Are dental X-rays unthreatening? – Recent York Times

Q: It seems like every time I visit the dentist they ask me to take an X-ray. Will this escalate the risk of cancer and how can this be reconciled with the potential benefits?

Dental X-rays are indispensable to your oral health. They can support dentists detect problems such as cavities, abscesses, abnormal growths and gum disease, often before they become solemn.

However, taking X-rays during regular dental cleanings may cause anxiety for some people. Dental X-rays emit energy called ionizing radiation, which can damage DNA and increase the risk of cancer. Is it risky to perform this type of tests regularly?

The amount of radiation you are exposed to during dental X-rays is very low, said David J. Brenner, director of the Center for Radiological Research at Columbia University. It’s much lower than it was decades ago and often less than the total radiation you’re exposed to every day from the environment, such as the sun, space and materials in the ground like rocks and soil, he said.

Still, experts say dentists should only take X-rays when a patient needs them, such as when a doctor notices a potential problem during an examination and needs more information, said Dr. Erika Benavides: dentist and oral and maxillofacial radiologist at the University of Michigan School of Dentistry.

“The clinical trial should always come first,” she said.

How much radiation does X-rays emit?

Different types of dental X-rays release different amounts of radiation. A typical series of bitewing X-rays – in which the patient bites on a wing-shaped device that holds the X-ray film in place – emits about five microsieverts of ionizing radiation, said Sanjay M. Mallya, an oral and maxillofacial radiologist at the University of California, Los Angeles School of Dentistry. That’s less radiation than they would be exposed to on a typical day, he said.

Panoramic X-rays – in which you rest your jaw against a surface and the X-ray beam rotates around your head – typically emit about 20 microsieverts of radiation, or background radiation lasting two and a half days, Dr. Mallya said. This is similar to the amount of radiation you are exposed to on a five-hour airplane flight. On the other hand, a chest CT scan exposes the body to background radiation for two years, he added.

Exposure levels to dental X-rays are very low – and much lower than they used to be, Dr. Brenner said. “Technology has improved over the last 30 years,” he said. Dr. Brenner added that while it is possible that such low levels of radiation could escalate the risk of cancer, the risk is “tiny compared to all the other cancer risks we face.”

Dr. Mallya explained that even taking into account cumulative exposure over a lifetime, the risks associated with routine dental X-rays would be “negligible,” he said.

According to American Dental Association and American Academy of Oral and Maxillofacial RadiologyDental X-rays are unthreatening for pregnant women and their fetuses. “Dental X-ray doses are 10,000 to 30,000 times lower than the doses needed to produce these effects,” Dr. Mallya said.

Both organizations also say they don’t need to be worn a protective apron or collar to protect the thyroid gland during a dental x-ray, even if you are pregnant. Lead aprons don’t provide useful protection, Dr. Benavides explained, and can interfere with taking photos. (These guidelines are relatively novel, so some states, e.g Californiastill require the apply of protective aprons.)

Is an X-ray always recommended?

Dr. Benavides says that in many situations, dental X-rays are necessary. They can support your dentist detect cavities that have developed in hard-to-see places, such as between teeth. They are also helpful in detecting bone loss resulting from gum disease and cysts and tumors that may grow in or around the jaw, Dr. Benavides says. Dentists may order X-rays for children to see where their eternal teeth are and how they are growing.

However, dental X-rays are not always necessary, and dentists and hygienists should not routinely take them at the beginning of every cleaning, Dr. Benavides says. Although the risks from X-rays are low, it is best to minimize unnecessary exposure whenever possible.

IN clinical recommendations published in The Journal of the American Dental Association in 2024, experts – including Dr. Benavides – said doctors should only order dental X-rays after a clinical examination suggests there may be a problem worth investigating.

Under these guidelines, a low-risk patient whose tooth decay does not occur regularly may only need X-rays every two to three years, Dr. Benavides says. Unfortunately, this is not usually the case, Dr. Brenner added. Many people undergo routine dental X-rays before examination, which is “not ideal practice,” he said.

If your dental hygienist orders routine X-rays before your dental visit, Dr. Benavides suggested asking her to hold off on your visit. “I would say, ‘I would feel more comfortable if someone examined me first and determined if I really needed it,’” she said. Your dentist should always explain why they are necessary and what benefits they will bring to your health.