Concerns About Full Mouth X-rays and Head Radiation Exposure Risks - Radiology

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The impact of a full-mouth X-ray on the head?


During a dental appointment two years ago, before the dentist examined me, the dental assistant requested to take a full-mouth X-ray for the dentist's future reference.
However, it seemed that the assistant was either not skilled in adjusting the equipment or there was a malfunction.
While the machine was rotating to take the images, it unexpectedly made contact with my right cheek, resulting in a blurred full-mouth X-ray.
Recently, I have read some reports indicating that X-rays should not be used unless necessary, especially for the head, which has made me quite concerned.

Could you please clarify whether the contact of the full-mouth X-ray with my right cheek means that the X-ray was continuously directed at my right face at a very close distance? Am I at an increased risk of cancer due to this incident? This situation worries me greatly, especially considering the inexperience of the assistant.
I am also concerned that she might have adjusted the X-ray dosage too high or too strong.
Should I return to the clinic to confirm this or to understand which areas were exposed to excessive X-ray radiation? Thank you!

Yin Yin, 20~29 year old female. Ask Date: 2014/10/02

Dr. Yang Jinghua reply Radiology


Dear Yin-Yin,
Hello.
According to the regulatory authority for medical ionizing radiation devices in Taiwan (Atomic Energy Council), it is important to pay attention to radiation safety when using dental X-ray machines, and approval must be obtained from the Atomic Energy Council.
Dentists may recommend dental X-ray examinations when necessary.
Dental diagnostic X-ray examinations involve fixed exposure methods and only expose a small portion of the body, combined with a low dose; for instance, the dose for a full mouth dental X-ray is approximately 10 microsieverts, which is about half the dose of a chest X-ray.
Therefore, the effects of radiation on the human body can be considered minimal.
During a dental X-ray examination, patients can also wear lead aprons to reduce unnecessary radiation exposure.

I am uncertain about the status of your equipment at that time; generally, if there is an operational issue, the X-ray output will typically stop.
If you have further questions, please feel free to contact us again.
Wishing you safety and health.
Sincerely,
Yang Ching-Hua
Director, Department of Radiology
Taoyuan General Hospital, Ministry of Health and Welfare

Reply Date: 2014/10/02

More Info


Your concerns regarding the exposure to radiation during a full mouth X-ray, especially after an incident where the X-ray machine malfunctioned, are completely valid. It's important to understand the risks associated with X-ray imaging, particularly in dental and cranial applications, and how they relate to your specific situation.

Firstly, let's clarify how X-ray imaging works. X-rays are a form of ionizing radiation that can penetrate the body to create images of internal structures. In dental practices, full mouth X-rays (also known as panoramic X-rays) are typically used to provide a comprehensive view of the teeth, jaw, and surrounding structures. The radiation dose from a full mouth X-ray is relatively low, approximately 10 microsieverts (µSv), which is about half the dose of a standard chest X-ray.

Regarding your specific incident where the X-ray machine may have malfunctioned and exposed your right cheek, it's crucial to note that the radiation emitted during an X-ray is generally directed towards the area of interest. If the machine was not functioning correctly, it could have resulted in unintended exposure. However, the amount of radiation that would have been directed at your cheek would still be within a low range, and the risk of developing cancer from such exposure is minimal.

The International Commission on Radiological Protection (ICRP) states that doses below 100 millisieverts (mSv) are unlikely to cause any significant health effects. To put this into perspective, the cumulative dose you might receive from multiple dental X-rays over a lifetime is still significantly lower than the doses associated with increased cancer risk. For example, the average person is exposed to about 2.4 mSv of background radiation annually from natural sources.

Your concern about the potential for increased cancer risk due to the incident is understandable, but it’s important to remember that the risk from a single or even a few dental X-rays is extremely low. The potential for harm increases with higher doses and repeated exposure over time, but dental X-rays are designed to minimize exposure as much as possible.

If you are worried about the specific exposure to your right cheek, it may be beneficial to discuss this with your dentist or the radiology department. They can provide you with information on the specific settings used during your X-ray and whether any additional measures were taken to protect you, such as lead aprons or thyroid collars, which are standard practice to minimize unnecessary exposure.

In summary, while your concerns are valid, the risk associated with dental X-rays, even in the case of a malfunction, is generally low. If you have ongoing concerns about your health or the exposure you received, it would be wise to consult with a healthcare professional who can provide personalized advice based on your medical history and the specifics of your situation. Regular dental check-ups and open communication with your dental care provider are essential for maintaining your oral health and addressing any concerns you may have about procedures like X-rays.

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