Invisible Risks of X-Rays [Are dental x-rays safe?]

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by Alvin Danenberg, DDS

“Dr. Al” Danenberg is a periodontist who was in private practice for 44 years. He received his dental degree from the Baltimore College of Dental Surgery in 1972 and his Specialty Certificate in Periodontics from the University of Maryland, School of Graduate Dentistry in 1974. He has a large number of additional certifications in the areas of nutrition and functional health. His book, Crazy-Good Living, was released in July 2017, based on ancestral nutrition and lifestyle. In September 2018, he retired from treating individual patients in an office setting. However, he still consults with patients by phone or Skype regarding nutrition, lifestyle, oral and overall health, and the importance of a healthy gut. You can also contact him here.

You can’t see them, smell them, or feel them. They’re invisible. But they can penetrate your body, accumulate over time, and damage human cells. And most importantly, they can cause cancer!

I’m referring to x-rays, which are a form of low-dose ionizing radiation.

Don’t get me wrong — X-rays are the only means for dentists and physicians to diagnose certain oral health problems as well as many medical concerns. X-rays are critical for diagnosing bone and other hard tissue damage that requires treatment sooner rather than later.

However, high radiation exposure from x-rays predisposes an individual to potential long-term risks.

Even though there are many benefits to dental and medical x-rays, you should be aware of the potential harm that ionizing radiation can do to your body.

Dental X-Rays: Types and Reasons for Use

Several basic types of intraoral x-rays and extraoral x-rays may be required to diagnose oral problems:

  • Bitewing: If your dentist has checked you for cavities, you’ve likely had a bitewing x-ray. You’ll be asked to bite down on special paper to match up your crowns and is most useful for finding interdental dental caries (cavities between your teeth).
  • Periapical: To see the whole tooth from root to crown, your dentist may use this kind of x-ray. It generally singles out a specific portion of teeth on either your upper or lower jaw.
  • Occlusal: This x-ray is good for seeing tooth placement of one entire arch. This is another x-ray used to see the placement of teeth.
  • Panoramic: These “bird’s eye view” x-rays show the full mouth in one portrait. A panoramic x-ray is used to identify how teeth are emerging, whether a tooth is impacted, and whether or not a tumor may be present.
  • Tomograms: This special type of x-ray blurs out all layers of teeth except the exact one the dentist needs to identify a specific issue.
  • Cephalometric projections: Used primarily by orthodontists, these projects examine the side of the head and how teeth are placed relative to the jaw and profile.
  • Sialography: A dentist looking for issues with salivary glands (like salivary gland blockages or Sjögren’s syndrome) may use this particular kind of x-ray using contrast dye.
  • CT scanning: Computed tomography scans aren’t necessarily common in a dental office but may be used in the hospital, are most frequently used to view bone placement and problems with facial bones (like fractures). You may need a CT if you need complex oral surgery.
  • Cone-beam computed tomography: CBCT for short, this new development in dental technology is sometimes called a 3D x-ray. This may help reveal lesions otherwise hidden on 2D x-rays, which is why it’s used for root canal patients to identify failed procedures.

Cancer in Dentists

I live in South Carolina. In my town, five dentists over the age of 60 died of glioblastomas over a six-year timeframe. The number of dentists over 60 years old practicing in SC is approximately 510.

I estimated the incidence of dentists dying from this brain cancer for this age group in SC to be 0.16% annually. The incidence of yearly deaths from glioblastomas in the general population over the age of 60 is 0.003%.

After doing the math, it turns out that the incidence of brain cancer deaths for these local dentists was 53 times more than in a similar age group of the general US population!

An obvious question one could ask is, “Why?” Why so many brain cancer deaths among dentists compared to the general population?

Is it just a genetic defect that dentists possess to cause these deaths? I don’t think so.

The science supports the fact that our environment is by far the major cause of cancer. Genetics are a factor, but our environment and lifestyle account for 70% to 90% of the development of cancer in the US.

My Cancer Diagnosis

I believe I am a living example of environmental factors causing cancer. You see, I have an aggressive form of multiple myeloma.

My cancer is incurable by conventional therapy today.

I am almost 73 years old. From a published medical study I uncovered, my current age-group of dentists has a significantly increased risk of developing cancer compared to the same age-group in the general population.

I believe this cancer of my plasma cells was both directly and partly related to my continuous exposure to dental x-rays while in dental school. While other environmental toxicities also may have been factors, the continuous toxic effects of low-dose ionizing radiation, which are cumulative, may be the most important factor leading to my cancer diagnosis in 2018.

My formal dental education lasted 4 continuous years in the early 1970s, and my graduate periodontal training was an additional 2 years.

In those days, I was in the dental clinic daily where many dental x-ray machines were in constant use by dental students. I don’t know how well I was protected from the continued use of the numerous dental x-ray machines in the clinic.

But the frequency over a long period of time could have tipped the scales allowing the formation of at least one malignant plasma cell in my bone marrow.

Low-Dose Ionizing Radiation & Cancer Risk

The medical community originally thought that high-dose ionizing radiation was the only radiation that caused permanent damage in humans.

Most of this research came from medical results after studying exposed individuals from the nuclear bomb dropped in Japan in 1945 and from the 1986 Chernobyl Nuclear disaster in Ukraine. However, newer health studies have debunked this assertion.

Current research uncovered that even low-dose amounts of radiation, with repeated exposure, could create severe long-term damage.

The important fact here is that cellular damage from recurrent low-dose exposure will accumulate — and the ultimate effects might not manifest for three or more decades from the initial exposures.

Here is another interesting fact: Individuals who survived exposure to low-dose ionizing radiation could accumulate damages that later manifested in their children.

These life-threatening cellular changes are chromosomal aberrations in cells that were both directly and not directly irradiated. It appears that complex tissue reactions cause damage to cells that are distant from the cells directly exposed.

The research that is being published today must be understood and taken to heart. Life-threatening cancers could result decades after repeated exposures.

In a 2012 paper published in Cancer, the authors reviewed people who received frequent dental x-rays in the past.

The researchers found that these individuals had an increased risk of developing brain tumors.

It was determined that some inherent risk factors for many types of cancer included varying degrees of prior radiotherapy, an unhealthy gut microbiome, a depressed immune system, and DNA susceptibility.

In another review paper published in 2018 in Environmental Health and Toxicology, the investigators concluded that there are potential cancer risks from frequent dental x-rays.

What appears to be happening to our cells from the accumulating exposure to low-dose ionizing radiation include:

  • Damage to the gut microbiome, its metabolites, and the gut epithelial barrier
  • Creation of oxidative stress and free radicals in exposed cells
  • Communication between cells through various biological modalities
  • Upregulating and downregulating cancer genes through diet and lifestyle habits
  • Transfer of DNA predispositions to our children and their children

How to Protect Your Body from X-Ray Exposure Risks

If you’re a concerned patient, don’t worry — the average person doesn’t receive daily doses of radiation likely to cause problems. However, that’s changing with technology every day, and prevention is always the best medicine.

There is no potential cure for many of the cancers caused by ionizing radiation. However, melatonin has been shown to reduce toxicity to cells that have been irradiated during cancer treatment.

I suggest that we be proactive.

For Patients

  1. Be sure your dentist or radiologist outfits you with a lead apron and thyroid collar to protect your sensitive organs from radiation exposure each time you get an x-ray.
  2. If you and your dentist have no reason to suspect tooth decay, gum disease, or other problems that require an x-ray as a diagnostic tool, ask if you can skip the x-rays at a routine checkup. Most of the time, a dentist uses an x-ray to confirm what they suspect from a physical exam (which should be performed first).
  3. If your treatment plan includes semi-regular x-ray exposure, talk to your dentist about potential risks and alternatives.
  4. Avoid direct exposure from dirty electromagnetic fields from cell phones and computer screens close to the body, the radiation dose of which has been shown to damage mitochondrial function.
  5. X-rays should be avoided for pregnant women in every case. If you suspect you’re pregnant, it’s best to make sure before even a simple dental x-ray.

For Dentists

  1. Try to avoid (and certainly reduce) any exposure to ionizing radiation which is not necessary for proper diagnosis of a medical or dental problem.
  2. Consider changing your lifestyle and nutrition so that you are helping your immune system to function at peak performance.
  3. Since cancers are also a disease of mitochondrial dysfunction, investigate methods to repair and enhance the mitochondria. These include incorporating a nutrient-dense anti-inflammatory diet, high-intensity interval exercises, fasting (intermittent and multiday), and PEMF (Pulsed ElectroMagnetic Field) Therapy.
  4. Whenever possible, switch from analog x-rays to digital x-rays in your dental practice, which result in a lower amount of radiation exposure.

FAQs

Q: Why would my dentist need to take x-rays?

A: Some factors that necessitate x-rays include symptoms of tooth decay/cavities, evidence of periodontitis (and potential bone loss), older age, or known trauma to the mouth or face.

Q: What does the ADA say about dental x-rays?

A: The American Dental Association (ADA) is confident that x-rays are safe except in cases of pregnancy. They recommend the ALARA principle (as low as reasonably achievable) is used for best results.

Q: Are dental x-rays safe for my child?

A: Sometimes, x-rays are the only good option for your child to receive the best dental treatment.

To make it as safe as possible, make sure x-rays are only used when necessary (not just as part of the routine) and make sure your dentist is using a digital x-ray. If they don’t use digital, request E-film over D-film.

You can also find out if your dentist uses a laser to detect cavities, which should put off less radiation.

The Bottom Line

Medical and dental x-rays are vital tools to determine the proper diagnosis and efficient course of treatment for many diseases and traumatic injuries. But they only should be performed when an appropriate healthcare professional has determined they would provide critical information.

You must be proactive in your healthcare decisions. Do your research, ask probing questions, then draw your conclusions.

Dr. Al Danenberg is the top nutritional periodontist in the world. He still works regularly with clients via online/telemedicine consultations. To schedule an online consult with Dr. Al, click here.

11 References

  1. Tamimi, A. F., & Juweid, M. (2017). Epidemiology and outcome of glioblastoma. In Glioblastoma [Internet]. Codon Publications. Full text: https://www.ncbi.nlm.nih.gov/books/NBK470003/
  2. Wu, S., Powers, S., Zhu, W., & Hannun, Y. A. (2016). Substantial contribution of extrinsic risk factors to cancer development. Nature, 529(7584), 43-47. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4836858/
  3. Koifman, S., Malhão, T. A., Pinto de Oliveira, G., de Magalhães Câmara, V., Koifman, R. J., & Meyer, A. (2014). Cancer mortality among Brazilian dentists. American journal of industrial medicine, 57(11), 1255-1264. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/25164308
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  6. Hwang, S. Y., Choi, E. S., Kim, Y. S., Gim, B. E., Ha, M., & Kim, H. Y. (2018). Health effects from exposure to dental diagnostic X-ray. Environmental health and toxicology, 33(4). Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341170/
  7. Najafi, M., Shirazi, A., Motevaseli, E., Geraily, G., Norouzi, F., Heidari, M., & Rezapoor, S. (2017). The melatonin immunomodulatory actions in radiotherapy. Biophysical reviews, 9(2), 139-148. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5425818/
  8. Srinivasan, S., Guha, M., Kashina, A., & Avadhani, N. G. (2017). Mitochondrial dysfunction and mitochondrial dynamics-The cancer connection. Biochimica et Biophysica Acta (BBA)-Bioenergetics, 1858(8), 602-614. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5487289/
  9. Sengupta, S., & Balla, V. K. (2018). A review on the use of magnetic fields and ultrasound for non-invasive cancer treatment. Journal of advanced research, 14, 97-111. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6090088/
  10. Han, G. S., Cheng, J. G., Li, G., & Ma, X. C. (2013). Shielding effect of thyroid collar for digital panoramic radiography. Dentomaxillofacial Radiology, 42(9), 20130265. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3828020/
  11. Santini, S. J., Cordone, V., Falone, S., Mijit, M., Tatone, C., Amicarelli, F., & Di Emidio, G. (2018). Role of mitochondria in the oxidative stress induced by electromagnetic fields: focus on reproductive systems. Oxidative medicine and cellular longevity, 2018. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250044/