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Medical Forum / General / Dentistry / June 2007Radiation in X-Rays?
So I'm at the dentist's office for a cleaning, and the tech says she needs current X-rays. She takes, I dunno, maybe three or four on each side for the molars. The she has me stand inside this semi-circular thing that goes around my head for "the full set". While they're developing she does the cleaning. Then she looks at them and says she needs to do the full set thing again because something is warped (probably because the dumb thing hit the lead shield draped over me as it swung around). So I stand in this thing again and sure enough, it hits me again. Yep, that try is crap. So the dentist tells her to take more spot pictures of my front teeth "to fill in the blanks", and she shoots X-rays into my head about six or eight times more. By now, of course, my teeth are glowing from all the radiation she's pumped into me and my hair is falling out. I noticed that she stepped outside the room each time she flipped the switch, so she's safe, but I wonder just how long do I have before I die of brain cancer? ** Captain Infinity Next Wednesday afternoon at 4:35 pm.  Signature/ Amatus / > So I'm at the dentist's office for a cleaning, and the tech says she > needs current X-rays. She takes, I dunno, maybe three or four on each [quoted text clipped - 15 lines] > ** > Captain Infinity On May 29, 3:28 pm, Captain Infinity <Infin...@captaininfinity.us> wrote: > So I'm at the dentist's office for a cleaning, and the tech says she > needs current X-rays. She takes, I dunno, maybe three or four on each [quoted text clipped - 15 lines] > ** > Captain Infinity please send the photos of your deterioration >but I >> wonder just how long do I have before I die of brain cancer? [quoted text clipped - 3 lines] > >please send the photos of your deterioration http://news.bbc.co.uk/2/hi/europe/940751.stm > On May 29, 3:28 pm, Captain Infinity <Infin...@captaininfinity.us> > wrote: [quoted text clipped - 19 lines] > > please send the photos of your deterioration Hey, Charlie! Steve >So I'm at the dentist's office for a cleaning, and the tech says she >needs current X-rays. She takes, I dunno, maybe three or four on each [quoted text clipped - 12 lines] >outside the room each time she flipped the switch, so she's safe, but I >wonder just how long do I have before I die of brain cancer? I'm not a dentist, but I think you have a legitimate concern. According to an article I read last year, NO amount of x-ray is completely safe; that is, any amount causes some damage and could contribute to causing cancer. I have found that since dentists started using these super low level xray machines, they seem to not be as careful about getting the 1st one right, and so they end up taking 2 or 3 (or 8 or 10...) instead of getting it right the first time. I find this unprofessional and think they should take time to get it right the first time, regardless of whether they think xrays are no longer at dangerous levels. But some of us believe - and some scientific evidence supports this (I can look it up if you want) - that ANY xray still has danger to it, and no one should be exposed to more than is absolutely necessary. So I really wish the dentists and/or technicians would make more effort (or be trained better?) to get these things right the first time. On May 29, 12:28 pm, Captain Infinity <Infin...@captaininfinity.us> wrote: > By now, of course, my teeth are glowing from all the radiation she's > pumped into me and my hair is falling out. I noticed that she stepped > outside the room each time she flipped the switch, so she's safe, but I > wonder just how long do I have before I die of brain cancer? I want to see those glowing teeth ! Kidding aside, I do think that American dentists are somewhat careless when it comes to taking x-rays. The fact that you get a lead vest and they hide in a nearby room should be a hint that this is not a harmless procedure. I know in Germany patients get a kind of scoresheet that contains dates of xrays taken to avoid over exposure when going to different doctors. I have been seeing a number of dentists recently and there seems to be a standard procedure of getting a full set of xrays no matter what. When I asked the tech whether this was necessary and she conferred with the dentist the response was No and we skipped xrays until after a visual inspection indicated that they would be helpful. Also if you need to go to a specialist you can ask your dentist for a copy of your current xrays- sometimes they'll give them to you right away, others are more reluctant to part with the photos the patient paid for. > On May 29, 12:28 pm, Captain Infinity <Infin...@captaininfinity.us> > wrote: [quoted text clipped - 10 lines] > scoresheet that contains dates of xrays taken to avoid over exposure > when going to different doctors. I have no objection to a patient knowing their x-ray exposure. But is this really useful in terms of determining whether a patient gets a PARTICULAR exposure or not? There are public health policies on the age at which women begin getting mammograms. These policies are supposed to balance benefit with risk. In the dental office, the number and frequency of exposures should be based on perceived need. No, I don't take x-rays (let alone a full series) on every patient for every recall. It's a bit silly to have a fixed radiographic frequency for (for example) a patient with rampant root caries on the one hand, and a 60-year old periodontally healthy patient who has never had a cavity--don't you think? Yes, there are dentists who IMO overdo the x-rays, but I wouldn't tar all American dentists with that brush. Steve > I have been seeing a number of dentists recently and there seems to be > a standard procedure of getting a full set of xrays no matter what. [quoted text clipped - 4 lines] > current xrays- sometimes they'll give them to you right away, others > are more reluctant to part with the photos the patient paid for. SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 On May 29, 3:28 pm, Captain Infinity <Infin...@captaininfinity.us> wrote: > By now, of course, my teeth are glowing from all the radiation she's > pumped into me and my hair is falling out. I noticed that she stepped > outside the room each time she flipped the switch, so she's safe, but I > wonder just how long do I have before I die of brain cancer? Rule of thumb : Exposure to 19 dental xrays = 12 hours from being under the sun Exposure to 1 panoramic xray = ~ 3 hrs from being under the sun It can't be any worse than the radiation you're getting from airplane flights at high altitudes. > Rule of thumb : > > Exposure to 19 dental xrays = 12 hours from being under the sun > > Exposure to 1 panoramic xray = ~ 3 hrs from being under the sun Seems a pretty arbitrary description to me. What sun exposure...at the north pole? equator? partly sunny day? at 9am or 2pm? And what speed film...D? E? F? An informed patient would laugh at this comparison. Please cite this reference. John >> Rule of thumb : >> [quoted text clipped - 8 lines] > > John I agree. Also not a meaningful comparison with regard to exposure of particular radiosensitive tissues (eg. thyroid) even assuming some figure for whole body dose could be given. Steve > > Rule of thumb : > [quoted text clipped - 8 lines] > > John I learned it a while back in dental school. At the moment, I don't have the references to the info given above. But, this site substantiates my claims about radiation from dental xrays being equivalent to radiation from sun exposure and/or airplane flights : http://www.goaskalice.columbia.edu/1393.html > > > Rule of thumb : > > [quoted text clipped - 15 lines] > xrays being equivalent to radiation from sun exposure and/or airplane > flights : http://www.goaskalice.columbia.edu/1393.html Maybe "these guys" might have a more "precise" idea... ;-) http://www.aaomr.org/omfr_career.php Webby > Maybe "these guys" might have a more "precise" idea... ;-) > > http://www.aaomr.org/omfr_career.php > > Webby- > If you want "precise", you should look up the chapter in radiation biology in Oral Radiology, written by White. The book explains how the environment of a cell and xray techniques affects irradiation outcomes. But one particular dental school in the US had its radiologist teach his students to use the sunlight/flight example for their lay patients. It's not my job to convince anyone on usenet and, hence, never prepared any specific references. > > Maybe "these guys" might have a more "precise" idea... ;-) > > [quoted text clipped - 11 lines] > patients. It's not my job to convince anyone on usenet and, hence, > never prepared any specific references. I've heard the explanation many times. I've read the explanation many times here in smd over the years. However, it isn't often that you actually know of someone or meet someone who is actually "at high risk of developing radiation caused illness" because of exposure to diagnostic radiation related to oral maxillofacial iatrogenic illness/injury. I am one of those rare people in that rare predicament. And the university-people were the ones to make the determination. ... for what it's worth, Webby >> Maybe "these guys" might have a more "precise" idea... ;-) >> [quoted text clipped - 11 lines] >patients. It's not my job to convince anyone on usenet and, hence, >never prepared any specific references. But... In SMD this is not considered good form. Us regs like to have something a little more solid to go on than analogy. >>> Maybe "these guys" might have a more "precise" idea... ;-) >>> [quoted text clipped - 17 lines] > Us regs like to have something a little more solid > to go on than analogy. I found radiation hygiene to actually be a surprisingly fascinating field for literature study. I did a literature review for this during my residency. Unfortunately, lost all the monographs from an agency that published widely on specific issues. Even photoemulsion films are responsible for a much lower dose than they were. Not only are they faster, but the old low kV machines have been outlawed. I'm old enough to have had one of those old black Phillips Oralix machines with the pointy cone. It was a 40 kV machine--obviously no longer acceptable. It was a workhorse though. Many of those old comparisons between diagnostic radiation and background radiation I believe were liberally inferred from data collected from where most of it was collected in the postwar years--survivors of Hiroshima and Nagasaki. Problem is we don't have uniform body doses, and some phenomena of radiation effects are tough to translate. For example, there are threshold and non-threshold effects. IIRC, cataract formation is a threshold effect; it requires single or multiple exposures individually above a certain dose. Leukemogenesis is believed to be a NON-threshold effect--there is no "safe dose" as such--the higher the dose, the higher the risk. This is analogous to actinic radiation and skin cancer, where basal cell and squamous cell cancers tend to correlate with chronic overexposure to the sun; melanomas in some studies correlate to single very severe burns. Steve > Problem is we don't have uniform body doses, and some phenomena of radiation > effects are tough to translate. Exactly true. Older dental x-ray equipment can deliver a rather high local dose (>1 REM as I recall). Any attempt to translate a local dose into an "equivalent" whole-body dose has always seemed silly to me because the exposure (and the potential damage) are concentrated in a relatively small part of the body and have little to do with the unexposed part of the body. For example: Try explaining to the accident victim who had a tooth knocked out that "on a whole body basis" the blow he took was actually negligible and he needn't be concerned. Additionally, attempts to translate the radiation dose away from actual units and into something like "Sunshine Units" is simply substituting public relations for science. In my opinion, that is always a terrible trade. Vaughn On May 31, 11:53 am, seagate1...@hotmail.com wrote: > On May 29, 3:28 pm, Captain Infinity <Infin...@captaininfinity.us> > wrote: [quoted text clipped - 9 lines] > > Exposure to 1 panoramic xray = ~ 3 hrs from being under the sun If you really think about, and realizing the analogy between sun radiation and x-rays getting a little dental radiation could actually prevent harm. For example someone with a sun-tan is far less likely to suffer further radiation damage from the Sun. For example someone with a sun-tan is far less likely to suffer > further radiation damage from the Sun. Less likely to get a burn, but that doesn't mean there is such a thing as a 'healthy tan'. ;-) Steve >On May 31, 11:53 am, seagate1...@hotmail.com wrote: >> On May 29, 3:28 pm, Captain Infinity <Infin...@captaininfinity.us> [quoted text clipped - 16 lines] >harm. For example someone with a sun-tan is far less likely to suffer >further radiation damage from the Sun. Ridiculous. Newsflash, our star emits X-ray radiation. Someone who regularly sun-tans is at a greater risk for skin problems including skin cancer. Radiation dosage is cumulative throughout life. Interesting discussion - I hope you all agree that the xray technician or dentist taking the xrays should be careful and not make mistakes so that xrays have to be re-done, exposing the patient to more xrays than should be necessary. Yes, of course, mistakes will happen, and it's not always easy to get the correct angle, etc.. But I've just noticed dentists making mistakes on these routinely, as if it doesn't matter, and that is what irks me. >>On May 31, 11:53 am, seagate1...@hotmail.com wrote: >>> On May 29, 3:28 pm, Captain Infinity <Infin...@captaininfinity.us> [quoted text clipped - 25 lines] > >Radiation dosage is cumulative throughout life. |
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