• Posted November 2, 2023

Dental X-rays Are Now Safer Than Ever

That heavy lead apron you wear at the dentist's office when getting X-rays may no longer be necessary.

While intended to shield patients from radiation exposure anywhere that isn't the jaw, the X-ray equipment used in dental offices today is quite safe compared to those of the past.

The amount of external radiation scatter from modern X-ray technology poses little to no threat to patients, according to the American Academy of Oral and Maxillofacial Radiology (AAOMR).

In an article published in the Journal of the American Dental Association, the AAOMR has now recommended that lead aprons and thyroid shields do not need to be used routinely for dental X-rays.

"There is ample evidence in scientific literature that shows that the apron and thyroid collar do not provide any additional benefit,"said Aruna Ramesh, associate dean for academic affairs at Tufts University School of Dental Medicine, in Boston.

Ramesh is a specialist in dental radiology and co-author of the article outlining the AAOMR's new recommendations.

A dental patient receives negligible radiation exposure through "internal scatter."

"The internal scatter that exposes the organs below the jaw cannot be prevented with an apron,"Ramesh said in an AAOMR news release.

It's possible an apron or collar can interfere with getting a clear shot of the jaw, making it necessary to try a second time, doubling the overall dose, Ramesh said.

"Preserving the quality of the images is the best way we have of protecting our patients,"said Hugo Campos, associate professor and director of oral and maxillofacial radiology at Tufts.

Yet most states still require protective gear during dental X-rays, so not using that isn't an option unless regulations change.

As states update policies, the focus for dentists should be on ways to communicate clearly with their patients about the rationale for the change and the data behind it, Ramesh said.

For some patients, that heavy apron makes them feel physical or mental comfort.

"The lead apron plays a very important role in the psychology of our patients,"Campos said. "They feel that you are protecting them."

Pregnant people and parents of pediatric patients appear particularly concerned. In both cases, Campos said, "the same dose is received with the shield as without the shield--and that is extremely low."

The dose of radiation exposure from dental X-rays to a developing fetus would have to be 10,000 to 30,000 times higher than it is to risk causing conditions such as microcephaly, growth retardation or intellectual disability.

"However, we know some pregnant patients are going to feel more comfortable and protected when they have the lead apron,"Campos said.

More information

The National Institutes of Health has more on X-rays.

SOURCE: Tufts University, news release, Oct. 26, 2023