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A Tumor, Really?

July 26, 2012

Filed under: Uncategorized — Dr. Buck @ 2:05 pm

I’m sure some of you were watching the Today Show several weeks ago and heard the story about how dental x-rays are causing brain tumors and that cancer is in the waiting after your next dental check up. We’ve had several inquiries about this issue in the past (even more since that story ran) so I thought I would give you some numbers and my take as a dentist. First off, one thing that I agree with the story that was aired is the fact that x-rays should only be taken when necessary. Contrary to some belief, we don’t just snap these things because “dental insurance” says it’s covered or because we want to add to the bill. As a dentist, I can only diagnose what I can see. I cannot see in between your teeth during your exam. The only thing that shows me a view of in between two teeth that are in contact with one another is an x-ray. In essence, I cannot perform a complete exam without x-rays. In my opinion, bitewing x-rays should be taken once a year at a minimum. If you have fillings that are in between your teeth, it might be a good idea to get them every 6 months whether your “insurance” covers it or not. Patients always want us to be conservative and get upset when we tell them they need a crown or root canal. Well in order for us to be conservative, we need to catch things early. Many times when a cavity that is in between the teeth becomes apparent in the mouth, we are usually talking about crowns. Remember that I can only diagnose what I can see.
The other type of x-ray that we utilize is the panoramic x-ray. This is the one that goes around your head and gives us a view from the right joint to the left joint including sinuses, carotid arteries, jawbones, and teeth. We recommend that x-ray every 3 years (although many “insurances” cover it only every 5 now). This x-ray does not have the fine resolution it takes to diagnose cavities, but it is great for diagnosing abnormalities including infection and cancerous lesions plus if a blot clot or plaque is big enough in the carotid then it’ll show up as well (BTW, we’ll drive you to the ER if we find one of those). So the next time we recommend a panorex x-ray, think about it’s ability to catch things early. It could help save your life.
Lastly, let’s talk some numbers. Everyone is scared that they are getting too much radiation. And if they’ve had a bunch of tests and x-rays in the hospital, they are worried that the dental x-rays may be the tipping point in causing cancer. These numbers come from the Department of Radiation so I’m not making them up. The maximum amount of occupational exposure for US radiation workers is 5000 millirems each year. High dose x-rays include mammograms (1000mr), spinals (around 450mr), and pelvimetry (875mr). The low dose group includes cervical spine (52mr) and femur (21mr). A film based panorex is 2mr (these are the ones we like to take once every 3 years). A digital bitewing (the kind we take) are less than 0.05mr meaning the series of 4 that we usually take each year is about 0.2mr. One last analogy, if you fly from coast to coast on an airplane, you get 4mr of background radiation. That’s equivilent to 80 digital bitewing x-rays. Don’t let the media hype scare you. The benefits of detecting cavities, gum disease, abscesses, and oral cancer far ourweigh the risks involving dental x-rays. They are safe and effective.

*BTW, if you were wondering why I put the quotation marks around the word insurance above, take a look at my previous blogs about “dental insurance”

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