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.
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]
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]
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