I was recently in a spirited discussion with a patient on the necessity of dental x-rays. This particular patient had not been in for a while; in fact, it was about two years since his last visit and check-up. As he sat in the chair, I reminded him of his last appointment date which included an exam and x-rays. I further explained that with his “extended” leave of absence I would recommend having check-up x-rays taken before we started the cleaning. With a sheepish grin, he responded, “No thank you, I want to live!” I couldn’t help but chuckle, and I knew I was going to enjoy our conversation. As we tried to outwit each other on the pros and cons of dental radiation exposure, our lighthearted and humorous verbal sparring went something like this:
Me: “I want you to live too, just pain-free!”
Him: “Well I don’t have pain, so I don’t think there is anything wrong.”
Me: “Many areas of decay may not be painful and when caught early can be easily removed with minimal involvement to the tooth structure. Other areas of decay may be so deep that they have affected the nerve of the tooth causing it to die and rendering the tooth unable to feel pain. This condition can lead to abscesses, which are incredibly painful and difficult to manage. Also, the x-rays allow us to see the bone level around the teeth and evaluate the existence of periodontal disease or bone loss, along with any pathologies or anomalies that may have developed since your last examination.”
Him: “Well there will be too much radiation exposure, and I don’t want that much radiation” he smirked.
Me: “There is absolutely radiation exposure and I understand that can be concerning. However, we are using the most current techniques to decrease and minimize the radiation level. Lead shields with thyroid collars are standard in every room protecting soft tissue organs from radiation. We also use digital x-rays which allow us to significantly reduce the level of radiation AND the exposure time. Valuable pictures are taken quickly and with low radiation levels! It doesn’t get better than that!” I quipped.
At this point, I was enjoying the challenge and inspired to change his mind. I could see he was proud of himself in trying to silence me with his very valid points. We were both beginning to tire however and knew we had to make a decision to move forward with the appointment. His last arguable point was:
Him: “Every time you take x-rays you never find anything wrong!”
He was right. He hadn’t needed dental treatment in several years, even after two radiographic evaluations spanning over the past four years. Remember, he had been gone for the last two years. How lucky for him!…
For me this was the easiest of all the arguments made during this battle; “When women go for mammograms, the goal is not to see anything on the x-ray. When adults go for colonoscopies, involving a miserable day of prep, a second day of anesthesia, a day and a half loss of work, the goal is that no biopsies are needed, and all is healthy. Blood work requested by medical doctors allows for complete and comprehensive evaluation of many systems in the body. The goal is to have results that confirm the systems of the body are functioning well. In fact, when parents take their babies and young children to the doctor for one month, three month, six month and annual checks these are referred as “Well Baby Exams” as the goal is to evaluate the child and confirm that they are doing well and maintaining health! …”
“It should not be viewed as a rip off if there are no decaying teeth, abscesses, fractured roots or glaring cysts found during the dental exam!!!”
Well, his x-rays looked great, and he was once again christened with good health and advised to go in peace. It was a fun and successful appointment for us all!
For longer than I have been in the dental profession (over thirty years), dentistry has focused on a preventative treatment philosophy. Our hope is to deliver minimally invasive care and restore dental health by catching concerns early before they cause pain, expense or tooth loss. A small cavity results in a small filling, not a crown, or worse yet a root canal and crown, or the final blow, an extraction. Generally speaking, as the neglect goes up, so does the cost, required time needed and invasiveness of the dental procedures.
So let’s review a couple of facts about dental x-rays and the subsequent radiation exposure to help relieve some anxiety:
Fact 1: Dental professionals are unable to detect decay between the posterior teeth and some anterior teeth without x-rays. In teens and adults, these areas are the most common to develop decay and will go unnoticed and therefore untreated, growing and undermining healthy tooth structure.
Fact 2: The skull is one of the most radioresistant parts of the body! The very thick bone allows protection against the lower levels of radiation required to diagnose dental concerns.
Fact 3: Advanced technologies and the use of digital x-rays render the radiation levels for tooth x-rays too small to cause damage to oral tissues, the brain or other areas of the body. The x-ray tube also minimizes the exposure level and confines the radiation to nearly that of the diameter of the cone.
Fact 4: According to Dentalplans.com “current dental x-rays require1/4 of the radiation” as that used before columniation of tube heads and the introduction of digital x-rays.
Fact 5: Our annual exposure to naturally occurring radiation is estimated to be approximately 2.4mSV.
These sources include cosmic, radon, foods, sun and soil.
The average dental x-ray is measured at .005-.008mSV.
Fact 6: Living in a brick or concrete building for one year exposes one to .07mSV
While a cross-country flight from New York to LA delivers .04mSV, both higher than the amount delivered from one dental x-ray.
Fact 7: The average mammogram has an exposure rate of 3.0-4.0mSV
Smoking 1.5 packs a day for one year equates to 36mSV
Radiation is no joking matter. If used irresponsibly, it can cause illness, cancers and even deaths. However, with the growing advances in radiology, the medical and dental communities continue to make strides in reducing levels in exposure while maximizing diagnostic abilities. The implementation of digital x-rays has provided the opportunity to reduce radiation requirements by 50-80% (Dental Radiography Safety Sources). Because of these advances, over 80% of our radiation exposure comes from natural resources while only 14% on average from medicine.
While we wouldn’t likely expect the cardiologist to examine our heart health by taking our blood pressure only, nor can we expect a dental exam to be completed with only a visual evaluation. It is sometimes necessary to compromise ideals to experience maximum health benefits.
Fact 8: Sleeping next to a loved one for one year provides a radiation exposure of .0005…but like dentistry, I guess the benefit outweighs the risk!
Happy Spring Everyone and on behalf of Seidner Dentistry…
Congratulations Seniors and Good Luck!
Julia Guerra, RDH, BA
julia@randolphnjdentist.com
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