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Dental Radiography

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         2 or 3 years ago, a British dental study was published that made a connection between dental x-rays and brain cancer. The study has since shown to have the least reliability in terms of meticulous data crunching that most published dental research undergoes, but as far as a study goes, it brings up an assertion that is not without value. This post has to do with dental radiography, or x-rays, most specifically the safety of these x-rays with patient exposure. First and foremost, I do take patient safety seriously.  Dental x-rays are extremely valuable for the proper diagnosis of dental disease.  A dentist's concern is to view the surfaces of teeth that only superman (with, by the way, of x-ray vision) can see. Hopefully, dentistry can view these spaces without x-rays in the future, but as of present, no other option exists.

         The salient point with dental x-rays is the principle of ALARA, which is a term to denote a concept of as low an exposure as possible. Most dentists have been trained in this concept.  The concept is fairly easily understood, but to make it even simpler, depending on the dentist's judgment, x-rays should be made as infrequently as possible, with a patient's susceptibility to cavities. For instance if one has a dental plaque problem, with the occasional cavity, x-rays may be recommended more frequently. Little to no history of cavities, no problem, less frequently. Research dictates this provides the patient with a level of safety from excessive radiation. Remember, the word is judgment, and each dentist views this a bit differently, depending on the situation.

           Radiation exposure is measured in a unit called a sievert, formerly roentgens, rads, grays, etc. In a standard periodic view of dental radiographs, an exposure of .005 millisieverts is within the normal tolerances. Interestingly , and most people forget, is that radiation exists in our normal environment! exposing a person to a relative mean of 3.2 Sieverts per year. One can see that although no one should be careless with this data, it has shown to be a minor risk to a person's health.

          With older models of dental radiograph machines, patients were exposed to higher levels of radiation. Todays units are engineered to provide extra protection, such as collimation. The dental team who make dental radiographs place an apron with lead inside to shield a person from harmful exposure. Digital radiography can expose a patient to less radiation. All this combines to provide what I view as an acceptable level of exposure.

           There are many options a dentist has to evaluate a patients condition radiographically. One relatively recent development is the practice of cone beam technology. While this concept can expose patients with a bit more radiation than a typical routine set of radiographs, it also can be an invaluable tool to aid in the diagnosis of dental problems we were previously unable to diagnose without a ct-scan (talk about radiation exposure:( ). Orthodontists and root canal doctors can see things that before were only guesses.

            I do not pretend that this covers all the information a patient could ask on this matter, but it is a good starting point for a intelligent discussion on dental x-rays. For instance, when one wants information on various types of health care radiation exposure, dental exposure is a fraction of what one can receive from medical offices/hospitals. I am very happy to discuss any matter of dental safety, including dental radiology. There is an excellent article in the September 2011 Journal of the American Dental Association that discusses this matter from a patient perspective. It deserves a look!




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