Category: <span>Dr. Drake</span>

Dental X-rays or radiographs are images of your teeth that your dentist uses to evaluate your oral health. These X-rays are used with low levels of radiation using the “ALARA” principle to capture images of the interior of your teeth and gums. This can help your dentist to identify problems, such as cavities, impacted teeth and tooth decay. Specific factors play into how often X-rays should be taken such as an individual’s current age, oral health, risk for disease and any signs/symptoms of oral disease.  That being said, there is no “one size fits all” when it comes to the interval between dental X-rays.  Dentists adhere to the “ALARA” principle.  This is a phrase created by the International Commission on Radiologic Protection.”  Under the ALARA principle, dentists take precautions to help ensure that:

• Exposure is kept as low as reasonably achievable (ALARA)
• Any and all X-ray exposures are justified in relation to their benefits
• All doses received by personnel and patients are kept well below the allowable limits.

We encourage dentists and patients to discuss dental treatment recommendations, including the need for X-rays, in order to make informed decisions together.

Topics:

ADA/FDA Guide:

The ADA, in collaboration with the U.S. Food and Drug Administration (FDA), developed recommendations for dental X-ray examinations to serve as an adjunct to the dentist’s professional judgment of how to best use diagnostic imaging. X-rays can help your dentist evaluate and definitively diagnose many oral diseases and conditions. However, the dentist must weigh the benefits of taking dental X-rays against the risk of exposing a patient to X-rays, the effects of which accumulate from multiple sources over time. The dentist, knowing the patient’s health history and vulnerability to oral disease, is in the best position to make this judgment. For this reason, the recommendations are intended to serve as a resource for the practitioner and are not intended to be standards of care, nor requirements or regulations.

Radiations Exposure Information:

Ionizing radiation has enough energy to affect the atoms in living cells and will thereby damage their (DNA). Fortunately, the cells in our bodies are extremely efficient at repairing this damage. However, if the damage is not repaired correctly, a cell may die or eventually become cancerous.

Exposure to much higher levels of radiation can cause acute health effects such as skin burns, acute radiation syndrome (“radiation sickness”), cancer and cardiovascular disease. Exposure to low levels of radiation encountered in the environment does not cause immediate health effects, but is a minor contributor to our overall cancer risk.

The amount of this radiation dosage is expressed as an effective dose. It is a term applied to the weighted sum of doses to tissues that are sensitive to radiation. This number is derived by calculation.  Effective dose as a unit of measurement was devised by the International Commission on Radiological Protection in 1990, and the method of calculation was updated in 2007.

Radiation Safety Requirements:

State laws and regulations set specific requirements for the use of ionizing radiation, including X-rays. The radiation protection program in your state may provide specific requirements for:

• Inspection and testing for the facility, X-ray machine, radiation monitoring equipment and radiograph processing equipment
• Dental office design
• Radiation shielding
• Permits or licensing
• Supervision of personnel
• Equipment
• Record keeping
• Dosimetry badges usage
• Training or certification

The X-ray training requirements for dental office staff are less difficult and are often different from than those in the other medical professions. The prerequisites and training requirement for dental office personnel are typically found in state dental practice acts or dental board regulations. The risk of exposure within the workspace is far lower than that in hospitals and medical offices. The occupational exposure limit is 50 mSv in one year, although, lifetime occupational effective dose is limited to 10 mSv times the number of an individual’s age, according to the NCRP. The NCRP also concludes that occupational exposure for dental personnel shall not exceed these limits, excepting for problems associated with facility design, diagnostic equipment performance, or operating procedures. For pregnant dental personnel, the radiation exposure limit is 0.5 mSv per month.