Concern about radiation is constantly with us. However, putting this in perspective, the amount of radiation that one gets in a dental office, assuming that one gets annual dental x-rays, represents less than 3% of all the medical radiation you will receive in your lifetime. This does not mean that we should ignore the exposure but it has to be put in context as well as having a discussion regarding the benefits vs. the risks of not taking x-rays.
Taking into consideration lead shields, high speed radiation and digital films, the amount of radiation we get today from a dental x-ray is a small percentage of we were all exposed to 40-50 years ago.
Since one size does not fit all, it's important to distinguish populations of people who seek dental care. I've encountered patients who have been immune to decay for decades. These patients should be looked at differently than individuals who've had decay since they were children, have multiple restorations, crowns, implants or missing teeth. Vulnerability to decay and periodontal disease varies among individuals and can change as we age.
Within my practice, most of the patients have sought care because of a history of dental disease albeit periodontal disease due to decay or loss of teeth.
This population which many of you represent needs to be monitored more carefully than the individual who walks into my office with 32 pristine teeth and having never had decay or loss of teeth far into their adulthood.
Certainly the judicious use of x-rays should only be done if they have diagnostic value.
A couple of caveats from my personal experience: I've treated patients where x-rays were not taken for a 2 year period. Because of changes in their saliva which is very common as we age or because of medications, a number of patients developed less saliva and the mouth was somewhat drier. Rapid decay would occur in many of these patients within a year resulting in multiple root canals and crowns on teeth which significantly increased the cost to treat these teeth and also the amount of radiation exposure.
As a general guideline, the greater the amount of dentistry you've had in your lifetime, the more you need dental x-rays because you are more vulnerable. The converse is true as well. But again, no one size fits all. In my practice, unfortunately, I've seen far more harm in people not having the early diagnosis of dental issues resulting in either root canals or lost teeth.
One form of x-ray technology which we have employed in the office over the last 10 years is 3D CT scan imaging of the upper and lower jawbones. This technology allows us to see not only the teeth and the bone beyond the teeth but also the sinus cavities and the nerves. It is very valuable in picking up non-dental issues such as cysts and even tumors developing.
The 3D CT scan is utilized when necessary to diagnose disease or when dental implants are being utilized to safely provide the patients with care that would be difficult to accurately perform without knowing the anatomy of the jaw. As I mentioned previously, one size does not fit all. The use of CT scan technology has enabled us to see things we never saw before and avoid problems that we used to incur whether it be taking out wisdom teeth or placing implants.
As always, I welcome your feedback and input.
Victor M. Sternberg, D.M.D.
Dental Office of:
Victor M. Sternberg, D.M.D., PC
Westchester Center of Periodontal and Implant Excellence
141 North State Road
Briarcliff Manor, NY 10510