I have patients who actually come from other holistic dentists or come from traditional dentists and I get a series of X-rays from those doctors that they’ve taken in the past, in the last year, and I’m baffled by how much radiation they put this patient through.
Why did we take these X-rays?
This is something I encounter far too often in my practice. When new patients bring me their previous X-rays, I’m genuinely shocked by the unnecessary radiation exposure they’ve received. It’s become clear to me that many dental offices – both traditional and even some claiming to be holistic – are not applying common sense when it comes to radiographic imaging.
Certain X-rays are taken to collect certain data and using common sense when you take an X-ray is very important. What does your patient need?
The Problem with Panoramic X-Rays
A lot of insurance will pay if you take what’s called a panoramic X-ray, and they’ll pay high levels of money. But panoramic X-rays really should only be taken if you’re looking for a pathology in the mouth, like a cancer, or if you have teeth that need to be pulled, like maybe four or five teeth that need to be pulled. If you need to have wisdom teeth pulled, you take a panoramic. You cannot diagnose anything else from a panoramic X-ray other than those two things.
According to dental radiology experts, panoramic radiographs should not be taken as routine radiographs and require specific clinical justifications. The appropriate indications include evaluation of impacted teeth (especially wisdom teeth), detection of jaw pathology, assessment of trauma, and pre-surgical planning for extractions.
I have healthy 30-year-old women who come to me who have had their wisdom teeth out that have a panoramic. And I say, “Why did they take this X-ray on you? What were they looking for?” Many patients don’t know.
This scenario frustrates me because it represents exactly what’s wrong with our current approach to dental imaging. When I see healthy young patients who’ve had panoramic X-rays taken without clear clinical justification, especially after their wisdom teeth have already been removed, I have to question the decision-making process that led to that exposure.
When you come to a holistic dentist, we’re not going to radiate you for things that just pay high levels of money or that are all-in-one X-rays that don’t give us any information we need.
Understanding Radiation Levels
Let me give you an example. Panoramics are three times higher in radiation than the simple small X-ray that we take. It’s called a digital film X-ray or digital X-ray. The amount of radiation is also way higher with a panoramic.
Research from the International Atomic Energy Agency shows that panoramic X-rays deliver approximately 5 times more radiation than digital intraoral X-rays, with panoramic exposures around 0.025 mSv compared to 0.005 mSv for digital bitewing X-rays. While both doses are relatively small compared to natural background radiation, the American Dental Association emphasizes following ALARA principles – keeping radiation “As Low As Reasonably Achievable”.
So, we don’t take that unless we need that.
A Conservative, Personalized Approach
Another thing is we’re very conservative. If you have no decay in your mouth and you’ve gone many years with no decay, like six years without decay, then maybe we don’t take X-rays all the time. Maybe we take them every other year or we tailor it to your body and your needs.
This personalized approach aligns with current evidence-based recommendations. Rather than following a rigid schedule, I evaluate each patient’s individual risk factors, decay history, and overall oral health status. For patients with excellent oral hygiene and no history of dental problems, extending the interval between radiographs makes perfect clinical sense.
The Cumulative Reality of Radiation
Radiation is very dangerous and it’s very additive. Once you have radiation, it stays with your body for the rest of your life. It’s like we’re making a list. How much radiation have you had until you break? And so we only want the radiation we absolutely need to collect the data we actually need.
Studies indicate that while dental X-ray doses are individually small, radiation effects do accumulate over time, and patients should keep track of their cumulative radiation exposure from all sources. The principle that “radiation exposure from dental imaging represents a minor contribution to total exposure from all sources” doesn’t negate our responsibility to minimize unnecessary exposure.
My Commitment to Conscious Imaging
In my practice, every X-ray decision goes through a simple but important filter: What specific clinical question am I trying to answer, and is this the lowest-radiation method to get that answer? I don’t take X-rays simply because insurance will pay for them or because it’s been a certain amount of time since the last ones.
When I review the radiographic history that new patients bring to me, I often find patterns of imaging that seem driven more by routine scheduling or financial incentives than by actual clinical need. This approach doesn’t serve our patients’ best interests.
We only want the radiation we absolutely need to collect the data we need.
This philosophy guides every imaging decision in my practice. By being truly conservative with radiation exposure and using common sense in our approach to X-rays, we can provide excellent dental care while minimizing our patients’ lifetime radiation burden.
That’s what holistic dentistry should be about – treating the whole person, including their long-term health and safety.
