibilities. The employer (our practice) sets the framework, procedures, and quality assurance programme. The referrer requests an exposure. The practitioner takes responsibility for justifying the exposure, deciding it will do more good than harm for this particular patient. The operator carries out the exposure, often a trained dental nurse. Every exposure must have all these roles fulfilled, and each person must be trained, competent, and formally entitled to act in their role.
Justification: Every Exposure Must Be Needed
Justification is the first governing principle and means every X-ray must do more good than harm for this particular patient. An exposure should only be taken when it is genuinely needed and will change the patient's care, not automatically or by routine. The practitioner must check whether suitable recent images already exist before justifying a new exposure. The clinical decision to justify and the justification itself must be recorded in the patient's notes. This protects patients from unnecessary radiation.
Optimisation: Keeping Doses As Low As Reasonably Practicable
Optimisation means keeping radiation doses as low as reasonably practicable while still obtaining a diagnostic image. Practical techniques include using correct exposure settings for the patient's size and the clinical need, rectangular collimation to limit the beam, beam aiming devices and holders for accurate positioning, and choosing the right view. Good technique produces diagnostic images the first time, avoiding unnecessary repeats. The practice must have dose reference levels and audit image quality regularly, recording and learning from rejected images.
Local Rules, Controlled Areas, and Safe Practice
Under IRR17, our practice must have local rules that specify safe working procedures around X-ray equipment. The controlled area is the space around the X-ray tube head and primary beam where radiation levels require restriction during exposures. Warning signs and lights mark controlled areas. Staff must know where to stand (at least 1.5 metres from the tube head and primary beam, ideally behind a protective screen or outside the room), never hold a film, sensor, or patient during an exposure, and observe warning signs. The radiation protection supervisor oversees day to day compliance with the local rules.
Quality Assurance, Equipment Testing, and Record Keeping
Our practice must have a quality assurance programme including routine checks of equipment and images, planned testing schedules, and input from the externally appointed radiation protection adviser and medical physics expert. Equipment must undergo a critical examination before first use and regular testing thereafter to ensure it produces diagnostic images at the correct doses. Every exposure must be recorded with the justification, settings, operator, and outcome. These records must be retained. Quality assurance and good record keeping are inspected by the CQC and are essential for demonstrating compliance.
Special Considerations: Children, Pregnancy, and CBCT
Particular care is needed for children, who are more radiosensitive and have a longer life expectancy for potential effects to manifest, so exposures must be especially well justified and optimised with appropriate settings. If a patient is or may be pregnant, the practitioner must consider this in justification, though most dental X-rays deliver very low doses to the abdomen. Cone beam computed tomography (CBCT) is three-dimensional imaging that delivers higher doses than conventional radiographs and carries additional requirements including stricter justification against referral criteria, additional training for practitioners and operators, and a written report by someone with appropriate training.
Recognising and Reporting Incidents
A clinically significant accidental or unintended exposure is one that is much greater than intended, involves the wrong patient or site, or is of a type that differs significantly from what was intended. Examples include taking an X-ray on the wrong patient, exposing the wrong tooth or area, or a much higher dose than intended due to equipment fault or error. Such incidents must be recognised, investigated, and reported. The employer must notify the Care Quality Commission without delay. Learning from incidents improves safety and is part of our governance and continuous improvement.
Key Points Covered
The things your team must remember.
- IRR17 protects staff and the public; IR(ME)R protects patients. The CQC enforces IR(ME)R and inspects dental practices for compliance.
- Every exposure needs a referrer, a practitioner who justifies it, and an operator who carries it out. All must be trained, competent, and entitled.
- Justification means taking X-rays only when genuinely needed for this patient. Check for existing recent images first.
- Optimisation means keeping doses as low as reasonably practicable using correct settings, collimation, holders, and good technique.
- Never hold a film, sensor, or patient during an exposure. Stand outside the controlled area, at least 1.5 metres from the tube head and beam.
- Clinically significant accidental or unintended exposures (wrong patient, wrong site, much higher dose) must be reported to the CQC without delay.
Who and how often
Dental Radiography and IR(ME)R is refreshed every year, for the staff in your care setting whose roles require it.
CQC and standards
Supports the training evidence CQC expects to see for a well-run, safe care setting.
How CareStream Delivers It
Not a slideshow once a year. Training that sticks.
CareStream delivers dental radiography and ir(me)r training in the hub your team already uses, grounded in best practice and your own policies, so it fits your care setting and not a generic template.
Teach, then assess
Short teaching sections and a real care scenario, then an assessment that checks understanding.
In any language
Staff complete it in over 60 languages, while your records stay in English.
Learn and retry
A wrong answer triggers a short follow-up lesson and a fresh question, so the gap is closed.
Renewals handled
Automatic reminders at 90, 30 and 7 days, with a live compliance dashboard.
FAQs
Frequently asked questions.
Give your team dental radiography and ir(me)r training that actually sticks.
See how CareStream delivers your mandatory training in the hub, in any language.