BITES&BRIEFS


For the Patient The value of dental x-rays


can show your dentist n an infection in your tooth or tooth root n cavities between teeth or under fillings n trouble with teeth or jaw development in children and teens who are getting their permanent teeth


X


n jaw problems, including infections and fractures, or prob- lems with the way teeth will fit together n bone loss from severe gum disease


TYPES OF X-RAYS Depending on your needs, there are different types of x-rays your dentist can take. Here are some common x-ray examinations n Bite-wings are taken with a small film or digital sensor that you bite down on with your back teeth. These x-rays show the back teeth from the chewing surface to the bone near the gumline. These can help your dentist spot problems like cavities between your teeth or problems with the bone that could be caused by gum disease.


n Periapical x-rays help your dentist see the whole tooth from the crown to the tip of the root. This helps your dentist see what is going on below the gumline.


n Panoramic x-rays produce a long film that shows the entire jaw and all of the teeth in 1 image. It allows your dentist to view supporting or surrounding structures such as sinuses, nerves, and joints. Dentists can also create a 3-dimensional image using a technology called cone-beam computed tomography (CBCT). With CBCT, the dentist takes a series of pictures to create a 3- dimensional image. Because CBCT relies on multiple images, the radiation exposure is higher than with commonly used 2- dimensional x-rays. To help limit the amount of radiation a patient is exposed to, dentists use CBCT only when more detailed information is needed.


ARE X-RAYS SAFE? Patients are exposed to some radiation when x-rays are taken. For that reason, dentists and physicians take them as necessary to help with treatment. They also take steps to help keep exposure to radiation as low as reasonably achievable. The amount of radiation associated with dental x-rays is


small. Here are some additional steps dentists may take to further protect patients1


-rays are an important tool in dental care. They help your dentist look at parts of the mouth that cannot be seen during a regular examination. For example, x-rays


n Conduct an examination to determine whether x-rays are needed.


n Contact a patient’s previous dentist to request a recent set of x-rays.


n Use digital sensors to take x-rays if possible. If the office has a film system, use film associated with the lowest amount of radiation.


n Focus the x-ray beam so that it is aiming at as small an area as possible. In the past, some dentists may have covered a patient’s


throat or abdomen with a lead collar or apron, which was thought to limit exposure to x-rays. This is no longer recom- mended.1 Research shows that the level of radiation in dental x-rays is not high enough to require this protection, and these shields can cause problems in getting a useful x-ray.2 This could require a second x-ray to get a better picture.


CONCLUSION Dental x-rays can be useful in helping your dentist see what is going on in spots they cannot otherwise see or examine, such as between your teeth and below your gumline. Talk to your dentist about the usefulness and safety of dental x-rays. n


DISCLOSURE Ms. Mark did not report any disclosures.


https://doi.org/10.1016/j.adaj.2024.02.001


Prepared by Anita M. Mark, informationist, ADA Library & Archives, American Dental Association, Chicago, IL.


Copyright ª 2024 American Dental Association. Unlike other portions of JADA, the print and online versions of this page may be reproduced as a handout for patients without reprint permission from ADA Publishing. Any other use, copying, or distribution of this material, whether in printed or electronic form, including the copying and posting of this material on a website, is prohibited without prior written consent of ADA Publishing.


“For the Patient” provides general information on dental treatments. It is designed to prompt discussion between dentist and patient about treatment options and does not substitute for the dentist’s professional assessment based on the individual patient’s needs and desires.


You can find more information for patients at ADAstore.org or at MouthHealthy.org.


1. Benavides E, Krecioch JR, Connolly RT, et al. Optimizing radiation safety in dentistry: clinical recommendations and regulatory considerations. JADA. Published online February 1, 2024. doi:10.1016/j.adaj.2023.12.002 2. Benavides E, Bhula A, Gohel A, et al. Patient shielding during dentomaxillofacial radiography: recommendations from the American Academy of Oral and Maxillofacial Radiology. JADA. 2023;154(9):826-835, e2.


ADA Launches Career Services Hub T


• Dental Career Pathways & Advising • Career Transitions • Dental Licensure


• Dental Associate Contract Evaluation • Career Connections • Financial Management


At ADA.org/careers, members will find all of ADA’s content in these areas easily accessible. Additional resources are being created based on dentist’s feedback and will be included here.


ADA Patient Resources Explain Imaging Safety


his resource hub on ADA.org launched this March to provide dentists with a one-stop-shop for resources, tools and services to support them at all stages of their dental career journey. This hub was curated with help from member dentists to highlight the available resources and make it easier for them to find what they need, when they need it. Members highlighted several areas of support they wanted from the ADA:


R WELL-BEING INDEX FROM MAYO CLINIC NOW AVAILABLE FOR ADA MEMBERS.


Your health matters. The ADA wants dental professionals to thrive and encourages members to prioritize their total health — including your mental health. Set up your WBI account, it only takes five minutes. ADA.ORG/RESOURCES/PRACTICE/WELLNESS/WELL-BEING-INDEX.


8 focus | SPRING 2024 | ISSUE 1


ecently, JADA published radiation safety recommendations from an ADA expert panel, which advised dental professionals that abdominal and thyroid shielding during diagnostic dental imaging, including CBCT, is no longer recommended. The ADA has new resources to help you educate patients who may have questions about imaging safety or the updated recommendations. A new JADA For the Patient is available to assist patient learning about radiation protection, patient and provider safety and the diagnos- tic value of dental imaging. Access it at bit. ly/43rvnJ5. The x-ray page on MouthHealthy. org also has updated information. You also can visit solutions.modental.org/company/ heldebrandt-consulting which has resources and articles about radiation safety. One of those, “Radiation Dose from Common Imag- ing Exams” can be used to give your dental patients a perspective of their radiation dose from intraoral, panoramic and CBCT exams in terms of natural background ra- diation we are all exposed to every day.


From Common Imaging Examinations Procedure


Approximate effective radiation dose (mSv)


Computed Tomography (CT) — Abdomen and Pelvis


Computed Tomography (CT) — Abdomen and Pelvis, repeated with and without contrast material


ABDOMINAL REGION


A


Computed Tomography (CT) — Colonography Intravenous Pyelogram (IVP) Barium Enema (Lower GI X-ray) Upper GI Study With Barium Lumbar Spine


BONE


Extremity (hand, foot, etc.) X-ray Computed Tomography (CT) — Brain


CENTRAL NERVOUS SYSTEM


Computed Tomography (CT) — Brain, repeated with and without contrast material


Computed Tomography (CT) — Head and Neck Computed Tomography (CT) — Spine Computed Tomography (CT) — Chest


CHEST


Computed Tomography (CT) — Lung Cancer Screening Chest X-ray Dental X-ray


DENTAL


Panoramic X-Ray Cone Beam CT


HEART


Coronary Computed Tomography Angiography (CTA) Cardiac CT for Calcium Scoring


Non-Cardiac Computed Tomography Angiography (CTA) MEN’S IMAGING


NUCLEAR MEDICINE


Bone Densitometry (DEXA)


Positron Emission Tomography — Computed Tomography (PET/CT) Whole body protocol


Bone Densitometry (DEXA)


WOMEN’S IMAGING


Screening Digital Mammography


Screening Digital Breast Tomosynthesis (3-D Mammogram)


< 0.001 mSv 1.6 mSv


3.2 mSv 1.2 mSv


8.8 mSv 6.1 mSv 1.5 mSv 0.1 mSv


0.005 mSv 0.025 mSv 0.18 mSv 8.7 mSv 1.7 mSv 5.1 mSv


0.001 mSv 22.7 mSv


0.001 mSv 0.21 mSv


0.27 mSv


7.7 mSv 15.4 mSv 6 mSv


3 mSv 6 mSv 6 mSv


1.4 mSv


Radiation Dose to Adults


Approximate comparable time of natural background radiation exposure


2.6 years 5.1 years 2 years


1 year 2 years 2 years


6 months < 3 hours 7 months


13 months 5 months


3 years 2 years


6 months 10 days 1 day


3 days


22 days 3 years


6 months < 2 years


3 hours 3.3 years


3 hours 26 days


33 days


Note: This chart simplifies a highly complex topic for patients’ informational use. The effective doses are typical values for an average-sized adult. The actual dose can vary substantially, depending on a person’s size as well as on differences in imaging practices. It is also important to note that doses given to pediatric patients will vary significantly from those given to adults, since children vary in size. Patients with radiation dose questions should consult with their medical physicists and/or radiologists as part of a larger discussion on the benefits and risks of radiologic care.


For the most current information, visit radiologyinfo.org.


02.21


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