Impact of Dental X-rays on Radiology Staff: Safety Concerns for Pregnant Nurses

Will dental X-rays affect AP personnel?

Hello Dr.
Wu, I have a few questions I would like to ask you.
I am a nurse working in the dental department of a regional teaching hospital, and there is a possibility that I may become pregnant soon.
However, I have not received clear answers from the dental specialists regarding X-ray concerns, so I would like to inquire from the radiology perspective.
Please help clarify the following:
1.
When we take dental X-rays (such as bitewings, panoramic, or cephalometric images) every day, even if we are outside the room, would being in the AP (anterior-posterior) position still pose a risk? If I want to stand in a safer position, should I stand in the middle of the doorway or near the doorknob, or does it not matter?
2.
Is the radiation dose from dental X-rays very low? If there is a possibility of exposure (in case of any loss) before confirming the pregnancy, could it cause teratogenic effects? Would it affect the baby's intelligence or increase the risk of congenital diseases (e.g., leukemia)?
3.
The hospital provides us with dosimeter badges, which we return to the radiology department for monthly testing.
If the results consistently show a "B" level, does this indicate that we are completely safe and have not been exposed to X-rays, or does it mean we have absorbed a minimal amount that is within acceptable limits?

Qiao Yun, 20~29 year old female. Ask Date: 2004/12/07

Dr. Wu Bin'an reply Radiology

Dear user, due to various factors, I apologize for the delayed response.
Here are the answers to your questions:
1.
Based on your current work situation at a regional teaching hospital, radiation protection personnel conduct strict radiation monitoring annually, so radiation safety should not be an issue.

2.
Regardless of whether it is a dental X-ray (such as a periapical, panoramic, or cephalometric film), as long as you are outside the room, any location should be safe.
If you are still concerned, you can ask the hospital's radiology department to personally measure the radiation dose with their detection instruments.
Generally, there should be no radiation leakage outside the door, in the middle of the hallway, or at any other external locations.
3.
The radiation dose from dental X-rays is very low.
If the staff follows proper radiation safety protocols, they will absorb almost no radiation dose.
4.
The occupational exposure dose limits for radiation workers are as follows: (1) The effective equivalent dose over any continuous five-year period must not exceed 100 millisieverts, and the effective equivalent dose in any single year must not exceed 50 millisieverts.
(2) The equivalent dose to the lens of the eye in one year must not exceed 150 millisieverts.
(3) The equivalent dose to the skin or extremities in one year must not exceed 500 millisieverts.
5.
If a woman of childbearing age is to undergo X-ray examination of the pelvic region or use radioactive isotopes, the physician must first inquire whether she could be pregnant.
If the possibility of pregnancy cannot be ruled out, the physician should ask whether her last menstrual period was delayed and record the results for assessment and management.
The only potential impact of radiological diagnosis on the fetus may be a slight increase in cancer risk.
Because the radiation dose from diagnostic imaging is very low, it does not cause other radiation-related injuries such as growth retardation, malformations, death, severe intellectual disability, or genetic effects.
According to research literature, when pregnant women receive radiation exposure with a cumulative dose of less than 50 millisieverts (for example, a chest X-ray typically delivers about 0.2 millisieverts), the risks of congenital abnormalities, growth retardation, or miscarriage are similar to those of pregnant women who have not been exposed to radiation.
The likelihood of accumulating a dose of 50 millisieverts from current X-ray examinations is quite low.
If radiation is necessary due to illness, you can ask your physician or radiologic technologist for appropriate protection to ensure the health and safety of the fetus.
Therefore, if you are pregnant, the risk mentioned above is negligible, almost zero.
6.
The TLD badge you referred to as "B" grade indicates that the dose received during this period is below the minimum measurable value, which is close to natural background radiation levels.
A TLD reading of 0 can occur for two reasons: (1) The background badge must be kept away from radiation work areas; otherwise, the dose recorded by the background badge will be higher.
(2) Effective protection measures were implemented, resulting in no dose received by the personnel.
Dr.
Wu Bin-An

Reply Date: 2004/12/07

More Info

The concerns regarding the impact of dental X-rays on radiology staff, particularly for those who may be pregnant, are valid and important. As a nurse working in a dental department, it is crucial to understand the safety protocols and the potential risks associated with exposure to radiation from X-ray procedures.

1. Positioning During X-ray Procedures: When assisting in dental X-ray procedures, it is essential to minimize exposure to radiation. Even if you are outside the room, there can be some level of exposure depending on the type of X-ray being taken. The safest position is indeed to stand behind a protective barrier or in a location that is as far away from the X-ray source as possible. Standing in the middle of the doorway or near the doorknob may still expose you to some radiation, albeit minimal. If possible, consult with your radiology department to assess the specific layout and radiation safety measures in place. They may have recommendations on the safest positions during X-ray procedures.

2. Radiation Dose from Dental X-rays: The radiation dose from dental X-rays is generally very low. For instance, a typical dental X-ray might deliver a dose of around 0.005 mSv, while a panoramic X-ray could be approximately 0.65 mGy. Research indicates that the risk of teratogenic effects (birth defects) or significant impacts on fetal development from such low doses is minimal. Studies have shown that if the cumulative radiation dose to a pregnant woman is below 50 mSv, the risks of congenital abnormalities or miscarriage are comparable to those of unexposed women. Therefore, the likelihood of X-ray exposure causing issues such as congenital disabilities or affecting the baby's intelligence is extremely low, especially if proper precautions are taken.

3. Monitoring Radiation Exposure: The use of dosimetry badges (TLDs) to monitor radiation exposure is a standard practice in healthcare settings. If your badge indicates a "B" level, this typically means that your exposure is below the minimum measurable level, which is close to natural background radiation. This suggests that you are not receiving significant radiation exposure during your work. It is important to continue wearing your dosimeter and to follow any additional safety protocols provided by your institution.

In summary, while there are inherent risks associated with radiation exposure, the levels encountered during routine dental X-ray procedures are generally considered safe, especially with proper protective measures in place. If you are pregnant or planning to become pregnant, it is advisable to discuss your concerns with your healthcare provider and your institution's radiation safety officer. They can provide personalized guidance and ensure that you are taking all necessary precautions to protect both yourself and your future child. Regular monitoring of radiation exposure and adherence to safety protocols will help mitigate any potential risks associated with your work environment.

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