Media Spin on Dental X-Rays
July 22, 2012
For the past couple of months, every dentist in the United States has had to deal (in some form or another) with the story on the front page of the Cleveland Plain Dealer newspaper entitled, “Dental X-rays Linked to Brain Tumors in Yale Study”. The story made national headlines, and why wouldn’t it with a title like that?
The reporter did publish excerpts from a meeting with ADA (American Dental Association) spokesperson Matthew J. Messina, DDS to get the dental communities’ perspective; however that was published on page A-4. As Dr. Messina explained, “Like a courtroom trial, the prosecution went first. Page 1 included the first six paragraphs of the article. The ADA’s defense was well presented, but after the ‘jump’ to page A-4. It required that a person be committed enough to understanding the story, to be willing to actually open the paper and read the article to the end. And that is one of the problems that ‘we’ will always face as a profession.”
For the rest of us who don’t live in Cleveland, or read the Cleveland Plain Dealer on-line, we got our story from the national news media. All I heard was that dental x-rays cause brain tumors. As a consumer and someone concerned about my health it raised an eyebrow. As a dentist I knew there was more to the story.
Here are the facts as presented by Dr. Messina:
How common are the brain tumors? (Six per 100,000) How did the researchers find a link between dental x-rays and brain tumors? (They asked people with brain tumors to remember how many x-rays they had over their lifetime) Is there a problem with this type of study? (Yes, it’’ called “recall bias”) Are dental x-rays different today than they were even 10 years ago? (Yes, the amount of radiation in current dental radiography is dramatically less than in years past) What should patients do with this information? (Talk to their dentist about any concerns so that their dentist can give them accurate information and reassure them)
While there is strong evidence that ionizing radiation may cause cancer, the question remains whether low doses lead to an increase in risk. Regarding dental x-rays, the effective dose is far below the yearly exposure received from natural background radiation. In the case of brain tumors, the cerebral (brain) region is not even in the primary radiation field of most dental x-rays. This was not even considered in the study.
Where do we go from here? If you are in the approximately 50% of the population that does not see a dentist on a regular basis, this information does not mean that much. If you are in the other 50% that understand that oral health means so much more than having your teeth cleaned or a tooth filled, I would recommend the ALARA rule (as low as reasonably achievable). Dental radiographs are a safe, essential and effective tool in identifying dental decay, gum disease, pathology, as well as monitoring proper growth and development.
As a society it is my hope that we are willing to move past the skimming of all the information that is available to us and ask questions when things relate to us. We (dentists) as a profession will continue to work towards educating our patients and providing the safest, most effective care.
Recent Studies You Should Be Aware Of
May 22, 2012
I have preached for years, based on the information available, that there was a direct relationship between gum disease, heart disease, stroke and other health issues. This morning I received an email from the American Dental Association (ADA) about the newest report on this subject.
A report published recently in Circulation, the journal of the American Heart Association (AHA), states that current scientific evidence does not establish a direct cause and effect relationship between gum disease and heart disease or stroke. Additionally, the evidence does not establish that gum disease increases the rate of heart disease or stroke.
The report was developed by an AHA expert committee comprised of dentists, cardiologists and infectious disease specialists. The ADA’s Council on Scientific Affairs appointed a representative to the committee that examined 537 peer-reviewed studies on the subject in order to develop the report. The CSA then reviewed the report and agreed with its conclusions.
The report acknowledges the value of good oral hygiene to maintain good overall health but noted that current scientific data does not indicate whether regular brushing and flossing or treatment of gum disease can decrease the incidence of atherosclerosis, which is the narrowing of the arteries that can lead to heart attacks and stroke.
Last week, in typical media-slanted coverage, was a study published in Cancer, a scientific journal of the American Cancer Society, associating yearly or more frequent dental X-rays with an increased risk of developing meningioma, the most commonly diagnosed brain tumor. This type of tumor is usually not malignant. The study has received widespread media coverage, and a number of the stories cite the ADA’s dental x-ray recommendations that help dentists determine how to keep radiation exposure as low as reasonably achievable.
Study participants averaged 57 years old and were asked to remember how many x-rays they received as kids before age 10. That’s a stretch for believability – remembering details from 47 or more years ago? That long ago, x-ray technology was vastly different from today. When I was a kid, I probably got 100 times more harmful radiation from x-rays than kids (or adults) today.
Statistics show about 5,000 of this type tumor diagnosed each year in the U.S. In a country of over 310 million people, 5,000 is less than .001%. And, there are almost certainly many other causes other than dental x-rays. Granted, every brain tumor is serious, particularly to the person with the tumor and his/her loved ones, and the topic must be approached appropriately.
So, what do these two recent studies mean to you as patients and “us” as dentists? To be honest, not much for most of us. The fact remains that if you have untreated or uncontrolled gum disease, which has a strong genetic component, you will lose your teeth but apparently won’t die from it. And, if you don’t go to the dentist regularly and/or refuse dental x-rays at appropriate intervals, you put yourself and your dentist at significant risk.
Studies like these are important for the progression in any area of our society. However, it is important to look at the big picture. Teeth are important and good dental health greatly increases the quality of life. Just ask the patient I saw last Sunday for an emergency extraction after days of excruciating pain having not been to a dentist in a few years.
Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@dentalhealthforlife.com. You can view all previously written columns at www.dentalhealthforlife.com.
