Link found between dental x-rays and brain tumour

A new study says the more bitewing X-rays you have, the greater your risk of a tumour.

A new study in the American Cancer Society’s journal Cancer which suggests links between dental radiographs and one of the most common types of brain tumours, meningioma, made news headlines this week, but dental associations both here and in the US have moved to quell any fears patients may have.

The Australian Dental Association commented on reports of the study, saying it is important to note that dental technology has improved markedly over the years, significantly decreasing the risk to patients today. The ADA added that present day dental radiograph films are much faster, and require less radiation exposure, while digital radiographs reduce exposure by up to 80-90 per cent compared to conventional film.

“It is likely that most of the patients in the study received their exposure to dental radiation many decades ago, when exposure was likely to be much higher,” the ADA said.

That echoes comments made by Dr. Elizabeth Claus, the study’s lead author and a professor at the Yale School of Medicine in New Haven, Connecticut, to Reuters news agency.

For her study, Claus’ team recruited 1,433 people diagnosed with intracranial meningioma between May 2006 and April 2011.  For comparison, the researchers also followed 1,350 people who were similar in age, sex and state of residence as the study group, but who had not been diagnosed with a tumor.

The study looked at how often people had three different types of dental X-rays: a bitewing, full-mouth and panorex films, respectively. The researchers found that those diagnosed with meningiomas were more than twice as likely as the comparison group to report ever having had bitewing images taken.

And regardless of the age when the bitewings were taken, those who had them yearly or more frequently were at between 40 percent and 90 percent higher risk at all ages to be diagnosed with a brain tumor.

Panoramic X-rays taken at a young age, especially if done yearly or more often before age 10, also raised the risk of meningiomas by up to five times, Reuters reported.

There was no association between full-mouth X-rays and the tumors, although the authors note they saw a trend similar to that seen for the bitewing X-rays. That lack of association made the connection questionable, according to Dr. Alan Lurie, president of the American Academy of Oral and Maxillofacial Radiology.

“They found a small risk (from) a pair of bitewings, but not a full mouth series, which is multiple bitewings. That inconsistency is impossible to understand to me,” he told Reuters.

Lurie also echoed Claus’ caution that radiation levels from dental X-rays when some of the participants were younger was much greater than is used now.

The Australian Radiation Protection and Nuclear Safety Agency’s Code of Practice and Safety Guide Radiation Protection in Dentistry establishes the responsibilities of those involved in dental radiology, and lays down requirements for equip and siting, image receptors and film and processing, and procedures to minimize exposure to ionizing radiation.


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  1. X-ray hygiene remains the traditional balance between risk and benefit. If radiographs are merely a means to by-pass adequate visual examination enhanced by magnification then there is an unacceptable risk. Lowered caries risk allows reduced reliance on radiographs and disallows routine usage without awareness of the risk no matter how slight.

  2. What amount of radiation is experienced in bi annual Bitewing radiographs is surely negligible when compared to Electromagnetic radiation from mobile phone use and other such devices.
    It would be interesting if this study cross referenced who had been exposed to mobile phones and who had not before pointing the finger and sensationalising the possible harm from a very a efficient diagnostic tool.
    However it does highlight the strong necessity to always practice ALARA principles, and the importance of getting it right the first time every time.


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