Worth the Worry? Research Links Dental X-Rays, Brain Cancer Risk ...

If you ?say cheese!? for annual dental X-rays, you might have found new research published in last month?s American Cancer Society journal, Cancer, to be a bit unsettling.

The study, out of Yale University School of Medicine at New Haven, suggested ties between yearly radiographs and an upped risk for the most common brain tumor in Americans: meningioma.

But don?t swear off scans completely, says Eastman Institute for Oral Health dentist Yan-Fang Ren. A deeper look into the matter ? and study design ? is warranted. He says visual examination alone often falls short, and X-rays remain an invaluable tool for helping dentists detect oral health issues before they devolve into bigger, harder-to-treat problems.

We spoke to Dr. Ren to learn more.

Scripts: According to the study comparing 1,400 meningioma patients to similar adults without tumors, cancer patients were much more likely to recall having frequent ?bitewing? and ?panoramic? x-rays, especially as kids. Can you describe what these procedures are ? and if they?re still commonly used today?

Ren: First, it?s really important to note that some of the subjects in this latest study received dental X-rays decades (even fifty years) ago ? a time when radiation doses were far greater due to less sophisticated technologies, like slower speed films.?Because of this, the study results can only be considered suggestive of a possible association ? more rigorous research would be needed to prove an actual cause and effect relationship. As other experts have carefully pointed out, the amount of radiation in modern dental x-rays is pretty small ? more than 100 times less than what a woman?s mammogram delivers to a single breast.

That said, yes ? bitewing and panoramic X-rays are still used today. Bitewings provide a picture of the upper and lower back teeth, showing decay between the teeth, as well as how the upper and lower teeth line up. They can also reveal bone loss due to severe gum disease or a dental infection.

Panoramic X-rays, as their name suggests, show a broader view of the teeth, sinuses, nasal area, and temporomandibular (jaw) joints. While they can?t image cavities, panoramics are still useful for detecting other problems, like impacted teeth, bone abnormalities, cysts, solid growths (tumors), infections, and fractures.

Scripts: Many critics of this latest research point out the study?s weak design: Using ?recall? surveys, which can be hazy. Still, the findings have left many patients worried that X-rays carry some risk, even if that risk is small. How do you weigh the benefits of regular X-ray exams against (even minute) radiation risk?

Ren: Each patient?s situation differs; some might have more complex oral health needs, and require X-rays more frequently than others. Again, infections of the teeth and gums can be quite grave, at times even pave the path for other serious medical conditions. And, not to downplay the danger of meningiomas by any stretch, but it?s worth noting that most of these tumors are benign and slow-growing.

Personally, at Eastman Dental, our priority is practicing minimally invasive dentistry ? which means we aim to make diagnoses at the earliest stage of disease, ideally reducing discomfort and preserving the most tooth structure, and a patient?s whole body health. Again, radiation doses are significantly lower now that they were decades ago, in part thanks to modern precautions we now take to reduce exposure ? such as using high-speed films, digital radiographs (which can cut radiations exposure by up to 90 percent), and machines with attached collimators (telescope-shaped devices that prevent radiation scattering, limiting the size and shape of the X-ray beam and ultimately delivering a smaller dose to tissue).

Scripts: But, for a generally healthy patient, is an annual X-ray overkill? Would every two to three years suffice (and does the recommendation differ for kids versus adults)?

Ren: The American Dental Association?s formal guidelines for healthy persons suggest that kids receive one X-ray every one to two years, adolescents receive one every one-and-a-half to three years, and adults receive X-rays every two to three years.

Still, this isn?t a one-size-fits-all recommendation, because it also depends on the patient?s risk level and any signs and symptoms of existing oral disease.?You should talk with your dentist to decide how often you need radiographs as part of your ongoing care plan.

Since 1915, Eastman Dental has been working to provide quality care, from simple cleanings to repair, replacement, or cosmetic work. Visit their website for more about the services offered, their emergency dental care, and special clinic locations that offer sliding fee scale discounts. To make an appointment, call (585) 275-5051.

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