By Barbara Bronson Gray, RN, MN
I have a common-sense approach to the dentist. Since teeth don't heal themselves, it seems smart to do all you can to catch problems early. So I have a cleaning and check-up every six months, and once a year, I bite for the bitewing x-rays.
It turns out, we probably shouldn't.
Research published online April 10, 2012 in “Cancer” suggests that early or repeated dental x-rays increase the risk for meningioma, a common brain tumor. While often benign, meningiomas can grow or cause symptoms which may require surgery or radiation therapy. The study is the largest ever to analyze the effects of common dental x-rays.
At every age, having more frequent bitewing x-rays was associated with increased risk. People with mengiomas were 1.4 to 1.9 times more likely than were control subjects to have had bitewing x-rays annually or more frequently.
The study is especially interesting because it shows how low-dose radiation exposure, when repeated, can have a cumulative negative impact on your health.
If you or your kids have had orthodontia, you're probably familiar with panorex x-rays, which give a two-dimensional picture of the jaw and teeth, including the surrounding bones. Most orthodontists work from panorex x-rays as they develop the treatment plan for straightening teeth. When our daughter had braces, I gave the OK for one set of panorex, but when she was finished with treatment, I said no to an "end of treatment" panorex the orthodontist wanted because I felt it was unnecessary. It turns out I was right. Kids who had a panorex when they were less than 10 years old had a 4.9 increase in the risk of developing the brain tumors.
Keith L. Black MD, chair and professor of the Department of Neurosurgery at Cedars-Sinai Medical Center in Los Angeles, told Medscape that dental xrays aren't without risk. "As a general rule, we need to be more concerned about x-ray exposure, particularly in the younger population," he said.
If there is no evidence of a problem, such as a cavity or the need for a root canal that might warrant further exploration, Black suggests saying no to dental x-rays. For more than 20 years, his dentist has asked him after his twice-yearly dental cleanings whether he wants x-rays. Without fail, he says no. "If I have no complaints and they see no cavities, I don't see the point in getting the x-rays, so I refuse," he said.
X-rays are a revenue source for dentists. Just this weekend my friend, who is a dental hygienist, told me that many dental offices frequently offer their hygienists a bonus if their patients say yes to x-rays. In light of this study, that's especially aggravating.
The bottom line? Know that every treatment and test has an upside and a downside. Discuss your questions and concerns with your dentist to see if you have a situation in which you really would benefit from an x-ray. But on the whole, you probably won't need annual x-rays.
If you do have an x-ray, be sure they cover your body and your thyroid with protective "aprons" to minimize radiation exposure.
Barbara Bronson Gray is an award-winning writer and a nationally recognized health expert. She's a regular contributor to HealthDay.com, preparedpatientforum.com and thirdage.com. Barbara has worked in hospitals, as a nurse and as an administrator, led a major healthcare magazine, created a website for WebMD, and served as a leader of global communications for Amgen, the world's largest biotech company. She continues to write and speak about healthcare and has a communications consultancy. Follow her on Twitter: @bbgrayrn.