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Study Links Dental X-rays, Risk Of Brain Tumor

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How often does your dentist routinely X-ray your teeth? Mine did it annually—until I told him to stop.

At first, I declined because I went through a period without health insurance and didn’t want to pay for anything that wasn’t absolutely necessary, especially at the higher prices charged to the uninsured. As I became more aware of the risks of radiation exposure, I continued to say no to bitewing X-rays, even after I regained insurance coverage.

Now comes a study, published online earlier this week in Cancer (and freely available), that links dental X-rays to meningioma, the most commonly diagnosed primary brain tumor—usually, but not always, benign. The study concludes:

Our findings suggest that dental X-rays, particularly when obtained frequently and at a young age, may be associated with an increased risk of intracranial meningioma, at least for the dosing received by our study participants.

The qualifier about the dosing stems from the fact that some of the participants had received higher radiation exposures than are now used for dental X-rays.

For adults with no symptoms and no elevated risk of tooth decay, the American Dental Association recommends bitewing X-rays every two to three years. The association’s most recent (2006) “update and recommendations” regarding X-rays say, “There is little evidence to support radiographic exposure of all dentulous areas of the oral cavity in search of occult pathoses in the asymptomatic patient.”

Elizabeth B. Claus, MD, PhD, lead author of the study, said, “The study presents an ideal opportunity in public health to increase awareness regarding the optimal use of dental X-rays, which unlike many risk factors is modifiable.” Dr. Claus,  of the Yale School of Medicine and Brigham and Women’s Hospital in Boston, was quoted in a news release about the study.

“Widespread dissemination of this information allows for increased dialogue between patients and their health-care providers,” she said.

My side of the dialogue with my dentist regarding bitewing X-rays of my teeth is going to continue to be “no, thanks,” unless my dentist has something specific he wants to check. I’m sure he means well. But it’s my mouth. If my decision means a delay in detecting a cavity, I’m OK with taking that risk. There are other risks I’d prefer to minimize.

Related seminar: UCSF Radiology Review: Clinical Highlights (just released)

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