Dental X-Rays and Cone-beam CT scans

I brought my daughter to the hygienist yesterday and the dentist recommended a panaramic x-ray. It’s an x-ray where the machine moves all around your head. I had read a report about panoramic x-rays being dangerous. I mentioned to the hygienist that I didn’t want her to have it because of the amount of radiation. She then went on about how safe they are. I really don’t think a 7 year old needs an x-ray to go around her head. All because an insurance company will pay for it i’m not going to jump and get it done. When I hear them say” well your insurance will cover it”, it just annoys me. In other words it may not be necessary but someone else is covering it, so take it. I know we pay into the insurance but i’m not going to get unnecessary x-rays and procedures done just because it’s covered. Anyway, I was trying to find the emailed article I read earlier this year about the cone beam x-rays and here it is. I believe that the conebeam and the panoramic are similar that they both go around the head.

This sounds familiar…

A new technology is introduced. It’s hailed as a great leap forward. It’s embraced by the mainstream. Then a few years down the line, problems start to become apparent. Watchdogs call for greater oversight. But by then too much time and money has been invested. The new technology is here to stay.

That’s sort of how it’s shaping up with cone-beam CT scans–a revolutionary dental imaging technique.

On a website that provides information about cone beam technology (, you’ll find this bold statement at the top of the home page: “CBCT FOR EVERYONE”

That’s a stunning statement. Because it’s a really REALLY bad idea.

Dangerous fun

Dentists tend to like CBCT. It creates crisp 3-D images of the jaw and teeth, including roots–very useful for complex problems like impacted teeth and braces.

And kids actually like CT scan too because of what one orthodontist calls the “wow factor.” On the computer display, kids can see their entire skull in vibrant colors.

As the orthodontist told the New York Times: “Fun for the kids.”

Fun…but dangerous.

A Times investigation reveals that this ingenious scanning method emits a massive radiation dose–much more radiation than a conventional x-ray. And it could be a huge risk for kids, because children–especially adolescents–are much more vulnerable to the effects of radiation than adults.

The enhanced detail of a CT scan image is helpful for orthodontists. But over the course of braces maintenance, patients usually get several scans. And unfortunately, scientists believe the effects of these powerful scans are cumulative. So the long-term risk of cancer is doubled after the second scan, tripled after the third, etc.

Now…here’s what’s infuriating: Orthodontists and dentists can also produce 3-D images with a digital camera that emits no radiation. But using the digital camera takes about a half-hour longer than the CT scan. And those half-hours add up, preventing orthodontists from booking higher numbers of patients each day.

Fueled by misinformation

But there’s one more detail about dental CT scans that actually goes WAY beyond infuriating. (My dentist would NOT be happy with me right now because I’m actually grinding my teeth as I write this.)

The selling of cone-beam CT technology has been outright dishonest.

In an online lecture earlier this year, a prominent 3-D technology expert who gives frequent professional presentations told attendees that the CT scan produces no more radiation than airport full-body scans.

But the director of the Center for Radiological Research at Columbia University Medical Center told the Times that such an estimate is “very wrong–by a lot.” In fact, he says CT scanners can be SEVERAL HUNDRED TIMES more powerful than those controversial airport scanners.

Unfortunately, this wildly misleading “estimate” is fairly popular.

According to the Times, a recent issue of the Journal of the American Dental Association ran a “favorable article” by an author who has stated that radiation from a CT scan is equal to–yep–an airport full-body scan.

Funny thing though: That entire JADA issue was devoted to cone-beam technology. In fact, the issue was actually underwritten by one of the leading makers of CT scanners.

Arrrgh! The dental mainstream is just as bad as the medical mainstream!

Here’s how the Times sums it up: “The cone beam’s popularity has been fueled in part by misinformation about its safety and efficacy.”

“Misinformation?” That’s a tactful way of saying what it really is: lies.

Please warn your friends and family about this travesty–especially those who have kids who may soon be headed to their first orthodontist appointment. But this warning is for everyone–not just kids. The next time your dentist needs to x-ray your teeth, ask him what technology he’s using.

If he says, “cone-beam,” tell him you don’t mind taking the extra half-hour for the digital camera–or that you’re willing to skip the special effects altogether.