Are Dental X-Rays Dangerous?

Are Dental X-Rays Dangerous?

Radiation scares people and the dentists at Sacramento Dentistry recognize the causes for that concern. It certainly is a fact that too much radiation, in a single dose or over a lifetime, can lead to serious disorders. The likelihood of dental x-rays causing you any form of disease, however, is extremely minimal. Actually, dental x-rays play a much larger role in protecting you from painful disorders of the teeth, gums and mouth. X-ray imaging guides us and our patients as we make decisions regarding the best dental care for our clients.

To make dental x-rays as safe as possible, Sacramento Dentistry follows all the recommended procedures created by the American Dental Association (ADA), including lead protective gear for patients and protocols designed to limit the already tiny doses used to make the images. Additionally, modern digital x-ray imaging systems require considerably less radiation to operate than older film-based systems, making them even safer and more effective.

Nevertheless, there are often “scare stories” in the media about x-rays and some studies have indicated a slightly increased risk for certain types of cancer from dental x-rays. Important points need to be made about these studies:

  1. They require patient self-reporting. Imagine if someone asked you how often you visited the dentist forty years ago and how many x-rays you received. What sort of answer could you provide? Nearly all of these studies rely on this type of data collection. When patient recollection is compared to actual dental files, most people overestimate the number of lifetime x-rays they have received.
  2. The studies include potential risk from x-ray technology that is now obsolete. As one study concluded: “Exposure to some dental x-rays performed in the past, when radiation exposure was greater than in the current era, appears to be associated with an increased risk of intracranial meningioma.” (Italics ours) Imagine the sort of report you would have on automobile safety if you included data on cars built decades ago. It would certainly make it appear that automobile travel was potentially more hazardous than it really is. Now imagine how the media covers that report. The Internet, TV, radio and newspapers seldom say: “Study Finds Old Cars are Dangerous!” They proclaim: “Study Finds Cars are Dangerous!”

While such studies remind us of the need for caution and continual improvement in x-ray technology, they do not provide a good look at the results from vigorous safety programs in place in dental offices across the country.

The facts about dental x-rays are this:

  • They feature the lowest radiation dosages of typical medical x-rays. The ADA estimates “dental X-rays contribute approximately one percent of the total dose of exposure in health care settings.”
  • They provide doses of radiation that are much less than ordinary background radiation or the amount of radiation received in a typical airline flight.
  • They improve dentist and patient decision-making when considering potential and necessary treatments, which improves your overall health and well-being.

Sacramento Dentistry considers x-rays a useful tool in our practice. We are happy to discuss any concerns you have over their use during your visits. Our dentists want to assure you that your health and safety are the primary reason we assist our clients each and every day!

Sacramento Dentistry
  • Myra
    Posted at 10:15h, 10 July Reply

    So, would a dentist think that doing dental x-rays for a pregnant woman is or isn’t a concern? My OB told me that it’s recommended that woman have a dental check-up while pregnant because sometimes preganancy hormones can affect a woman’s dental health.

  • Dr. Castro
    Posted at 12:17h, 11 July Reply

    Hi Myra,
    During pregnancy, the risk for cavities and gum disease markedly increase. Dental radiographs are recommended to catch disease early before it grows into a larger problem. Dental radiographs are safe during any stage of human pregnancy. Common sense also tells us that we would want to limit any radiographs to the least and necessary amount as possible. The amount of x-ray radiation absorbed during a dental radiograph can be compared to flying in a airplane. It is a measured exposure, and we receive these exposures in our environment anyway.

  • Ashkan Alizadeh, DDS, FAGD
    Posted at 21:46h, 14 July Reply

    Hello Myra,

    I agree with Dr. Castro and here is the American Dental Association’s position on Radiographs and pregnancy. I hope we have answered your question.

  • Myra
    Posted at 13:04h, 15 July Reply

    Thank you both for your answers! I remember getting a check up when i was pregnant, but not an x-ray…Good to know it’s safe to.

  • Jessica (@squareduptweets)
    Posted at 08:11h, 29 July Reply

    I cringe when the dental tech hits the x-ray button, but I also cringe when I see people with their teeth falling out way too soon or with icky gums that look painful. Afterwards I go eat some antioxidant filled fruit to make me feel better.

  • Fly OntheWall
    Posted at 13:12h, 27 September Reply

    Would appreciate the dentist/partners in the practice discussing this in a management team meeting, preferably with all the dentists and the office managers present. I’d like to persuade you not to quote or refer to Nuclear Industry Association or Health Physics information when discussing radiation dose rate and human health.

    In reference to the safety of x-rays in current, modern dental practice, your web site says this:

    “They …” (dental x-rays) “…provide doses of radiation that are much less than ordinary background radiation or the amount of radiation received in a typical airline flight.”

    ****First, let me say, I consider modern dental x-ray exposure to be minimal, and likely relatively safe for the average person. Furthermore, you run an excellent practice, and I am convinced you have the appropriate level of concern for the safety of your patients.**** As a patient, I’m not concerned your x-rays have exposed me to unacceptable levels of ionizing radiation.

    Why is what is termed low dose external radiation such as that received from “background radiation” or airline flights compared to exposure to ionizing radiation received from radiological technologies, in your online education materials?

    There was no issue in my mind with your explanation of why modern day digital x-ray technology is relatively safe, in the big picture.

    But when you compare such x-rays to Nuclear Industry Association or NIA (“Health Physics”) models of what they call “low dose” radiation exposure, your comparisons become meaningless. Comparisons to NIA statements about radiological safety trivialize the seriousness of lifetime exposure, given actual background radiation levels and actual levels of lifetime human exposures.

    A little background about me: I was a team member of the Yucca Mtn. Seismic Studies project at University of Nevada, Reno. A close family member is the former Chief Operating Engineer of the Hanford Nuclear Testing and Reactor site near Richland, Washington. Am not talking out of a personal vaccuum of knowledge, and am sharing a well informed opinion with you. My personal research for the past 3 1/2 years has focused mainly on radiation exposure safety and the epidemiological effects of radiation on human health.

    That being said ….

    Are dentists, as a group of professionals, aware background radiation levels are somewhere on the order of 35-1,000 times higher than they were before the advent of the Nuclear Era and atmospheric weapons testing? (Yes, that’s a big range, but it depends on airborne CPM levels on any given day, in any given place.) Airborne radiation levels are many times (several orders or magnitude) higher since the Fukushima melt outs of three nuclear reactors (ongoing since 2011) and the recent WIPP plutonium/high level waste storage accident in Carlsbad, New Mexico in February, 2014 (also emitting ongoing plumes).

    There is no longer a n”ordinary background radiation” level comparable to radiological exposures in medical or dental practice. There is no longer an “ordinary background radiation level” almost anywhere on earth, at this time. Such comparisons (origin: nuclear civilian power industry, NIA, DOE) are outdated and meaningless. Man-made sources of radiation are ubiquitous in the environment, and have been since the advent of nuclear weapons testing.

    Are dentists not aware we all are exposed to radiation from multiple nuclear reactor and nuclear waste storage accidents (Chernobyl, Fukushima, La Hague, Sellafield, Hanford, and most recently, WIPP)? See this for an understanding of the discussion: (measurements in CPM, counts per minute, at citizen monitoring and EPA monitoring sites, worldwide)

    Background levels of airborne radiation, ionizing radiation before the advent of nuclear weapons testing were virtually zero. There was minimal exposure from some naturally occurring sources such as volcanic and mineral deposits, and natural exposure to gamma radiation, UV rays from the sun.

    Please also refer to NRC (Nuclear Regulatory Commission), MIT, and EPA discussions of radiation exposure and human health. Read the EPA PAG’s (Protective Action Guidelines) from 1973 if you can find them. A reading of John Gofman, M.D.’s book, Poisoned Power, is very instructive. It is available online as a free .PDF download. Dr. Gofman was an M.D., an employee at Lawrence Livermore Laboratory, and a U.C. Berkeley professor. He participated in some of the earliest studies of effects of ionizing radiation on human health.

    Until recently, the EPA had set alert radiation levels for measurement of background radiation at 100 CPM, or 100 Bequerels (Bq) per minute. That’s 100 radioactive disintegrations per minute. The EPA recently raised the threshold to 350 CPM, a level at which a person might have greatly increased risk of developing cancer within five (5) years.

    If it were me making the comparison to safe levels of dosage or long-term exposure, I’d avoid any comparisons to airline flights or background radiation levels. Note: airlines have, since the Fukushima accident, re-routed some flights to avoid having crews and passengers exposed to high levels of in-flight radiation (which is much more intense at high altitude). Some airlines are even limiting the number of hours flight crews can be exposed to radiation in flight, change routes to avoid some exposure, or change the altitude at which aircraft and their operators are able to fly.

    Comparisons of dental x-ray exposure with “background radiation levels” is virtually meaningless. This comparison implies dental x-rays subject one to high levels of radiation (for those people who realize what background radiation levels actually ARE), and actually might expose a person to unacceptably high levels of radiation.

    It would be better to provide the patient with an actual range of exposures, in Microsieverts, Roentgens, Grays, Sieverts, etc. (Sieverts is the standard of measurement referred to by most of the medical scientific community, outside the nuclear industry and medical and dental professions using radiological testing and analysis). See a discussion of the “Linear No Dose Threshold” which is the standard of radiological safety accepted by the National Academy of Sciences. (Even MIT and the NRC set lower acceptable exposure thresholds than the NIA.)

    See this, from the CDC (Centers for Disease Control):

    “Measuring Emitted Radiation
    When the amount of radiation being emitted or given off is discussed, the unit of measure used is the conventional unit Ci or the SI unit Bq.”

    NO exposure to man-made radiation is safe. The Health Physicists and NIA trivialize and minimize the risks of radiation exposure, claiming “low dose radiation” exposure is safe.

    Even the NRC sets lower annual “safe” limits of exposure for nuclear plant workers than what the NIA says is a “safe” level of exposure.

    The Linear No Dose Threshold states there is linear correlation between exposure to ionizing radiation and development of disease in human beings. This model of exposure and dose is accepted by the National Academy of Sciences. It is the accepted model used by many epidemiologists (not health physicists, and oxymoron if there ever was one). Most biologists and scientists not working in fields related to radiology and/or nuclear energy accept the LNT model of radiation exposure and safety.

    Please do your homework on this. IMO it makes you look unprofessional and uninformed to compare exposure from modern dental x-rays to background radiation or in-flight exposures.

    You’re of course free to disagree, and I realize my point of view is completely opposite to that which the NIA and radiological societies would have you believe.

    If you were to assure your patients your machines are state-of-the-art machines, regulary calibrated and maintained, that would be reassuring. You might also state, given the machines in your office and the technology, what dose range a patient might expect per X number of X-rays. Dr. Sheila Harris in Natomas provides this information on request. Unfortunately, her references to exposure dose rate are also based on NIA statements about radiological safety.

    At least you’re not making comparisons to eating bananas, a naturally occurring (and safe) source of radioactive Potassium 40. (The human body is adapted to consumption of K40.)

    I wish you well, but please carefully consider what I’ve said. For people who understand LNT, any NIA-based assumptions are just ludicrous, and can actually cause patients like me to feel we’re being misled. It can make us very distrustful of anyone using X-ray machines, CAT scan machines, and so on. We just feel like we’re not getting a straight answer when we voice our concerns.

    Included below are websites discussing alternate views to the NIA perspective. The first link is to the National Academy of Sciences. It is a link to their main page discussing their radiological safety studies.

    A sante, Fly OntheWall

    • Dr. Castro
      Posted at 22:18h, 30 September Reply

      Like most things in life, too much of a good thing can be a bad thing. With dental radiographs we balance using the least amount possible and the benefits derived against potential effects.

      Proper radiographic use in dentistry to date has shown no adverse effects. Considering the length of its use, this is significant. Even better news is that today through the advances in digital radiography, the exposures are a fraction of what was produced decades ago!

      Because we care about the health of our patients we promise to stay current with technological advances limiting radiological exposure with the goal to optimize ones health.

Leave a Reply