Dental X-rays In the News: again!

  

Last week the conversation for many of us turned to dental radiographs (x-rays) thanks to the news media and medical research. Yale School of Public Health completed a study of over 1500 people and correlated their “remembered” exposure to x-rays with development of meningioma. first reaction to this is to rebuke the study, so I went to get the details. The first thing to consider is that the exposure to dental radiographs and frequency was based on the patient’s memory, even of their childhood years, not on hard data where they scoured through old dental records. The next challenge is that the average age of the patients they included was 58. Our current technology for dental x-rays is far different; more sensitive film speeds or digital along with better equipment have dramatically reduced the exposure.  Current dental radiographs expose the patient to 2-3 mrads for four bitewings and 10-20 mrads for a full set. The problem is that all of this information makes those of us who work in the dental profession feel better about radiographs, but what about our patients?

As a team in our office we do two things that are very important regarding dental x-rays. First, we follow all of the guidelines to maximize your safety using new, low radiation digital technology. Our equipment is checked and maintained and we will always use proper shielding. Second, we recommend using the ADA guidelines as a standard, but in an individual way based on what we know about dental health and the risk for cavities or gum disease. We are proud of both of these things and happy to share them with anyone.

So how often “should” we take x-rays? The word “should” implies there is a right and a wrong answer. We like to think of it as a “could”. We could set up a standard of annual bitewings and a full set every three years. The problem is that it may be too often for some patients and not often enough for others. The other challenge is deciding which films to take. Our patients with bone loss from periodontal disease are better diagnosed with vertical bitewings, but we may need a full-series of x-rays for the removal of wisdom teeth. Instead of defending a protocol, we diagnose the need for x-rays one patient at a time, with them, based on their individual needs.