Last year, I read this article indicating that dental bitewing x-rays may increase the risk of getting a brain tumor (emphasis mine):
Getting frequent dental X-rays appears to increase the risk for a commonly diagnosed brain tumor, a new study finds.
Exposure to ionizing radiation -- the kind found in X-rays -- is the biggest known environmental risk factor for largely non-malignant meningioma brain tumors. Routine dental X-rays are among the most common sources of radiation for most healthy people in the U.S.
The new study suggests that performing frequent X-rays may expose patients to unnecessary risk.
"These findings should not prevent anyone from going to the dentist," says lead researcher and neurosurgeon Elizabeth B. Claus, MD, PhD, of Yale University School of Medicine and Boston's Brigham and Women's Hospital. "But it appears that a large percentage of patients receive annual X-rays instead of every two to three years, which is the recommendation for healthy adults."
While the vast majority of meningiomas are non-malignant, they often grow to be very large and can cause a wide range of potentially serious symptoms, including vision and hearing loss, frequent headaches, memory loss, and even seizures.
I checked the American Dental Association’s (ADA) website, and they have specific recommendations (pdf)
which arise out of this issue:
...it is the dentist's responsibility to follow the ALARA Principle (As Low as Reasonably Achievable) to minimize the patient's exposure. Examples of good radiologic practice include…limiting the number of images obtained to the minimum necessary to obtain essential diagnostic information.
In response to this information, I decided that it would be prudent to talk to my dentist about my concerns. He seemed like a nice enough guy. However, he did, in fact, take bitewing x-rays every year. In fact, I’ve had bitewings taken every year for as long as I can remember.
When I went in for my biannual cleaning last week, I told my dentist about the article that I read and the information that I found on the ADA website. I asked him if he would be flexible for patients concerned about radiation exposure and reduce the frequency of bitewing x-rays from every year to every two or three years. Pretending not to understand the question, he told me that it’s important to visit my dentist more frequently than every two or three years. I gently explained that I will continue to have my teeth cleaned twice a year.
I asked again. Will you limit the frequency of bitewings to every two or three years for patients who are concerned about radiation? Taking me for an idiot, he told me that he contacted the ADA about their recommendations, and the anonymous person that he spoke with told him that their recommendations for limiting the frequency of bitewings apply only to persons who have never had a cavity. Really? Never? I calmly explained that this response is inconsistent with the information that I read in the article and on the ADA site.
At this point, my dentist was visibly frustrated with my persistence. Nevertheless, I pressed on: “Will you limit bitewings to every two or three years for patients who are concerned about radiation?” He finally gave me a direct answer to a direct question. "No." Apparently offended by the idea, he then asked that I find another dentist. Of course, I'm happy to oblige. In fact, given the amount of bullshit that he was throwing my way, I had already decided to do so.
Look, I don’t know whether bitewings are safe. If my dentist had simply said that the research is inconclusive (it is), and that he felt that he couldn't give the proper level of care without bitewings, then he might not have lost three patients (me, my wife, and my child). On the other hand, given the evidence, limiting bitewings to every two years or so is not unreasonable, and in my humble, dentists should be willing to let patients decide for themselves without sending them away without their goodie bag for even broaching the subject.
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