A recent article in the New York Times casts doubt and raises unnecessary fears about the need and safety of dental X-rays.
The highly publicized article by author Austin Frakt, “You Probably Don’t Need Dental X-Rays Every Year,” is in fact a biased hit piece on the dental profession by someone with no medical background and an obvious agenda.
Like most dissemination of misinformation, there is some truth scattered within the narrative to attempt to give the appearance of balance and credibility. Even so, the overall message is that dentists are willing to risk a person’s health for financial gain and the “smart” thing to do is to refuse dental x-rays due to their inappropriate use.
In his article, Frakt quotes the American Dental Association (ADA), “Adults without apparent dental problems do not need dental X-rays of any kind every year, the A.D.A. says. Adults who properly care for their teeth and have no symptoms of oral disease or cavities can go two to three years between bite-wing X-rays, according to the A.D.A." Frakt goes on to summarize an ADA position paper on the subject.
Dental X-rays help dentists see cavities and bone levels between teeth, the condition of fillings, impacted teeth, cysts, tumors, and many other things that can not be detected by a hands-on examination. Where Frakt shows his bias is that he leaves out the most important component, which is the dentist’s judgment and experience as to when, if, and how frequently dental x-rays are needed for each individual patient.
Frakt also quotes Dr. Jay W. Friedman, a dentist who believes that “Many patients of all ages receive bite-wing X-rays far more frequently than necessary or recommended.” This, of course, is impossible to know, because every situation is different and every dentist makes thousands of individual decisions regarding the need for bite-wing as well as other X-rays each year.
Even so, dentists are very concerned about minimizing the amount of radiation a patient receives at the dental office. That’s why we use special high-speed film, can use digital X-rays, and cover patients with a lead apron during X-ray procedures.
Even though Frakt admits the extremely low level of radiation in dental X-rays, he still raises the specter of the supposed increase risk of the brain tumor meningioma from those who have received dental X-rays.
He conveniently leaves out that meningioma is usually benign and tries to back up his incendiary claims with flawed studies based on the patient’s own memory of how many X-rays they had, not their actual dental records.
Frakt’s assertion that dentists are taking X-rays to “double their revenue” apparently without regard to a patient’s health is outrageous. Dental x-rays are a minor source of revenue, but extremely important for dental health. In fact, you could more easily argue the opposite point of view.
By avoiding X-rays, a small cavity that is hidden between the teeth could get deeper and by the time a patient feels any symptoms, the tooth could require a root canal and crown or an extraction and dental implant, procedures that easily cost ten times more. These procedures can often be avoided by a safe, timely, and inexpensive x-ray.