Undergoing Yearly Head X-Rays During Dental Check-ups Potentially Uncalled For
Rewritten Article:
In the dentist's chair, when you're swathed in a cumbersome, yet oddly comforting, lead apron, questioning the passage of time and wondering if your time warp isn't a reality - hey, didn't I just leave here, and isn't it too early for more X-rays?- there's a glimmer of hope. You might be spot on.
Some dentists are making waves, challenging the prevalent use of dental imaging technology. They argue that compelling patients to undergo regular X-rays, regardless of any visible dental issues, not only inflicts harm but goes against the standards established by the American Dental Association, (yeah, you could crack a joke about the nine out of ten dentists agreeing it's bad, but don't, there's no sound scientific backing for that joke).
This debate ignited back in May when a threesome of Brazilian dentists penned a letter to the Journal of the American Medical Association (JAMA), accusing their field of falling behind the times. They called out dentistry for being overly influenced by the financial aspect of running a practice, causing financial barriers for many and overdiagnosis and overtreatment for those who can afford it. While the issue of X-rays wasn't specifically addressed, it emerged as a hot topic in the comments. As many physicians from various fields argued the tool was overused, others disagreed, asserting that imaging technology is critical for preventing tooth decay and other dental and periodontal diseases.
X-rays are popular among dentists. A 2023 study found that an astounding 320 million dental radiography procedures were performed in 2016, which equates to approximately one for every resident in the nation. This is astonishing, given that, according to the CareQuest Institute for Oral Health, around a quarter of the population doesn't have dental insurance. The costs of X-rays can vary based on both the type and location, but average between $30 and $750 for a set, as per dental care financing company CareCredit.
In response to the Brazilian letter, a response was published in JAMA on October 14 by Sheila Feit, a retired dentist from Syosset, New York. Noting that the ADA updated its guidelines in 2012 to recommend that adult patients without cavities or increased risk of developing them get new X-rays every two to three years, the experts who updated the guidelines emphasized that, while the level of radiation in a dental X-ray is typically below the threshold causing serious damage, "any amount of ionizing radiation can elevate the risk of adverse health effects."
Rather than X-rays being performed at regular intervals, such as every six months or a year, dentists should instead employ them "based on diagnostic and treatment planning needs, and dentists shall make a good-faith attempt to obtain radiographs from previous dental examinations," they wrote. This means that X-rays should only be taken when they're necessary. The determination of this shouldn't solely be a dentist's best guess, but also includes a discussion with patients about the advantages and risks involved.
In another response, Yehuda Zadik, an associate professor at Israel’s Hebrew University, compared the use of dental imaging to fitting a crown to the outdated practice of X-raying children's feet while shoe shopping. He suggested that performing routine radiographs during regular check-ups would be inappropriate, akin to conducting periodic full-body computed tomography scans without specific clinical indications, symptoms, or patient concerns.
Recent updates to dental X-ray best practices may come as a surprise to us frequent chair occupants. In February, the ADA introduced new recommendations for X-ray practices. Among them was the advice to cease using the heavy lead aprons during imaging. The ADA stated that studies have shown the aprons, as well as thyroid collars, aren't necessary to protect patients from radiation exposure, regardless of age, or even if the patients are pregnant. They noted that the protective gear could potentially hinder the imaging, leading to more X-rays being necessary.
The internet is brimming with misconceptions about dental X-rays. When stuffed with the question "dentist X-rays once a year," Google's AI unhesitatingly stated that this frequency is appropriate. Now that you're enlightened, feel confident engaging your dentist in a conversation the next time they try to shove that peculiar piece of plastic into your mouth. It probably won't affect your health, but you could save yourself some cash.
- Despite the popular use of X-rays in dentistry, some argue it's overused, potentially causing harm and overdiagnosis, as suggested in a letter to the Journal of American Medical Association by three Brazilian dentists.
- A study in 2023 found that 320 million dental radiography procedures were performed in 2016, raising questions about the necessity and affordability, given that around a quarter of the population doesn't have dental insurance.
- In response to the concern, the American Dental Association updated its guidelines in 2012, recommending that adult patients without cavities or increased risk of developing them get new X-rays every two to three years, considering the risks associated with any amount of ionizing radiation.
- Dentists should employ X-rays based on diagnostic and treatment planning needs, discuss the advantages and risks with patients, and aim to obtain radiographs from previous dental examinations, as stated in another response to the Brazilian letter by Yehuda Zadik, an associate professor at Israel’s Hebrew University.