Radiation Exposure from Dental and Skull X-rays

What is the radiation dose of a skull X-ray?

Dear Dr.
Wu,
I have recently undergone root canal treatment and have had several dental X-rays taken (due to changing dentists multiple times, I ended up with quite a few X-rays, and some dentists did not provide lead aprons).
Additionally, because the dental issue may have spread to my nasal area, the ENT specialist requested several skull X-rays (also without a lead apron).

I would like to ask:
1.
Will having so many X-rays have any side effects?
2.
What negative effects could the radiation doses from dental X-rays and skull X-rays (without a lead apron) have on my body?
Thank you.

Zhiziko, 30~39 year old female. Ask Date: 2004/09/14

Dr. Wu Bin'an reply Radiology

Dear Naoko,
Here are the comprehensive answers to your questions:
1.
First, let me correct your terminology: the protective garment used for radiation shielding is called a "lead apron," not an "iron apron." Generally, patients are not required to wear lead aprons for X-ray examinations unless they are young children or pregnant women.
2.
The effects of radiation on the human body are as follows: Human tissues and organs are composed of numerous cells.
When exposed to high levels of radiation, cells may exhibit the following damage responses:
(1) Low-dose radiation may not affect cellular metabolism or may delay its normal cycle, and after a period, the cells can self-repair and return to normal.
Most diagnostic radiology and nuclear medicine examinations involve low-dose radiation, which poses a lower risk than smoking.
(2) High-dose short-term exposure or low-dose long-term exposure can damage cells, leading to a loss of their ability to divide and reproduce, ultimately resulting in cell death.
(3) If damaged cells divide abnormally, changes in the genetic material (DNA) of germ cells can affect offspring, and abnormal development in somatic cells may lead to tumor formation.
(4) If the energy is very high, irradiated cells may swell and rupture immediately.
3.
How many X-rays can one have in a year? Current regulations in Taiwan do not specify or limit the amount of radiation that individuals can receive from medical X-ray examinations within a year.
This is because the doses from typical X-ray examinations are very low, and the areas exposed are usually localized rather than whole-body or extensive exposures.
Additionally, low-dose radiation is not harmful to human tissues, and the benefits of early disease diagnosis through low-dose radiation outweigh the risks.
4.
For cranial (sinus) X-rays and dental X-rays, the skin dose from a single exposure is approximately 280 to 480 millirads (mR).
In fact, these radiation doses have minimal impact on the body, comparable to the radiation exposure received during frequent long-haul flights, and are considered to have almost no adverse effects, making them quite safe.
Dr.
Wu Bin-an

Reply Date: 2004/09/14

More Info

Dear Patient,
Thank you for your inquiry regarding the radiation exposure from dental and skull X-rays. It’s understandable to have concerns about the potential risks associated with multiple X-ray examinations, especially when it comes to dental procedures and head imaging. Let’s break down your questions and provide some clarity on this important topic.

1. Potential Side Effects of Multiple X-rays
The primary concern with X-ray exposure is the cumulative effect of radiation over time. However, it’s important to note that the radiation doses from dental X-rays and skull X-rays are relatively low. For instance, a typical dental X-ray exposes a patient to about 0.005 millisieverts (mSv), while a head CT scan can expose a patient to approximately 2 mSv.
According to the International Commission on Radiological Protection (ICRP), exposure levels below 100 mSv are not associated with significant health risks, including cancer. In fact, the average person is exposed to about 3 mSv of natural background radiation each year from environmental sources. Therefore, while it is prudent to minimize unnecessary radiation exposure, the doses from dental and skull X-rays, especially when performed for legitimate medical reasons, are generally considered safe.

2. Radiation Doses and Their Effects
When comparing the radiation doses from dental X-rays and skull X-rays, the amounts are quite small. As mentioned, dental X-rays are around 0.005 mSv, while a head X-ray can be around 0.1 mSv. The cumulative exposure from multiple dental X-rays and a few head X-rays may still remain well below the threshold that is considered harmful.

In terms of specific health impacts, the risk of developing cancer from such low doses of radiation is extremely low. The body has mechanisms to repair DNA damage caused by radiation, and the risk of significant adverse effects, such as cancer, is generally associated with much higher doses of radiation. For example, a single CT scan of the abdomen can deliver a dose of around 10 mSv, which is significantly higher than that of dental X-rays.

Protective Measures
While the radiation doses from dental and skull X-rays are low, it is still advisable to take precautions when possible. For dental X-rays, lead aprons are often used to protect sensitive areas, such as the thyroid and reproductive organs. If you find yourself in a situation where protective measures are not taken, it’s reasonable to discuss this with your healthcare provider. They can explain the necessity of the procedure and the precautions that should be in place.

Conclusion
In summary, while it is wise to be cautious about radiation exposure, the doses from dental and skull X-rays are generally low and considered safe when performed for necessary medical reasons. The benefits of accurate diagnosis and treatment often outweigh the risks associated with radiation exposure. If you have ongoing concerns, it may be beneficial to discuss them with your dentist or physician, who can provide personalized advice based on your medical history and the specific procedures you have undergone.

Thank you for your thoughtful questions, and I hope this information helps alleviate your concerns regarding radiation exposure from dental and skull X-rays.

Best regards,
Doctor Q&A Teams

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