The safety of dental x-rays is another one of those hotly debated subjects in the field of dentistry. Like with fluoride, both sides of the x-ray argument have merit.
But once in the dental chair, it doesn’t matter if you are at risk of tooth decay, periodontal disease, or both, x-rays are the go-to diagnostic tool.
Tech improvements
When considering the safety of x-rays, it’s all about the amount of radiation that our bodies are exposed to that matters.
Proponents of the safety of modern x-rays state that we’re exposed to much less radiation from x-rays now than we were in previous decades thanks to the protective gear used during the scan and improvements in x-ray equipment.
We find that this argument doesn’t take into consideration the following factors:
Environmental threshold (body burden):
We live in an ever-increasing toxic soup.
Our metabolic detox pathways are running on overtime just trying to keep up with removing/mitigating the myriad toxic compounds we’re exposed to every day.
This argument for why undergoing x-rays is much ‘safer’ today than in previous decades presupposes that our bodies are capable of mitigating the additional potential challenges that radiation can cause.
Given the dramatic global rise we’ve been seeing in chronic diseases, it seems to us that our average health in society is declining.
This suggests that our ability to mitigate the potential damage from x-rays (on top of everything else our bodies are dealing with) may be reduced. Time will help tell the story–just by living our daily lives, we are participating in a global open trial of Pottenger’s famous cat studies, only this time the unwitting test subjects are we humans.
The timing of safety protocols with tech innovation:
Yes, technology has improved and the digital x-rays used today expose us to much less radiation than before. Plus, protective aprons do lower our risk of exposure.
But let’s think about this for a moment… When x-rays were first introduced, no one knew of the problems associated with radiation exposure. In fact, the dental industry didn’t begin to use any protective aprons until many years after introducing x-ray technology in the dental office. So is it possible that we will discover later how our x-ray exposures from today (even with newer technology and some safety precautions) have adversely affected our health?
Little personal story from my history…
Before I was born, my mother was a dental assistant. She has shared with me stories from her ‘in the trenches’ experiences. You know, simple stuff like mixing up mercury amalgam with zero knowledge of the toxic vapors she was inhaling everyday. (I sometimes wonder if my potential health was impacted by this exposure pre-conception.)
She recently shared with me that when she was working in the dental office, she would sometimes hold the x-ray plate in a child patient’s mouth while the x-ray was taken. (Notice when any x-rays are taken these days, everyone leaves the room to reduce their exposure to radiation.)
So, we’re told that x-rays are ‘safe’ now, just like ‘we’ were told back then that x-rays were safe.
Another example is how the protective aprons have changed over the years. At first, the heavy, lead-filled aprons just covered the torso. Then they started making sure it also covered the reproductive organs. These days, most aprons have an extra piece that wraps around the neck to protect the thyroid gland (this is a super smart move by the way, so if you do choose to get x-rays, make sure your dental team uses vests that include a thyroid shield).
Here’s the thing… We would be foolish to believe what the industry claims is ‘safe’ for x-rays. The industry simply hasn’t proven that they are certain what really is safe, and they have continued to roll out ever-increasing protections all while telling us that the current use of x-rays is safe.
So, how much radiation is actually in x-rays these days?
The reply that dental professionals are taught to give to a patient concerned about the safety of x-rays is that the amount of radiation we’re exposed to from a set of bitewing x-rays is about the same amount of radiation we get from our TVs or over the course of spending a day in the sun (aka solar radiation).
At first blush, this sounds reasonable. However, ponder the implication of getting all the sun you’d get in a whole day outside compressed into one tenth of one second. When put this way, receiving a full day’s sun exposure in such a short time sounds like it could be problematic to any living tissue that happens to be in the path of this burst.
Plus, along with that burst of a full day’s worth of exposure, you’re still going to be exposed to the rest of the radiation you’d normally encounter throughout the day (you can’t just switch off the rest to offset the fact that today was x-ray day).
Now, to be balanced, we should state that all things relative, if we’re worrying about whether dental x-rays are safe or not, we’re not in immediate danger. Yes, we should be prudent about exposure to x-rays, as they have been proven to cause damage to our cells. Let’s be informed, but let’s also be fair (and kind to ourselves) and not cause undue stress to our precious health today over this one.
So what are the benefits?
It’s true that dentistry is a very visually-driven profession. Without being able to see what’s going on under the tooth surface, a dentist is definitely left ‘flying blind’ to know what’s going on inside our teeth. In fact, some dentists will refuse treatment if a patient does not consent to x-rays.
Our dental team needs to be able to see if there’s any decay developing under the surface of the outer enamel in order to do the best job possible helping us navigate this path to greater oral health and a cavity-free life.
Are there other technologies available to help?
Yep, medical and dental technology tends to be several years ahead of actual clinical use. Some dental offices looking for minimally invasive dental strategies have found benefit from using tools such as the DIAGNOdent and CariVu.
The DIAGNOdent technology uses a low power laser to detect changes in the reflectivity of subsurface tooth tissue. If you’ve read our article, ‘How Teeth Decay’, you’ll remember that decay occurs first under the surface of our outermost enamel. This tool can look inside the crystal structure of the tooth to read the relative level of subsurface demineralization.
Pretty cool, huh?
In a simple application of laser technology, the DIAGNOdent beeps if the tool determines a level of subsurface demineralization is high enough to warrant a closer look.
In an article on DentistryIQ from 2011, the author echoes our concern we originally wrote about in our article, “Can a routine visit to the dentist actually cause tooth decay?” regarding the risk of dentists using a dental explorer (the sharp metal pick the dentist uses) to search for decay. DentistryIQ’s article states, “Thus, the use of the dental explorer in the traditional manner must be avoided, because it will fracture the surface layer and eliminate the possibility of reversing the caries process.”
The DIAGNOdent is particularly helpful for children. One study compared DIAGNOdent against visual inspection and x-rays and determined that DIAGNOdent was the most effective at identifying early decay on the chewing surface of kid’s molars. Yep, even better than x-rays!
Another intriguing technology is a product called CariVu. This small pen shaped tool allows the dentist to literally look through a tooth using a patented transillumination technology. This gives the dentist the ability to look from all angles through each tooth looking for signs of trouble.
Here’s a link to a video showing how the CariVu works.
So, clearly there are other technologies that can help a dental team see ‘under the hood’ while helping us lower our exposure to radiation.
How often should we have x-rays?
According to the ADA and FDA, how often we ‘should’ get dental x-rays varies depending on our age and whether we have a history of tooth decay.
First, their disclosure warrants a quote.
Because every precaution should be taken to minimize radiation exposure, protective thyroid collars and aprons should be used whenever possible. This practice is strongly recommended for children, women of childbearing age and pregnant women.
For young children, if there’s no evidence of tooth decay, they may not require x-rays.
For children, depending on whether or not there are signs of existing decay, the recommended frequency is from every 6 to 24 months.
Teenagers and adults can vary from anywhere from every 6 months to up to 3 years between x-rays depending on the presence of active decay (or lack thereof).
Here’s the problem…
Many dental insurance plans cover x-rays annually, more often than some in the industry say are needed. In other words, there is an unfortunate risk of a financial gain for the dental office if they convince you to get x-rays more often than even the ADA recommends.
While we don’t ever assume that a dental team would expose a patient to an unnecessary treatment for their financial gain, we do like to make sure we feel self empowered in the chair by choosing dentists who will dialogue with us instead of dictating to us and by knowing the recommended time frames for x-rays and declining them if they seem unwarranted.
Here are our links on how to find a dentist who will work WITH you:
Helpful Resources to Find a Qualified Dentist to Assist You
7 Key Components of a ‘Dream Dentist’
How to navigate x-rays with your dentist…
If the dental office suggests routine x-rays before an exam, ask for the visual exam first to determine need for x-rays. Be polite but firm to avoid being pressured. After all, they are working for us. They are an important member on our team of helpers.
Ask your dental office if they use or have heard of CariVu or DIAGNOdent as safer alternatives to x-rays for identifying early decay (especially for those of us with children or grandchildren under our care).
Be kind with the dental office. They mean well. They are in the office working, and they might not have much time or the ‘outside-the-conventional-box’ initiative that is needed to research alternative methods. As we, their paying patients, ask them to learn about alternative tech options like DIAGNOdent and CariVu, we are asking them to step up their game to continue to earn our business.
Dentistry is getting more and more competitive. Dentists feel this too, and those who see the increased demand for more holistic strategies are educating themselves to offer these alternative (and effective) services to their patients.
In the end, each of us has to weigh the relative risks and benefits of choosing to have an x-ray.
Some dentists will refuse to treat if a patient declines x-rays.
What’s most important is that you find a dentist who has a helper’s heart and is willing to listen to your concerns and preferences and work together with you to find the best path for you and your family. Sometimes, the best path for you may be to move away from one dental office and into another.
If you’d like to know what questions to ask to find a dental team who will work with you on your journey to greater oral health, feel free to download our FREE eBook, the Guide to Safe Dentistry.
How do you handle x-rays with your dental team? Do you feel x-rays are risky or have the risks been understated or overstated? Please share your thoughts in the comments below. We can learn so much from one another when we dialogue these subjects.
Helpful, Related Resources:
Is fluoride safe to use? [article]
What causes tooth decay? (and how to stop it) [article]
How to stop periodontal disease at home [resource page]
4 steps to help your kids live a cavity-free life [article]
Can a routine dental visit actually cause tooth decay? [article]
How teeth decay [article]
Helpful resources to find a qualified dentist to assist you [article]
7 key components of a dream dentist [article]
Guide to Safe Dentistry [FREE eBook]
Other Resources:
DIAGNOdent cavity detection [article]
Study comparing various cavity detection strategies [research study]
Clinical case study of CariVu [youtube video]
FDA procedure for medical/dental x-ray exposure [pdf]
Are ct 3D scan cone X-rays safe?
The only way to tell if your root canal is bad!
Aloha Cheryl,
Thank you for reaching out to us.
Great question!
We here at OraWellness aren’t medical or dental professionals, so we can’t treat, diagnose, advise, etc. Instead, what we can do is share information with you to help you become self-empowered on your journey. 🙂
We haven’t yet researched the relative safety of 3D cone beam scans specifically. However, if you do decide to get a 3D cone beam scan (or any other type of x-ray), we recommend that you make sure your dental team uses vests and a thyroid shield to protect you from radiation.
In case you’d like to dive into some of the research on the safety of 3D cone beam scans, this academic article may be a good place to start: Patient radiation dose and protection from cone-beam computed tomography
Also, in case you’d like to check it out, our other article on x-rays shares how to nutritionally protect yourself from x-ray damage.
Finally, since you mentioned root canals, you be interested in our article about how thermal imaging technology could be used to screen for root canals.
I hope that helps! Aloha 🙂
What about the cone 3D ct scan is this dangerous radiation??? I’ve heard it’s the only way to see if your root canal is toxic?
Your articles and references are truly helpful and welcome. Thanks for publishing them.
Wonderful article on the pros/cons of dental x-rays. In the past, have had really negative dental experiences … and today, I feel as though I have much more holistic knowledge than most dentists in my area. Holistic dental approaches are still more rare than common
… and I bless the day I learned (and now use daily) OraWellness.
Thank you for your positive impact on my dental health!
Fantastic article — long overdue discussion in the profession!
Hello,
I took my son to his dentist today. He is 7 and was getting ready for X-rays. I asked if they had the thyroid shield. The dentist said that the assistant would cinch up the torso shield higher. By the time I turned around the assistant was already doing the xrays and had not cinched it up even after hearing everything between myself and the dentist. When I asked her why she said if she raised it any higher it could mess up the xrays. She also said since they only do these every 3 years that my son wouldn’t get that much radiation. But my son had been to a different dentist last year and had the same xrays then I believe. The torso apron was at the bottom of his neck . Should I be concerned? I am calling that office tomorrow to talk with the dentist. I am very upset that a Thyroid shield wasn’t even offered after I asked!!!! Thank you. Any advice Welcome please.
Aloha Donnica,
Thanks for stopping by.
We’re sorry to hear about your recent experience with that dental assistant! It’s definitely frustrating when our wishes aren’t respected.
Here’s an article that might help empower you with options about what you can do now: How to nutritionally protect yourself from x-ray damage
Also, it’s good to remember that not all dental teams are created equal. So, in case you might like to check out some other dental offices for the future, here’s an article that can help you find and evaluate some candidates: Helpful resources to find a qualified dentist to assist you
We hope that helps!
🙂
This is a nice blog, we can see people are not much familiar with dental radiology but information like you share here will surely help them to go with this and keep their oral health good forever.
Has anyone heard of thermography to detect infections under crowns/root canaled teeth instead of x-rays? I would like to hear any experiences or opinions you might have on thermography.
Excellent dialogue as I have to deal w/ this question every day in my practice. I’ve been in practice for 37 yrs of which 30 yrs of those I’ve practiced Holistic/ Biological dentistry. I have not placed a mercury filling since 1987, do not use or promote the use of fluoride, am not an advocate of root canals and teach all my patients the importance of nutrition. I switched to digital x-rays over 15 yrs ago as it fit w/ my philosophy to reduce my patients exposure to x-ray radiation. The digital x-rays are approx 75% less radiation than standard x-rays. So more important to this conversation is “does your dentist offer digital x-rays”. This also indicates their concern environmentally as digital x-rays dont use fixer and developer which are toxic to employees and the environment. Yes, some dentists may be pushing x-rays when not necessary but understand the importance to see decay(caries) and other pathology that can not be seen by oral exam or any of the new diagnostic tools( diagnodent , cariVu or my favorite Spectra). By refusing x-rays you are at risk for missing serious pathology or cavities that could ultimately reach the pulp requiring a root canal( more toxic than x-rays) or in my office an extraction. We do offer specific supplements and homeopathics prior and following x-rays to counter the negative effects. I will check in next week to provide that list. And as mentioned above taking x-rays is the standard of care. Always consider the benefits vs. risks.
Yes we are exposed to a lot more toxicity today than previous generations but its our personal responsibility to reduce these exposures w/ proper nutrition, detoxification, chelation, infrared sauna, etc. Also the bottom line is do you trust your dental practitioner?
Aloha Dr Gene!
Wow! Thank you SO much for adding your experienced voice to this conversation! We feel so blessed to be able to offer this platform where we the public and caring dentists like you can share thoughts. We would LOVE to see the list of ideas to help mitigate the impact of x-rays. We plan to share our research on this subject very soon as well. So, anything you’d like to add to the discussion, as always, we’re all ears!
Thanks again!
Thank you. Good article, good comments. This is extremely productive.
Hi guys – After reading articles from Yale and bottom line that claim x-rays for dental check-ups can cause brain tumers and voice abberations, I no longer will have x-rays done in dental office. My voice is almost lost, my taste is gone. Hearing -Old age??? maybe. I`m staying on the safe side.- —
I am a dental hygienist.
We have had inconsistent results when using our Diagnodent, so were frustrated in trying to use it consistently.
Aloha Jo-Anne,
Thank you for stopping by to add your experienced voice to the conversation!! I’m sorry to hear that your office has found DIAGNOdent inconsistent. Do you all use other alternatives or are digital x-rays the best option at this point?
My 2 youngest children (below age 11) are only getting digital bitewing x-rays once every 2 years. They are both more prone to decay. I require they wear the lead vests with a thyroid collar since we have a history of thyroid disease. My oldest has shown resistance to decay (never had a cavity), so we are now requesting no x-rays for that child. Our “holistic” dentist has a DIAGNOdent in his office, but they still primarily use digital x-rays for diagnostics. I’ve learned to ask for the DIAGNOdent.
I’d like to see discussion of the panoramic x-rays and i-CAT (3D cone beam) imaging that are frequently used in dentistry. Are these necessary for routine care or only for specific circumstances?
Thank you for addressing this important topic.
I have Thyroid cancer
I rare form , got dental X-rays my whole life perhaps too much radiation and now it’s caused cancer
Thanks for this balanced approach! Is there anything we can do after or before x-rays happen to mitigate the effect?
Aloha Michelle!
Great to hear from you again! Awesome question! Check back here next week for the next ‘installment’ of info on this exact subject!!
there are medical professionals out there who will bring up hormesis. yes, there are a handful of studies out there showing a hormetic effect of radiation. I’m wary of the situation, though, as how many of us know where we are on that exposure graph?, I only request bitewings every 5 yrs. or so.
What about digital x-rays? The radiation is much less. My dentist uses this and it seams I’m the only person who still requires them to us an apron.
I’m the same as you C. My dentists uses digital xrays and I always request the apron. A good friend of mine had thyroid cancer and believes it is due to many xrays overs the years w/o ever using an apron. Her doctors now have recommended her to always request the apron. Better safe than sorry.
I agree it is important to work with your dentist to help minimize X-ray exposure, but X-rays are still an important and necessary diagnostic tool. There are things an X-ray can detect, especially at an early stage, that can’t be detected any other way. The type and frequency of X-rays may be open to discussion with your dentist. To request no X-rays, ever, is unreasonable and not in your best interest. Even if you offer to sign a “waiver” declining X-rays and that you understand the risks, it puts the dentist and licensed dental hygienist in a tenuous medico-legal situation. You are asking him/her to practice below the “standard of care” and risk legal liability or action by the state board of licensure if a complaint is ever filed (even if the complaint is not from you). So, do ask your dentist to be as conservative as possible with X-rays, but respect that he/she wants to give you the best service possible, including accurate diagnosis.
Thanks for taking time to explain from a caring dentist’s perspective, Dr. Rubin. This, along with Will’s informative article, helps arm us to be a better part of the team.
As always, thanks so much Dr Paul for adding your experienced voice to the conversation.
We agree that not having x-rays at all makes dentistry almost impossible. Truly, the dental team can’t do their jobs without these tools. It makes sense why some dental teams refuse treatment if a patient refuses x-rays. Like you state so well here, if a dentist can’t do their job, how can they (you) be asked to be liable for your work, right?
Thanks again Dr Paul. It’s always an honor to have you here!!
I went to a dentist who had new technology. He recapped a tooth in one day for example. But I had a pain in another tooth which he visually examined without seeing anything. So sent me to a room for x-rays. Several x-rays later he couldn’t see anything wrong. A year goes by and I’m at my old dentist office. He wants to x-ray my whole mouth for the same reasons Dr Paul would. I say no but I have this one tooth that sometimes bothers me. It’s the same tooth the other dentist x-rayed. So he x-rays the same tooth and can’t see anything after he tells me the x-ray will show what’s wrong. So the x-ray showed him nothing and now he wants to x-ray the whole mouth. I say no because I’ve had my finger x-rayed, my ankle, my shin bone and a CT scan all in 3 years. I don’t want unnecessary radiation as we’re all getting it from the environment too. I especially don’t want it when they don’t always show what’s wrong. I ask what will the x-ray show and he says maybe a shadow if the tooth is getting a cavity. It sounds like total BS! These new technologies outlined in this article will hopefully be safer.