Updates in Dental Radiation Procedures!

Hi, everybody. I'm Dr. Sandhya Moldovan, periodontist and nutritionist. Welcome to the Holistic Dentistry Podcast, the show that gives you the tips and tools to detoxify your mouth for a healthier body as we explore together the root cause of disease. Remember, you're not healthy until your mouth is healthy, so take care of it in the most natural way.

Welcome to today's show. I want to talk to you today about the updates in dental radiography safety recommendations that the ADA suggested earlier this year. Specifically, they actually published a paper in February 2024 in the Journal of the ADA to advocate against the use of the lead aprons that a lot of you, if you've had them on X rays, you see that they put on heavy apron on top of you that's made out of lead. And essentially it is to protect your internal organs from radiation. We also actually used to use a thyroid collar. This thyroid collar is made out of lead and it goes right around your neck in order to protect your thyroid from being exposed to radiation. The last time the ADA updated the recommendations for dental x rays was in 2012. So earlier this year, they put together a panel of experts. They looked at a total of 95 articles, documents and regulations and the way radiation really affects our body when a digital X ray is taken. And they found out actually that these thyroid collars that are made out of lead and the aprons are not really needed because radiation does not really go that low. It is interesting that it's taken this long to actually come up with these recommendations, but of course this is to be expected since it is federal regulations and usually they do take years before they come up with the right recommendations. These recommendations apply universally to everyone, whether you're a child, you're an adult, whether or not you're pregnant. Modern digital X rays and precise beam targeting are really important when it comes to taking dental X rays and ordering dental X ray. As a dentist, we have to make, however, every effort to use images from other dentists, especially if you're going for a second opinion. Let's look at this paper of optimizing radiation safety in dentistry. You can find it at the link below in the show notes, February 2024 in the Journal of the ADA. Basically, why are we concerned about radiation? Well, really, radiation as the one taken from dental X rays is ionizing radiation. And ionizing radiation is known as a carcinogen. So I know we take it lightly, right? We need, we go to the office, oh, yeah, I need dental X rays. We do have patients that are overly worried, of course, about how the radiation is impacting their body. In a 2023 report, it is estimated that 320 million density imaging procedures were conducted in the United States in 2016. That's really more than 46% of the total diagnostic imaging procedures nationwide. So radiographic imaging in the dental practice is still amongst the most common and most frequently performed in United States. Exposure to the amount of radiation can increase certain risks and especially tissue interaction. For example, if you radiate the same tissue over and over again, you can get actually radiation burns, cataracts or cellular death. However, in dentistry we use a very small amount of radiation, especially with the modern digital X rays. Unfortunately, it is not mandatory for all dentists to use digital X rays. So you will still find some dentists out there using the old film technique. In this article they actually have a table that looks at the difference between digital X rays and an F speed film, which is basically your regular film that needs to be developed. And really, let's say when you're looking at a digital bitewing, right, a small little X ray for the back, it's really anywhere from 0.3 to 1 microsievert in radiation. And actually when you look at a image with the F speed, this is up to five microsie birds of radiation. So you're talking about almost 10 times as much radiation when using regular film. But this is one of the reasons why we also changed basically the need for the lead apron. Now dental imaging exposure levels usually are well below the threshold that causes tissue reactions. However, studies have shown that cumulative low level radiation exposure can be associated with a triggering oxidative stress. We talked about oxidative stress a previous episode. So what can you do to combat oxidative stress? Let's say, you know, you're going to have a dental implant, you're going in for a cone beam CT scan. And in order to offset oxidative stress, it is important to take more antioxidants. And how. What kind of antioxidants? Definitely colorful fruits and vegetables. You can also take a dose of natural vitamin C. I Recommend Taking about 3 grams that day. That's a great antioxidant. But you can also do glutathione as an antioxidant as well as have a green juice or a combination of any of these. There's also some homeopathic remedies that help with radiation, especially to help not get absorbed in your body. And that's something that in our office at Beverly Hills Dental Health and Wellness, we actually provide for Patients. What's the problem with oxidative stress? Oxidative stress can induce damage to the cellular DNA that increases the risk for cancer, of course. But as a nutritionist I always recommend that we take a high level of antioxidants, especially in the world we live in today. We are constantly bombarded with radiation, not just from dental X rays, just from your cell phone or a computer in your lap or the WI fi in the building that you work in. So our body has to deal with a lot more oxidative stress today than to 50 years ago. Now, regarding cone beam CT scanning. A cone beam CT scan is important in biological dentistry. And that's the 3D imaging that we do in order to diagnose cavitations and infected root canals. When somebody does not have extracted teeth or does not have root canals, it is not necessary to take a cone beam CT scan. Remember, ionizing radiation is a known carcinogen. However, we have to look at do we want to diagnose properly. So in that case we need comb CT scans. We always follow this rule as low as reasonably achievable. If we can diagnose things on regular small two dimensional X rays, then we take those X rays. However, regular two dimensional X rays only allow us to see about 50% of the dental problems. That's why with a cone beam CT scans, when necessary, it allows us to diagnose much better so we can treat you better. Children and young adults are more susceptible to the effects of radiation because they're growing and their cells are growing and their organs are more sensitive to radiation. It is important to really choose how much radiation we give to a child. If your child is susceptible to cavities, and we do need those diagnostic X rays in order to see how deep the cavities are. What about the thyroid gland? The thyroid gland should be shielded with a protective collar during intraoral radiography for children. That was the old recommendation for the ada. Thyroid collars are no longer recommended with any imaging modality. The thyroid collars and abdominal shielding can introduce artifacts by blocking the primary beam, potentially resulting in additional radiographs being taken. Really, it does not really protect against the scatter radiation. Patient radiation doses can be minimized most effectively with proper use of the collimation beam and really taking just the imaging necessary for us to be able to diagnose. As dental practices continue to evolve with the use of electronic dental records, precision dental medicine, imaging equipment advancements and artificial intelligence applications, the article says we will have updated recommendations. This concept of as low as reasonably achievable was introduced in 1977, and it's really to help us minimize the radiation in dentistry. But remember, if you're going to take a dental X ray, up your antioxidants to avoid the oxidative stress that dental radiation is placed when taking any kind of dental imaging. If you have any questions or comments, go ahead and post them in our YouTube channel. Until next time. Hope this episode was helpful.

Thank you so much for joining me this week. Please make sure you check out the show notes for any links mentioned in the show. If you like today's show, please invite your friends to listen as well. That would mean a lot to me. Do you have a question you'd like me to answer? Message me on Instagram. Doctorsanda this is Dr. Sanda. And remember, your mouth is the gateway to your health, so take care of it in the most natural and best way possible.