January 2013
Why are X-rays necessary?
Megan Arnold, RDH, BSDH, MA
In the past few
months, I have heard some of our patients express concerns about the safety and efficacy of dental X-rays
and I want to shed some light and scientific data on the subject.
Dental radiographs, commonly called
X-rays, provide valuable information to the dentist that may not otherwise be
accessible based on a visual examination alone, such as decay between the teeth
and under fillings; cracks and other damage; periodontal disease; abscesses,
infections or cysts; and developmental abnormalities. Additionally, radiographs
are a useful tool to treatment plan procedures such as implants, orthodontics and
dentures. Radiographs show disease early enough for a problem to be addressed,
treated and cured.
Dr. Uppgaard follows guidelines
provided by the American Dental Association (ADA) and the Food and Drug
Administration (FDA) when prescribing dental radiographs (X-rays). He treats
each patient as an individual and bases his recommendations on that patient's
needs, risk factors such as present oral health, risk for cavities, age/state
of growth and development, periodontal status, and signs and symptoms of oral
disease.
Below is a table which compares dental X-rays to other forms of radiation. Note the normal background radiation for an average day is 0.01 mSv. 1 - 4 dental x rays exposes humans to less than 1 day's worth of natural radiation. A full mouth series of radiographs is equivalent to a 5 hour plane ride. Look at the amount of radiation one receives during a mammogram or CAT scan. Often, people will have these taken without a second thought.
We cannot emphasize enough the importance, in medical and dental decisions, of weighing risk vs. benefit. Many things can be discovered with dental radiographs that cannot be found any other way. Yes, there is risk in subjecting oneself to radiation, but as the table shows the radiation amounts in dentistry are very, very low; thus the risk of ill effects is very, very low. The benefits of taking x rays can be great; instead of being unaware of deep decay which leads to a root canal and crown a filling may be placed, tumors are discovered in their infant stages, nerve problems are found before a debilitating abscess occurs, and so on.
Occasionally we have patients who refuse x rays. In listening to their reasons we oftentimes hear that they had heard or read that x rays were "bad for you". We encourage those who do so to examine carefully the facts. Unlike a poorly done scientific study or poorly researched news article, the facts do not lie.
The final note about radiographs is we cannot treat patients without having made a proper diagnosis. Being we are responsible for your oral health we are medically and legally required to use the means we have available to do so. Not taking radiographs when they are indicated, besides potentially resulting in harm to the patient due to a missed diagnosis, may also be regarded as malpractice. The standard of dental care, in Minnesota, includes the taking of necessary x rays. In other words we are required, medically and legally, to take necessary x rays for all of our patients. If a patient continues to refuse our recommendations we, unfortunately, must dismiss that patient from our practice.
Common Sources
of Radiation
Sources
|
Estimated Exposure
|
Comparable to Natural Background radiation (Estimated)
|
Natural Occurring Radiation (Natural Background Radiation)
for the average person in the United States
|
3.0 mSv
0.01 mSv
|
1 year
1 day
|
5 hour airplane flight
|
0.023 mSv (at 0.005 mSv per hour in the air)
|
3 days
|
Mammogram
|
0.042 mSv
|
50 days
|
Chest X-ray
|
0.1 mSv
|
10 days
|
CT Scan – Whole Body
|
10.0 mSv
|
3 years
|
Dental X-ray – single BWX or PA
-- 4 BWX
-- FMX
|
0.001 mSv
0.004 mSv
0.02 mSv
|
Less than 1 day
Less than 1 day
2 days
|
Note: All figures are average values. Actual values may
vary
|
|
|
- Colgate Oral and Dental Health Resources, 2012
- American Dental Association, 2012
- U.S Department of Human and Health Services, 2012
- U.S. Food and Drug Administration, 2012
