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26300 Euclid Avenue
Suite #510 (Donald, Fred and Derek Nevar, DDS)
Euclid, Ohio 44132
Phone: (216) 731-5600

recent study links dental x-rays to brain tumors

April 26, 2012

http://www.cancer.org/Cancer/news/News/study-examines-possible-link-between-dental-x-rays-and-meningioma-risk

The American Cancer Society recently published a study in the journal 'Cancer,' citing a correlation between dental x-rays and a frequently benign (1-2% malignancy rate) brain tumor called a meningioma based upon memory recall of patients diagnosed with the condition compared to those without. NBC 'Nightly News' and Cleveland's 'Plain Dealer' newspaper are just a small sample of media outlets that covered the study following its publishment.

The study does not argue against the need for use of such important diagnostic tools as bitewing x-rays, which allow dentists to evaluate areas between teeth for the presence of cavities. The overall response from dentists, patients and the American Dental Association has been interesting in many ways. Personally, there are good points made in arguments for and against the conslusions drawn by the study, which can be summarized by the need for being more conservative when deciding whether or not to take x-rays. This is especially true when current x-rays exist that could prevent unnecessary exposure to additional radiation by requesting copies from the provider that originally took them.

The ADA issued a statement to member dentists citing the acknowleged inaccuracies of the study, which are primarily the ability of anyone to recall with accuracy their past exposures to various types of radiation let alone dental x-rays specifically. A major limitation of the study is recall bias. Those that have been diagnosed may be more likely to recall, or seek to explain, the causative factor for their condition (as compared to their healthy counterparts).

This is not meant to discredit the study, as it is our belief that such research helps to raise awareness to the potential dangers of cumulative doses of radiation regardless of the source (ie. medical imaging such as MRI scans, dental bitewing x-rays, or everyday exposures we encounter using cell phones or simply being in the sunlight). Since the time period of radiation exposure by study participants (meningiomas are typically slow growing tumors), safety procedures and standards of care have greatly improved. Advancements in x-ray film speeds (requiring less exposure time), digital technology (requiring less radiation intensity), protective devices (used to limit the scatter of radiation to unintended target areas), x-ray unit designs and sharing of current x-rays with other providers are all areas in which dentistry has succeeded in reducing radiation exposure.

Typical dental insurance coverage allows for bitewing x-rays to be taken once every 12 months. Following ADA recommended guidelines, in the majority of cases where contact of adjacent teeth (children and adults) prevent visual confirmation of the absence of cavities, 12-month intervals are appropriate. However, when factors such as good homecare, lack of previous cavities and low risk diets are taken into consideration, patients are better suited for 18 - 24 month intervals. Combined with advancements in x-ray films and technology, patient-specific recommendations on x-ray intervals are made to help limit radiation exposure. 

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