Exposure to Dental X-Rays Raise Some Questions Regarding its safety

With the world all a-buzz about radiation levels in airport scanners, one has to wonder about the safety of exposure — or repeated exposure — to dental X-rays.

Are they safe?

The short answer is, “yes.” But it’s a qualified “yes.” As with any kind of diagnostic X-ray, dental X-rays, including “panoramic”, “full-mouth series”, “bite-wings”, and CT scans should always be medically necessary and justified with good rational.

A patient who was recently referred to me for wisdom teeth surgery had reservations about our repeating diagnostic X-rays prior to her treatment. Eighteen months earlier, she had had a panoramic X-ray, which is a single large image of the entire jaws and teeth taken by a machine that circles the head (hence, “panoramic”). Her dentist had also just taken a new set of dental X-rays (smaller scans made from inside the mouth).

Unfortunately, the panorex was too old and not diagnostic, and the smaller X-rays were incomplete, failing to show the wisdom teeth at all. Old X-rays can leave dentists in the dark as to what may be going on under the patient’s gum-line. Basic oral surgery protocol indicated a new panoramic X-ray in order to plan for a successful surgery. The patient, however, was worried about repeating the panorex, citing a media report about excessive radiation and cancer risk from X-rays.

So we reviewed the facts of the matter together:

  1. There are no studies to indicate that radiation emitted from routine dental X-rays increases the risk of cancer.
  2. X-rays are necessary for accurate diagnosis and even play a role in the prevention of disease, as they give us insight into what’s going on under the surface of the gums.
  3. Everyone should have a full-mouth series of  X-rays (consisting of 21 small X-rays taken from inside of the mouth) at least every 5 years. For patients prone to teeth and gum disease, the full-mouth series may be required to repeat more frequently.
  4. Panoramic X-rays are indicated most often for wisdom teeth extraction, dental implant treatment, and orthodontic treatment. Most importantly, to be of diagnostic value, panoramic X-rays must be taken within six months of treatment.
  5. Bite-wing dental X-rays are usually taken during follow-up or hygiene visits in addition to — not in lieu of — the full mouth series. Depending on individual circumstances, bite-wing X-rays may be taken every six to 12 months.
  6. Dental X-rays are indicated at the onset of disease symptoms, such as pain and swelling, or during root canal treatment or dental implant placement.
  7. CT scans have revolutionized dentistry. They are more readily available and less costly to do. They are indicated for management of various pathological conditions and trauma. They have also become extremely valuable in dental implant therapy and root canal treatment, providing dentists with better accuracy and treatment results. Additionally, they are used by orthodontists and oral surgeons for diagnosis of facial-skeletal abnormalities and disruptions in teeth eruption, including impacted wisdom teeth and canines.
  8. Current medical practice considers radiation from X-rays taken over time to be completely safe. Moreover, avoiding X-rays when they are warranted can detrimentally delay the care of disease and trauma in otherwise treatable teeth and gums.

After a thorough discussion of the benefits and risks of dental X-rays as well as a review of her symptoms (and her dentist’s reason for referring her), my patient agreed that there was, in fact, a medically sound rationale for a new panorex. I am happy to report that we proceeded with an accurate diagnosis and successful surgery.

I would encourage anyone with questions about X-ray radiation to speak with a dental practitioner to get all the facts. After all, X-rays were invented to raise clarity, not fears.