Are Dental X-Rays Safe?

tweety tooth and nail

As parents and individuals, it is natural to worry about the health implications medical tests and procedures can have on us both in the short term and the long term. It is the smart thing to do. One such test is the dental x-ray. This common and valuable procedure has been pushed into the forefront for reasons both valid and otherwise as a test that may be harming us more than we know.


Dental x-rays or radiographs are electromagnetic radiation images that allow us to view the internal structure of otherwise non-transparent objects. Such objects include the human body and its inner workings. Radiation is of course one of the most feared words in the English question. Exposure to the ‘r-word’ has been linked to increased rates of cancer, cell mutation and pregnancy issues. These are all less pleasant than they sound. And they sound terrible. So why on Earth would is our dentist exposing us to such risks?


The truth of the matter is dental x-rays can provide incredibly valuable insight into potential issues that cannot be seen during a visual exam. This includes infection, irregular tooth development below the gum line along with bone loss and disease. Although there is no denying that radiation exposure should be a concern for everyone – parent or otherwise, the truth is we are exposed to minute amounts of radiation on a daily basis. Most of us are just completely unaware of it. Radiation occurs naturally in sunlight and in our atmosphere as well as via nuclear power plants, medical facilities and smartphones. These sources mean the average North American is exposed to 3.1 millisieverts of radiation annually. In contrast, two to four bitewing x-rays of your back teeth with CDA approved x-ray machinery exposes us to 0.005 millisieverts or a little more than half a day of normal exposure.


Dental x-rays are now widely considered to deliver the lowest radiation dose of any medical x-ray. The issue is that people, children in particular are more likely to receive dental x-rays than any other medical screening that employs radiation.


Guidelines for Dental X-Rays


The concern with dental x-rays and medical x-rays is accumulated exposure over years or decades. Each x-ray and the cons that come with it should be weighed carefully against the pros of early detection and treatment of oral health issues that cannot be seen otherwise. Each dental x-ray should be agreed upon by the patient and their dental professional.


The following should be used as general guidelines for deciding whether or not and how frequently to have dental x-rays. They can be a critical part of your oral health assessment:


  • Your first dental visit with a new dentist will likely require a full spectrum of tests including a full range of dental x-rays. This is common and recommended for proactive treatment planning.


  • Get dental x-rays only when necessary. Routinely scheduled x-rays (say every 6 months) are not required or recommended and can be opted out of by patients regardless of whether your insurance covers them or not. Coverage is not a good enough reason to expose yourself to radiation unnecessarily.


  • As a general rule of thumb the better your oral health and teeth, the less frequent your need for x-rays. Children who are not at risk of cavities should get a dental x-ray once every one or two years. Low-risk teens every one and a half years to three years and low-risk adults every two to three years. Higher risk individuals, particularly children may need more frequent imaging, giving us yet another reason to practice excellent oral health habits.


  • Never agree to dental x-rays until you have seen the dentist and ensure that it is their recommendation that you have them done. Feel free to ask why and question how often they suggest you have x-rays as compared to the suggestions above.


  • Be sure that a lead apron and thyroid shield (neck cover) are used during the x-ray process. If the thyroid shield is not included (either as part of the apron or a separate piece), raise the issue and opt out of the x-ray. You have the right to protect yourself from undue risk.


  • If offered the choice, opt for x-ray imaging that is as focused as possible, meaning that a traditional cone machine should be chosen over new rotating x-rays whenever possible. The latter exposes the brain and head to unnecessary radiation exposure that can add up over time.


An example of a bite wing x-ray

An example of a bite wing x-ray


  • Pregnant women should never have x-rays – dental or otherwise and should therefore always opt out of such imaging procedures. For a comprehensive guide on dental treatment while pregnant click here.


Although dental x-rays can be extremely helpful in the early detection and treatment of oral health and developmental issues, exposure should be minimal and dictated by the oral health of the patient. The better your oral health, the less you will ever need to be exposed to radiation via dental x-rays.


Sources: CDA, CNN, Care2, Straight, The Star

Photos: Dental Collectibles, Dr. Seth Rosen

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