January 30, 2015

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New recommendations on dental X-rays could be on the horizon

DentistXRaysA visit to the dentist often involves a check-up and a routine cleaning. Many dentists prefer to do annual X-rays as part of preventative care — helping to diagnose oral problems that cannot be seen by the naked eye. However, new developments may change the frequency of dental X-rays.


The American Dental Association has reviewed recent studies that link yearly or more frequent dental X-rays to an increased risk of developing meningioma, the most commonly diagnosed brain tumor. The ADA’s longstanding position on X-rays is that dentists should order dental X-rays for patients only when necessary for diagnosis and treatment. In addition, steps must be taken to safeguard patients against radiation while the X-rays are being taken.


Care and diligent records keep patients safe

Since 1989, the ADA has published recommendations to help dentists ensure that patients’ exposure to radiation is as low as possible. The association encourages the use of abdominal shielding (e.g., protective aprons) and thyroid collars on all patients. In addition, the ADA recommends that dentists use E or F speed film, the two fastest film speeds available, or a digital X-ray.

In some cases, dentists ask patients when their most recent dental X-rays were taken, especially if the patient is new to the practice. This happens frequently thanks to changes in dental coverage that force employees to choose a different dentist who accepts the new insurance.

But relying on a patient to recall their most recent X-rays is flawed. Studies have shown that the ability to recall information is often imperfect, and, as a result, patients may get more frequent X-rays than is necessary. Therefore, carefully document when and where dental X-rays were given.


X-ray studies accuracy raise concerns, questions

While studies linking X-rays to brain tumors may have some basis in truth, the ADA has said that studies that look at the prevalence of X-rays and rates of cancer can be flawed if patient information is included based on the individuals’ own recall of when X-rays took place. The type of X-ray the patient received also needs to be given consideration. X-rays taken decades ago relied on heavy concentrations of radiation. While research into the medical ramifications of frequent X-rays seems promising, the ADA encourages further research about the possible link between X-ray exposure and patient safety.


X-rays do serve a purpose

Although X-rays put the body in the path of radiation, the data collected from X-rays is important. Dental X-rays are valuable in helping dentists detect and treat oral health problems at an early stage. Many oral diseases can’t be detected on the basis of a visual and physical examination alone, and dental X-rays can fill in the blanks about certain conditions, such as early-stage cavities, gum disease, infections or some types of tumors. How often dental X-rays should be taken depends on the patient’s oral health, condition, age, risk for disease and any signs and symptoms of oral disease that the patient might be experiencing.

Patients should talk to their dentists if they have questions about their dental treatment. Patients also have the right to refuse X-rays or question their necessity at a dental visit.