American Dental Association Says Lead Aprons No Longer Needed During X-Rays

A panel of experts deemed the aprons unnecessary and said the aprons can prevent dentists from getting required imaging, potentially leading to more X-rays.
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Lead aprons are no longer required during dental X-rays, according to the American Dental Association (ADA). The new recommendations, published in the Journal of the American Dental Association, are the first update in more than a decade and seek to improve radiation protection and clinical outcomes for patients.

In establishing the new guidelines, an expert panel reviewed 95 pertinent articles, guidance documents, and regulations.

The new recommendations are supported by medical physicists from the U.S. Food and Drug Administration (FDA) and the American Academy of Oral and Maxillofacial Radiology. The panel determined that lead aprons and thyroid collars aren’t necessary to shield patients from radiation.

The recommendations are for all patients, including pregnant women, regardless of age or health status. According to the panel, modern digital X-ray equipment can restrict the X-ray beam to the size of the area needing to be imaged. Additionally, lead aprons or collars can prevent dentists from getting the required image.

“When this happens, more radiographs need to be taken, and unnecessary X-rays are what we want to avoid,” Dr. Purnima Kumar, professor of dentistry and chair of the Department of Periodontology and Oral Medicine at the University of Michigan School of Dentistry and chair of the ADA Council on Scientific Affairs, said in a statement.

“The central point of these recommendations is that clinicians should order radiographs in moderation to minimize both patients’ and dental professionals’ exposure to ionizing radiation.”

Recommendations to Prevent Radiation Exposure

Radiation exposure can have adverse health effects, including tissue reactions and random effects, the panel wrote. According to the World Health Organization (WHO), the extent of potential damage to tissues or organs depends on several factors, including the type of radiation, the sensitivity of the affected tissues and organs, the route and duration of exposure, and the overall health of the individual exposed. Acute health effects include nausea and vomiting, skin redness, hair loss, radiation burns, or death. Long-term effects include the development of certain cancers, including thyroid cancer.

X-ray radiation, known as ionizing radiation, is no different.

“When X-ray radiation is absorbed within our bodies, it can damage molecular structures and potentially cause harm,” according to the University of California–San Francisco. “Very high doses of radiation cause damage to human cells, as evidenced by skin burns, loss of hair, and increased incidence of cancer. Because high doses of radiation can cause cancer, it is therefore generally assumed that low doses may also cause cancer.”
The ADA acknowledges that ionizing radiation is a known carcinogen, and the FDA notes that it can harm a person’s DNA. To reduce cancer and other health risks, the ADA’s new recommendations suggest dentists:
  • Use digital X-ray film for imaging instead of conventional.
  • Limit beam size during an X-ray exam to the area needing examining.
  • Position patients properly.
  • Adhere to all federal, state, and local radiation safety regulations.
  • Order X-rays to maximize diagnostic information and use past imaging whenever possible.
  • Use cone-beam computed tomography only when lower-exposure options will not suffice.
The FDA emphasizes that patients should understand the risks associated with X-rays. Patients can make the best decisions about their health by asking the dentist about the radiation dose and if the facility is accredited.

Dr. Kumar said, “We encourage dentists and their teams to review these best-practice recommendations, comply with radiation protection regulations, and talk with their patients about any questions or concerns before ordering dental imaging.”

A.C. Dahnke
Author
A.C. Dahnke is a freelance writer and editor residing in California. She has covered community journalism and health care news for nearly a decade, winning a California Newspaper Publishers Award for her work.
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