Of all the people (adults to be more specific) I’ve met over the years, I’ve only known 2 who reached their 20s without ever having a cavity. One was the child of a dentist; the other was equally as conscientious about oral hygiene. Perhaps both had good genetics, too. I assumed the latter individual must visit the dentist every 6 months, so I was surprised to learn that she hadn’t made an appointment in more than a year. Her reason? She was afraid of dental x-rays and radiation.
Radiation exposure is a legitimate concern in the realm of public health. In 2012, the American Dental Association (ADA), in collaboration with the FDA, revised recommendations for dental radiographic examinations to serve as an adjunct to the dentist’s professional judgment of how to best use diagnostic imaging. According to the ADA, how often x-rays should be taken depends on specific factors, including the individual’s current oral health, age, risk for disease, and signs or symptoms of oral disease; there is no “one-size-fits-all” when it comes to the interval between x-rays. Dentists also adhere to the ALARA (As Low as Reasonably Attained) principle for exposures, a phrase coined in 1973 by the International Commission on Radiologic Protection (ICRP).
Planmeca has taken the ALARA precaution a step further by introducing its proprietary Planmeca Ultra Low Dose (ULD) technology, which delivers an even lower patient radiation dose than standard 2D panoramic imaging. In a recent study*, Planmeca ULD protocol was found to reduce the effective patient dose by an average of 77% without a statistical reduction in image quality. The technology is based on intelligent 3D algorithms that allow clinicians to choose the optimal balance between quality and dose based on the ALARA principle.
Dr. Alex Bumann, an orthodontist, puts the dosage into perspective with his real-life experience at MESANTIS 3D Dental-Radiologicum, which produces about 7,500 CBCT images per year at 8 locations in Germany. According to Dr. Bumann, traditional digital 2D X-rays at an orthodontist’s clinic usually have an effective dose ranging between 26–35 uSv (ICRP 2007), and conventional CBCT images of the head with modern CBCT equipment show an effective dose ranging between 49–90 uSv.
“In medical terms, [ULD] allows radiologists to adjust imaging parameters individually according to the clinical needs of each case. The mA values, in particular, can be individually adjusted and reduced for each patient, as it is required according to all international scientific guidelines,” said Dr. Bumann. “Therefore, it is possible to further reduce the effective dose significantly by using the Planmeca Ultra Low Dose protocol. Depending on the field of view, nowadays CBCT equipment with a Planmeca Ultra Low Dose algorithm has an effective dose between 4 to 22 or 10 to 36 uSv.”
* (Ludlow, John Barrett and Koivisto, Juha: Dosimetry of Orthodontic Diagnostic FOVs Using Low Dose CBCT protocol)