Thursday, April 12, 2012

Current View of Dental Xrays and Brain Tumors

One can always find a dental topic in the media today, and the latest one comes out of Yale University School of Medicine and Boston's Brigham and Women's Hospital.  The title of the report is "Dental X-rays Linked to Brain Tumors".  Our office has had questions regarding the findings and I will try to lend some insight.

There have been several "loose" studies completed in the past on this very subject.  What I mean by "loose" describes a very small number of test group people or a test resulting in somewhat inconclusive data.  This latest report has a much larger testing group and defines it's results with recommendations that can be considered by most dental offices.

I do not consider all reports nor all recommendations found in their respective journals to have practical worthiness just because they are published.  For instance, the "amalgam wars" have been going on since this material was introduced over a hundred years ago with recommendations for it's use and non-use from each camp.  I used dental amalgam (silver filling) material probably in the first 10-12 years of my practice.  When composite (tooth colored, bonded filling) materials were introduced, I did not immediately embrace the technology.  I allowed others to embrace the technology and then read their submitted reviews positive or negative, and made clinical decisions based on current literature and these reviews by my peers.  I try to stay and year or two behind the "cutting edge".  I do this in my dental philosophy and I do it with my iPhone/iPad, etc. (excitement technology) as well!

With the current report, it has validity to me due to it's structure and objectivity, and because of this, it makes recommendations that can be taken to heart by dental practitioners.  The recommendations suggested is for x-rays on a periodic average of 2-3 years for adult patients with other recommendations for kids, special needs and geriatric folks.  In my opinion based on 30 years chairside, I do not embrace 3 years at all.  Two years would be the extent of my comfort zone and individual clinical indications, medication use and type, habits or lack thereof would dictate radiography on an as-needed basis.  For instance, there are so many people taking meds today that have dry mouth as a symptom. Dry mouth means cavities.  Period.  Or folks with an unapologetic soft drink habit or "sweet" habit need to be radiographically examined every time they are routinely seen.  Changes occur so fast in these type of cases that it is almost inexcusable to not know exactly what is happening with these folks.  The consequences of inattention can be sudden, intense and disasterous.

What I hope will not happen but that I anticipate will be a debating point are folks who will take this report as a reason to not take needed, appropriately suggested x-rays, much of this resistance based on financial considerations.  This can, like in most everything in life, boil down to money.  Dental radiographs cost money.  If there are any dangling financial branches out there to grab in orer to keep as much of our hard earned money in our pockets as possible, we look for reasons to grab!  I don't blame anyone for being responsible with their exchequer. As for my patients I will continue to make recommendations about x-rays or any other treatment needs based on what I would do for my own family. 

Life is a daily learning forum and I love what modern dentistry can offer patients today.  I learned from this report and encourage everyone to take all information out there from their individual dentists and the media, mull over what is being said and proposed, and make decisions based on knowledge and trust.

Someone smarter than I wrote the following:

     There is a price to pay for education.....
          There is a price to pay for ignorance.

     There is a price to pay for good health.....
          And there is a price for sickness and disease.

     There is a price to pay for attending to relationships.....
          And a price to pay for neglecting them.

     We cannot choose whether or not we will pay.....
          We can only choose for what.

Dr. S

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