Concerns Related to the Risks of Dental X-Rays

A recently published article in Cancer “Dental X-Rays and Risk of Meningioma” has raised many questions regarding the safety of dental imaging procedures. Based on scientific evidence we know there is a risk of induced cancer with ionizing radiation, even at low doses. The probability is directly related to the dose, the lower the dose the lower the risk. We also know that radiographic images are a valuable aid in detecting and treating oral health problems. Therefore we should do all possible to reduce the risk to our patients, ensuring the benefits outweigh the risks.

ECU School of Dental Medicine is currently establishing protocols for the assurance of safe and effective radiation practices for all. We will strictly enforce the ADA recommendations for keeping the exposure as low as reasonably achievable (ALARA). These recommendations, established in 1989, include making sure every patient receives a thorough clinical examination prior to a faculty prescription for a radiographic image, along with a reason for the radiographic examination. In other words, there are “no routine dental radiographs.” Our clinics will be equipped with digital imaging equipment allowing us to use much lower technique factors than were required with slower speed film. In addition, we will implement the use of rectangular collimation of which has been proven to reduce patient exposure by as much as 60 percent.

The American Dental Association(ADA) and the American Academy of Oral and Maxillofacial Radiology(AAOMR) have released statements in response to the article. In brief, their statements point out limitations of the study. The study was based on patients’ own recall of their dental imaging exams over the last 20 some years, which is highly unreliable. The study also focused on patients who received dental imaging decades ago when the exposures were higher due to use of older technology. Most importantly the ADA and AAOMR statements emphasize that  patient concerns regarding radiographic examinations should not be dismissed. Instead, informing our patients of the expected benefit to be gained from the examination along with our judicious use of ionizing radiation should be the first step to establishing effective rapport with our patients.