- Patients receiving a dental X-ray are covered with a lead apron to limit radiation
- But the experts said the same dose is received with the shield as without it
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The protective gowns used at the dentist may actually do more harm than good, top experts say.
Anyone who has an X-ray taken at the dentist will be familiar with the heavy lead apron that is draped over them, which is supposed to reduce radiation exposure to other parts of their body.
But experts at Tufts University say they are no longer necessary due to the accuracy of modern X-ray machines.
The aprons could actually do more harm than good by interfering with obtaining a clear absorption from the jaw, making it necessary to try again and thus double the total dose.
Wearing a lead apron during a dental x-ray can hinder obtaining a clear view of the jaw, especially if it has a collar, necessitating a second try – doubling the total dose
Dr. Aruna Ramesh, professor of dental radiology at Tufts University School of Dental Medicine (TUSDM) in Boston, Massachusetts, said, “There is ample evidence in the scientific literature to show that the apron and thyroid collar do not provide any additional benefit.”
The American Academy of Oral and Maxillofacial Radiology (AAOMR) – which provides evidence-based recommendations to dentists and others – published new guidelines in August stating that lead aprons and thyroid shields do not need to be used routinely for dental X-rays.
Patients receive only a ‘negligible’ amount of radiation to areas away from the head from a dental X-ray through ‘internal scattering’ – where a small amount of radiation enters through the head and neck and bounces off to other parts of the body, says Dr . Ramesh said.
“The internal spread that exposes the organs below the jaw cannot be prevented with an apron,” he said.
However, you will probably still need to wear one for your next dental x-rays.
Most states have regulations mandating protective equipment during the procedure, and until these rules are changed, which should happen on a state-by-state basis, dental teams will most likely continue to use aprons and shields.
Anthony Blatnica, assistant professor of radiology at Tufts University School of Medicine, said, “If it’s not in the primary beam, you’re just dealing with internal scattering. And so external shielding makes no sense.’
If some of the coating gets into the X-ray field and obscures the anatomy, “it becomes problematic,” he said.
But some patients appreciate the level of comfort the lead apron provides, both physically (like a weighted blanket) and mentally.
Dr. Hugo Campos, associate professor and director of oral and maxillofacial radiology at TUSDM, said: ‘The lead apron plays a very important role in the psychology of our patients. They feel like you’re protecting them.’
But current X-ray techniques and technology provide adequate safeguards, he added, such as specifically targeted X-rays.
Dr. Campos said: ‘With the shield the same dose is received as without the shield – and that is extremely low.’