Breaking Down The Truth Behind the 1999 vs. 2022 Radiation Guidelines

In this episode of the Tooth or Dare Podcast, Irene and Victoria tackle one of the most misunderstood topics in dentistry today: radiation protection guidelines and the confusion surrounding lead aprons.

You've probably heard the statement:

"Lead aprons are no longer required."

But what does that actually mean?

With the transition from the 1999 radiation protection guidelines to the updated 2022 recommendations, many dental professionals, especially in Ontario, Canada, have been left trying to determine what has changed, what hasn't, and how these recommendations should be applied in clinical practice.

Because this conversation isn't about removing protection.

It's about understanding protection.

In This Episode We Discuss:

• The key differences between the 1999 and 2022 radiation protection guidelines

• Why the phrase "not required" is often misunderstood

• The anatomy of a lead apron: apron vs. thyroid collar

• When patient shielding may still be appropriate

• What defines an elective radiograph

• Why radiographs should only be prescribed when there is a clear indication or risk factor

• How digital imaging and handheld X-ray devices have changed the landscape

• The importance of critical thinking when applying updated guidelines

Clinical & Real-World Insights

• How advances in digital radiography have influenced modern safety recommendations

• Increased specificity in the 2022 guidelines regarding equipment handling, storage, inspection, and damage protocols

• Real-world examples of responding to equipment alerts and quality concerns

• The growing emphasis on quality assurance and documentation

• Why "not required" does not mean "never use"

• How misinterpretation of guidelines can directly impact patient care

Key Takeaway

At the end of the day, using protection appropriately based on evidence, clinical judgment, and patient-specific factors.

Guidelines evolve, but our clinical judgement and patient needs need to be considered. 

The standard of care remains.

A simple framework to remember:

Assess Risk → Justify Exposure → Optimize Protection

Because radiographs are not routine and ought to be prescribed with purpose and reason

Resources & References Canadian Resources

CDA Position Statement for the Control of X-Radiation in Dentistry
https://www.cda-adc.ca/en/about/position_statements/xray/

RCDSO X-Ray Safety Requirements for All Ontario Dentists
https://www.rcdso.org/en-ca/standards-guidelines-resources/rcdso-news/articles/1393

Health Canada – Radiation Protection in Dentistry (Safety Code 30, 2022)
https://www.canada.ca/en/health-canada/services/environmental-workplace-health/reports-publications/radiation/radiation-protection-dentistry-recommended-safety-procedures-use-dental-equipment-safety-code-30.html

Healing Arts Radiation Protection Act (HARP) – Ontario
https://www.ontario.ca/laws/statute/90h02

HARP Certification Course (George Brown College)
https://coned.georgebrown.ca/courses-and-programs/dental-radiography-harp-approved-certification

Federation of Dental Hygiene Regulators of Canada – Scope of Practice
https://www.fdhrc.ca/pages/dental-hygiene-in-canada/the-profession/

CDHO Update on Scope of Practice for Dental Hygienists in Ontario
https://cdho.org/update-on-scope-of-practice/

International Resources

ADA Releases Updated Recommendations to Enhance Radiography Safety in Dentistry
https://www.ada.org/about/press-releases/ada-releases-updated-recommendations-to-enhance-radiography-safety-in-dentistry

ADA & AAOMR Patient Selection for Dental Radiography and Cone-Beam Computed Tomography
https://jada.ada.org/action/showPdf?pii=S0002-8177%2825%2900631-2

AAPD Guidelines for Prescribing Dental Radiographs for Infants, Children, Adolescents, and Individuals with Special Health Care Needs
https://www.aapd.org/media/policies_guidelines/bp_radiographs.pdf

Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography (US)
https://codes.findlaw.com/cfr/title-42-public-health/cfr-pt-42-75-app-g/

Additional Resources

Toothlife X-Radiation Downloadable Resource
https://www.toothlife.ca/products/x-ray-radiation-resource

Designs for Vision Loupes
https://www.designsforvision.com/DentHtml/HygDes.htm

🎙️ Listen to more episodes of Tooth or Dare for evidence-based conversations, clinical insights, and practical discussions that help dental professionals think critically—not just follow headlines.

 

If you made it all the way down here, hit a like and share a comment. 

Until next time, Peace out peeps! ✌️

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A follower left a comment asking if their 30 years of experience mean something. Sure, it means a lot...but it doesn't automatically mean you're current.

I've been an RDH for 20 years. I know what it looks like when experience is the real thing, and I know what it looks like when someone has done the same thing on repeat for two decades and called it tenure.

Both exist. Dentistry is full of both.

In this episode, we dig into a real question from an experienced hygienist starting over at a new office, and we don't let either side off the hook.

Because there are two very different versions of this story.

Version one: you've kept up, you've grown, and you're walking into an office that's behind where you are.

Version two: you've been doing the same thing for 30 years and calling it experience.

In this episode:

▪️ How to tell the difference between expertise and habit ▪️ Why the interview isn't the time to pitch improvements, regardless of how right you are ▪️ How intentional questions help you vet a workplace before you're committed to it ▪️ What a team's response to new ideas tells you about the culture ▪️ Why trust has to come before change, even when the change is obvious ▪️ The question worth asking every time: "Is there anything here that would prevent me from growing?"

The framework: Problem. Understand the consequences. Offer a solution.

Experience is only an asset if it's actually current.

 

If you made it all the way down here, hit a like and share a comment. 

Until next time, Peace out peeps! ✌️

_______________________________________

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I might get "speaker" cancelled for this, but I believe it would be a worthy cause and perhaps the right hill to die on for our profession.

Trying to register for a continuing education course shouldn't feel like repeatedly hitting a brick wall. But for many hygienists, it does.

Many have given up on fighting for it, sadly. 

 

In this episode, Irene and Victoria talk about why quality restorative education is so hard to access in Canada, what happened when they tried to sign up for a course and got nowhere, and what they decided to do about it.

 

What we cover:

▫️ Why most high-quality restorative courses require you to travel far to attend

▫️ The registration process and the advocacy that came with it

▫️ How rigid CE systems end up discouraging the most motivated clinicians

▫️ What it looks like to stop waiting and build something yourself

▫️ How the Restorative Dental Hygiene Study Club came together, four meetings per year, virtual and in-person, with hands-on components. Now Pre-registering at RRDH.ca 

 

The bigger picture:

The RRDH designation has existed in Ontario for 10 years, backed by George Brown College's post-graduate program, one of the only formal pathways to the designation in the country. It remains largely Ontario-specific. This episode is part of a larger conversation about what it would take for major Canadian conferences and regulatory bodies to open access, standardize registration, and formally recognize restorative dental hygiene as a designation across provinces.

 

There are real gaps in continuing education for dental hygienists. Limited access slows professional growth. Community-driven learning can fill those gaps, but someone has to build the community first.

 

Resources mentioned:

Ontario Dental Association Annual Spring Meeting

https://www.oda.ca/member-resources/events/event/annual-spring-meeting-2026/ 

Restorative Dental Hygiene Study Club

https://rrdh.ca/ 

George Brown College Restorative Dental Hygiene Program

https://www.georgebrown.ca/programs/restorative-dental-hygiene-program-postgraduate-s400 

Southern Ontario Dental College Restorative Dental Hygiene Program

https://sodentalcollege.com/academics/restorative-dental-hygiene/ 

Canadian Academy of Dental Health Restorative Dental Hygiene Program

https://www.canadianacademyofdentalhygiene.ca/programs/restorative-dental-hygiene-diploma-program 

 

If you made it all the way down here, hit a like and share a comment. 

Until next time, Peace out peeps! ✌️

_______________________________________

📦 Amazon Store with my FAV things:

https://www.amazon.ca/shop/toothlife.irene?listId=YLX0271390I3  

Restorative Dental Hygiene Study Club: 

https://rrdh.ca

 

Follow on Social Media: 

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Dental peeps, this one is super personal… what happens when oral care is overlooked in cancer patients? We see these patients in our ops, but what happens when that patient is your Dad?

My dad... My patient

In this episode of the Tooth or Dare Podcast, I share the story of my father’s battle with cancer and the parts of care that too often get missed.

It began with the kind of phone call no one is ever ready for:

“Your dad is coughing blood.” While I'm elbow deep in a 6mm pocket during an SRP. 

From that moment on, life changed quickly. Emergency visits. Hospital admissions. A diagnosis that had likely been developing quietly for some time.

The truth is, many lung cancers are not found until they are already advanced.

But this episode is about more than the diagnosis and the outcome being tragic. It is also about something rarely talked about enough: oral health during cancer treatment. What I learned, what we created and how I shared it with the folks at the Cancer Center.

If you want the same download, you can grab it here: Oral Cancer Products Digital Download from Toothlife.ca

 

We discuss:

⚪ How life can change in a single moment

⚪ Warning signs that were easy to dismiss: chronic headaches, rapid weight loss, persistent coughing

⚪ The emotional reality of watching a parent go through cancer

⚪ My memories of my dad: motorcycle rides, soccer, scuba diving, and the bond we shared. #1 dental dad. 

⚪ How families can be close, yet still silent about health concerns

⚪ What hospitals commonly recommend for oral care during treatment

⚪ Why “rinse with baking soda four times a day” is not enough

 

Clinical + real-world insight:

⚪ A firsthand look at how oral health can be overlooked in hospital settings

⚪ The absence of dental professionals on many cancer care teams

⚪ Four separate hospital admissions within 4 months and oral hygiene was never meaningfully addressed

⚪ The effects of radiation and cancer treatment can have on the mouth

⚪ Why preventive oral care should be part of treatment planning from day one

At its core, this is not a story about my loss. It is a call to do better, and perhaps for us dental people who have not seen this journey firsthand to trust me and talk about this with our patients and teams. 

Oral health is connected to overall health. Always has been, not new news to us, but to the folks at the hospital, I was speaking gibberish, apparently.  

And when that connection is ignored in critical care, patients feel the consequences even if they don't know it. Increased risks of infections, lower immune response... the list goes on, and we discuss that here. 

A simple takeaway: Awareness → Advocacy → Integration

 

Because patients deserve complete care, and that includes the mouth, too. 

If you made it all the way down here, hit a like and share a comment. Until next time, Peace out peeps! ✌️

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Dentistry in NYC is changing, and in Tribeca, there's a little hidden gem.

I sat down with Cody Levine, and honestly, this conversation felt like stepping into what dentistry could be when it’s done differently.

We talked about the kind of journey that doesn’t look linear. From doing dentistry under a cellphone light on mission trips to building one of the most intentional, beautifully designed practices in Tribeca, NYC. The story shared is a vision that materialized and is making a change in how patients see dentistry. 

And I’ll be honest… if I didn’t live in Toronto, I’d be in New York. And if I were in New York, I’d probably be picking up a shift or two at Smile House. That’s how aligned this philosophy feels with how we also practice at Toothlife Studio. 

What Cody and his team are building is a complete shift in how we think about care, moving away from quick fixes and toward something comprehensive, collaborative, interdisciplinary and way rooted in the connection between oral and systemic health. 

This episode shows you what can happen when you stop treating teeth in isolation and start treating people as a whole. Sign it with me..."Head, shoulders, knees and toes."

In this episode, we yap about:

▪️ The journey from mobile dental units to creating a modern, tech-driven dental practice in New York

▪️ Why dentistry is shifting toward a mouth-body connection instead of isolated treatments

▪️ The four pillars of care: esthetics, structure, function, and biology—and how they change patient assessment

▪️ How advanced diagnostics and collaboration between specialists improve patient outcomes

▪️ Real patient cases involving TMJ, airway issues, sleep improvement, and recovery from past dental experiences

▪️ How to educate patients who come in expecting “just a cleaning” and shift their understanding of oral health

▪️ The challenges of running a modern dental practice and continuously improving both clinically and as a leader. 

Connect with the Smile House Squad: 

https://www.smilehouse.co/ 

https://www.instagram.com/smilehousetribeca/ 

https://www.instagram.com/codymarclevine/ 

 

If you made it all the way down here, hit a like and share a comment. 

Until next time, Peace out peeps! ✌️

_______________________________________

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Follow on Social Media: 

_______________________________________

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_______________________________________

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RDH's...Are you taking BP at every visit? 

In this episode of the Tooth or Dare Podcast, Irene and Victoria break down one of the most common questions in dental hygiene:

“Is taking blood pressure at every visit mandatory?”

 

Patients often say:

“I’ve never had this done before.”

 

So what do the guidelines actually say?

 

We discuss:

• Is blood pressure screening mandatory in Canada or the U.S.?
• What provincial and ADA guidelines recommend
• What to do when a reading is over 180/110
• Can patients decline?
• When to defer treatment or refer
• Real clinical stories from practice
• The disconnect between dental and medical care

 

Clinical stories shared:

- A patient with BP over 200 systolic who went to ER and was later medicated

- A young patient with elevated BP who turned out to be pregnant with gestational diabetes

- Patients dismissed to physicians

- What happened when a patient was told by physicians, “We’re not concerned and monitor.”

- The disconnect between dental and medical frameworks

 

Blood pressure screening is strongly recommended — but in most places, not legally required. So, where does that leave us as preventive healthcare professionals?

 

We unpack it and discuss the following Resources & References:

CDHO Hypertension Advisory

https://cdho.org/advisories/hypertension/

 

CDHO Hypertension Factsheet

https://cdho.org/factsheets/hypertension-in-adults/

 

American Dental Association – Hypertension

https://www.ada.org/resources/ada-library/oral-health-topics/hypertension?utm_source=chatgpt.com

 

Today’s RDH – Pre-Operative BP Screening

https://www.todaysrdh.com/heart-health-importance-of-pre-operative-blood-pressure-screenings-in-the-dental-office/?utm_source=chatgpt.com

 

Peer-Reviewed Study (PMC) – BP Screening in Dental Settings

https://pmc.ncbi.nlm.nih.gov/articles/PMC7523566/?utm_source=chatgpt.com

 

If you’re a hygienist, dentist, or healthcare provider navigating this conversation in your operatory — this episode is for you.

 

If you made it all the way down here, hit a like and share a comment. 

Until next time, Peace out peeps! ✌️

_______________________________________

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Follow on Social Media: 

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_______________________________________

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_______________________________________

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f you're a dental professional curious about using technology to SEE sub-G this is the episode for you!

In this episode, Irene sits down with Kristen Ranaldo, a perio-focused hygienist who has spent her career using dental endoscopy to treat advanced perio and failing implants. Kristen shares how seeing below the gumline transforms diagnosis, treatment, and patient communication and why blind SRP and laser-only approaches often fall short. They also discuss how desiccation gels like PerioDT and Hybenx fit into workflows and what it takes to implement this technology in everyday practice.

In this episode, we talk about:

▪️ Kristen’s early hygiene career and how she became part of the 1% of hygienists using an endoscope routinely

▪️ When to use endoscopy alone vs. combining it with lasers, biologics, and desiccation gels like PerioDT

▪️ Practical implementation: appointment flow, patient communication, coding, fees, and how general practices can keep more advanced cases in-house

▪️ The bigger picture: technology, insurance, and why hygiene needs better protocols, standardization, and support to truly move forward

Connect with Kristen:

Instagram → @thesubgingivalqueen

_____________________________________________________

If you made it all the way down here, hit a like and share a comment. 

Until next time, Peace out peeps! ✌️

_______________________________________

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Follow on Social Media: 

_______________________________________

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Dear Dental Hygienists,

If your patients keep coming back with the same amount of calculus, this is the episode for you.

In this Op Talk edition of Tooth or Dare, Irene and Victoria take one of the most misunderstood tools in modern periodontal care and pull it apart clinically, practically, and honestly.

Desiccation therapy is often described as “drying,” “etch-like,” or “just another add-on.” In this episode, we explain why none of those descriptions are quite right — and why that misunderstanding is exactly why so many clinicians either misuse it or underutilize it.

Using real Instagram questions and real operatory experience, we walk through what desiccation therapy is doing at the tooth, tissue, and biofilm level, how it changes the feel and efficiency of scaling, and how to integrate it into everyday periodontal appointments without disrupting workflow, patient comfort, or ethics.

This episode is supported by the folks at Young Specialties, the company that brings PerioDT to the American dental market. Their efforts to expand the reach of this innovation led to this episode and the use of this product nationwide.

To learn more about this therapy, visit this link for a FREE 1-hour webinar:
https://yng.ink/4qClAef

If you’ve ever wondered whether desiccation therapy is “worth it,” if you’ve used it but never felt confident explaining it, or if you want to tighten up your perio workflow without adding chaos — this episode is for you.

📲 Questions or Episode Topic Requests?

@toothlife.irene — Check the top 3 pinned posts to access the download and leave your questions in the comments.

We'll be answering them in upcoming episodes!

Until next time, Peace out peeps! ✌️

_______________________________________

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Follow on Social Media: 

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______________________________________

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Is there statistical proof of a decline in dental hygienists in Canada?
The answer isn’t as simple as social media headlines suggest.

In this episode of Tooth or Dare, Joe Siegfried and I unpack the current climate of dental hygiene in Canada and challenge the idea that fewer hygienists are entering the profession.

Graduation numbers and class sizes haven’t declined. What has changed is retention and migration.

🇨🇦 Canada has approximately 33,600 registered dental hygienists, yet distribution varies widely
▪️ Rural and remote communities continue to struggle with retention
▪️ About 9% of hygienists plan to leave the profession within 2 years, and 18% within 3–5 years
▪️ Temping is at an all-time high, reflecting burnout, flexibility needs, and shifting work preferences

As the profession evolves, traditional 9–5 practice models are being challenged. The workforce exists, but it’s moving differently than it used to. Joe brings important nuance to a topic that’s often oversimplified.

We also explore a deeper shift happening across dentistry: how clinicians define value.

Value in dental hygiene isn’t always about money or production. And practice isn’t limited to the box you work in.

Joe and I discuss how value shows up through discussion, treatment planning, culture, ideas, flexibility, autonomy, respect, growth, and alignment, not just a few extra dollars of production. When the definition of value shifts, so does how, where, and why people choose to practice.

This episode continues from our previous conversation about Joe’s personal journey and expands into the broader challenges facing dental hygienists today.

In this episode, we talk about:

▪️ The dental hygienist “shortage” debate and uneven workforce distribution
▪️ Pay models, cost-of-living pressures, and compensation realities
▪️ Temping, scheduling flexibility, and changing career expectations
▪️ Union conversations and lessons from other professions
▪️ Education pathways, incentives, and workforce planning
▪️ Why protecting patient care must always come first

Connect with Joe:

Instagram → @joesiegfried_rdh

_____________________________________________________

If you made it all the way down here, hit a like and share a comment. 

Until next time, Peace out peeps! ✌️

_______________________________________

 📦 Amazon Store with my FAV things:

https://www.amazon.ca/shop/toothlife.irene?listId=YLX0271390I3

Follow on Social Media: 

_______________________________________

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______________________________________

🎤Podcast @ToothorDare.Podcast https://www.instagram.com/ToothorDare.Podcast

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🔗🌲Cool links in my Linktree https://linktr.ee/TOOTHLIFE.IRENE

What happens when you choose authenticity, even when it feels risky?

In this episode of Tooth or Dare, Joe Siegfried opens up about his life beyond the dental chair. From growing up in rural Ontario and pursuing acting, to becoming a father, coming out during dental hygiene school, and building a supportive blended family, Joe shares the personal experiences that shaped who he is today.

This conversation explores identity, acceptance, and the courage it takes to live authentically, especially within a professional setting. Joe reflects on how personal transformation doesn’t happen in isolation and how support systems, inclusion, and self-honesty can redefine both happiness and success in dentistry.

In this episode, we talk about:
▪️ Growing up in rural Ontario and early creative ambitions
▪️ Pursuing acting before dentistry
▪️ Coming out while in dental hygiene school
▪️ Fatherhood, co-parenting, and blended family life
▪️ Support systems, inclusion, and LGBTQ+ representation in dentistry
▪️ How living authentically can reshape both personal and professional paths

Connect with Joe:
Instagram → @joesiegfried_rdh

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If you made it all the way down here, hit a like and share a comment. 

Until next time, Peace out peeps! ✌️

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 📦 Amazon Store with my FAV things:

https://www.amazon.ca/shop/toothlife.irene?listId=YLX0271390I3

Follow on Social Media: 

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💁🏼‍♀️Personal Instagram @Toothlife.Irene https://www.instagram.com/toothlife.irene

Personal Instagram: @victoriaarmaly_ https://www.instagram.com/victoriaarmaly_

🙋🏼‍♀️Facebook Irene Iancu https://www.facebook.com/irene.iancu

💃🏼TikTok @Toothlife.Irene https://www.tiktok.com/@toothlife.irene

🛒Online Store and Instagram @Toothlife https://www.instagram.com/toothlife

🥼Office Instagram @ToothlifeStudio https://www.instagram.com/ToothlifeStudio

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🎤Podcast @ToothorDare.Podcast https://www.instagram.com/ToothorDare.Podcast

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🔗🌲Cool links in my Linktree https://linktr.ee/TOOTHLIFE.IRENE

This episode is dedicated to all dental professionals who have ever discovered expired materials hiding at the back of a drawer, couldn’t find what they needed mid-procedure, or found themselves buying supplies from the dollar store with no real system, strategy, or purpose.

My office had just celebrated its 4th birthday when I discovered a bag of materials that were already two years expired. That was my wake-up call.

I knew it was time to make a change...so we overhauled Toothlife Studio using Zirc’s proven Color Method, and I haven’t looked back. If you’re looking to improve efficiency, reduce waste, and bring clarity to your clinical systems, you won’t want to miss this episode.

🔁 What Changed After Our Office “Reset”

Here’s what we discuss that has literally changed for the better:

🔵 Mismatched bins and organizers replaced with colour-coded cassettes, trays, and tubs by procedure
🔵 Instruments and materials grouped and easily identified by assigned procedure colour
🔵 Increased team efficiency with quicker setup and room turnover
🔵 Reduced waste and lower supply expenses
🔵 Smoother onboarding for temps and new hires

🎁 Try the System Yourself

Want a sample tub in the colour of your choice?

👉 GET YOUR TRIAL TUB HERE
⏩ https://tr.ee/Zirc-Tub-Trial-Kit ⏪

✌🏻 This episode is sponsored by Zirc Dental Products.

📲 Questions or Episode Topic Requests?

Follow @toothlife.irene and check the top 3 pinned posts to access the download and leave your questions in the comments.
We’ll be answering them in upcoming episodes!

If you made it all the way down here—hit like and leave a comment.
Until next time, peace out peeps! ✌️

📦 Amazon Store (My FAV Things)

https://www.amazon.ca/shop/toothlife.irene?listId=YLX0271390I3

🔗 Follow on Social Media

💁🏼‍♀️ Instagram: @toothlife.irene
https://www.instagram.com/toothlife.irene

🙋🏼‍♀️ Facebook: Irene Iancu
https://www.facebook.com/irene.iancu

💃🏼 TikTok: @toothlife.irene
https://www.tiktok.com/@toothlife.irene