A Response to the New York Times: You Probably Need Dental X-Rays
This week, I read a New York Times article titled, “You Probably Don’t Need Dental X-Rays Every Year.” The author, Austin Frakt, argues that dentists tend to overuse X-rays for moneymaking purposes and, in doing so, expose their patients to unnecessary harm. I strongly believe this is a weak and unfounded argument. I would like to offer a response for you to understand my position on taking dental X-rays.
It will be helpful for you to know that we are caring dentists, and we take X-rays that are necessary for diagnostic purposes to enhance your health. Patients who have been with me for the past 14 years know this, and know that, first and foremost, I care about your wellbeing.
I hope you understand that one of the advantages of coming to a doctor who knows you well—and whom you know well—is that the frequency of taking X-rays is individualized based on your past history and how well you take care of your mouth.
There are many important deciding factors, including: your medical conditions, medications, caries risk, rate of caries development, exposure of root surfaces, previous restorations, oral hygiene, frequency of flossing, fluoride toothpaste, crowded teeth, mal-positioned teeth, smoking, alcohol, habits, diet, pH level in the mouth, bacterial composition, history of surgery, history of fluoride usage or during development, clenching, grinding, use of nasal products, frequency of sinus infection, sleep quality, history of radiation treatment, chemo treatment, consumption of carbonated drink (yes, seltzer water counts), and so on. I can add to this list, however, these are the factors that go through my head when I check a patient.
It’s also important to keep in mind that X-rays are not just for checking cavities. We check for disease, infection, bone level, growth and development, sleep apnea issues, etc. Given these criteria, let me ask you this: Would you let anyone perform surgery in your mouth without first detailing a custom plan and checking the anatomy of your body? The answer should be no.
In regards to radiation exposure, Frakt wrote, “An unnecessary bitewing or other dental X-ray is an unnecessary harm.” This is a gross oversimplification of an often crucial procedure. Medical technology is invented for a good reason: to provide higher degrees of safety margins for doctors to utilize and ensure better outcomes for their patients. Downplaying the importance of this technology is like saying, “Let’s go back to the Stone Age to practice today’s dentistry.”
For anyone still worried about the radiation caused by dental X-rays, let’s look at the facts:
Microsievert is a way for measurement of radiation exposure.
- 1 intra-oral Dental xray = 5 microsieverts
- Background dose received by person on average day = 10 microsieverts
- Flight from NY to LA = 40 microsieverts
- Full mouth series = 90 microsieverts
- Chest xray = 100 microsieverts
- Dose per person from food per year = 400 microsieverts
- Mammogram= 700 microsieverts
- Smoking 1.5 packs a day for 1 year = 36,000 microsieverts (bitewings every day for 5 years)
- Maximum yearly dosage permitted fro US radiation workers = 50,000 microseiverts
The X-ray is a diagnostic tool, and one that is often necessary to ensure the best patient experience. This is why Chang Dental Group invests in the latest digital technologies that allow the lowest radiation exposure.
Frakt also wrote, “Though your insurance may cover annual bitewings, they’re not free … So, when dentists take bitewings at routine visits, they may be doubling their revenue.” Your dentist should always take a customized approach, not an insurance-driven approach. However, there are medical guidelines determined by each state. Following these are necessary for administering the best patient care.
It’s vital for patients to understand the importance of X-rays. Choose a great dentist who cares about your health and knows how and when to use available technology to improve and maintain your health.
Dr. Jenny Chang