How Many Dental X-rays Are Too Many?

QUESTION: Every couple of times that I visit my dentist’s office, she asks me to submit to more dental X-rays. I seem to be getting an awful lot of them. I don’t want to increase my chances of getting cancer. How often should I be getting dental X-rays?

ANSWER: You’re not the only patient who has expressed concerns about exposure to radiation from dental X-rays. The thought has crossed my mind many times, too. So it’s a good question. But, unfortunately, there is not one answer for everyone.

It depends on many factors including how much dental work you’ve had in the past, the current condition of that work, your dental hygiene and if you have any signs or symptoms of dental decay or gum disease. Even your age needs to be taken into account because your risk of oral problems varies throughout your life.

The dentist’s decision to take an X-ray “always has to be patient-specific and risk-based,” explains Dr. Susan Sutherland, chief of dentistry at Sunnybrook Health Sciences Centre.

Dental X-rays, she notes, are necessary for identifying hidden dental decay — such as in the areas between teeth or beneath old fillings and crowns. They also reveal bone loss that accompanies gum disease. This information can help determine what treatments you might need. Early intervention might help save a tooth or limit the amount of required restoration.

There is clearly a benefit to having X-rays. But any level of radiation poses a potential risk to patients. For that reason, you want to minimize your exposure as much as possible.

“There is a general principal in radiation safety called ALARA — as low as reasonably achievable,” says Dr. Sutherland. In other words, you always prescribe the least amount of radiation that’s necessary to do a particular job — such as monitoring or diagnosing a certain condition.

To help dentists make these critically important decisions, professional dental organizations issue general guidelines about when X-rays should be performed.

For instance, a document produced for the American Dental Association suggests that an adult with good oral health and low risk of dental problems should have x-rays taken at intervals of every 24 to 36 months.

The Canadian Dental Association relies upon the same document for its recommendations.

Even with theses guidelines, dentists shouldn’t be blindly following them to the point where they automatically have X-rays taken at set times for their patients, says Dr. Ernest Lam, a professor of dentistry and head of oral and maxillofacial radiology at the University of Toronto. (MORE)

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