«Doctor, isn't that too many X-rays?» It is a fair question, and the answer is not «don't worry». It is a line of reasoning, and it is worth going through it together.
The principle that binds us
Two principles govern medical radiology: justification and optimisation. The first says an examination is performed only if the expected clinical benefit outweighs the risk. The second says that, if it is performed, the dose must be as low as reasonably achievable to answer the clinical question.
In plain terms: a radiograph is not prescribed «routinely», out of habit, or to complete a file. It is prescribed when it changes a decision.
Why dental doses are contained
Dental radiographs have features that place them among the lowest-dose examinations in radiology: the field is small and circumscribed, the tissues examined are superficial, and digital sensors need far less radiation than old film. Each of us also receives a natural background dose from the environment every day: WHO notes that natural exposure is part of everyday life.
This does not mean the dose is zero. It means it should be compared with a context, not feared in the abstract.
A 3D CBCT is not a «bigger» X-ray
CBCT provides a three-dimensional volume: it shows bone, maxillary sinuses, nerve pathways, the position of impacted teeth. It is irreplaceable in implantology and in some orthodontic and surgical cases — and it is also the highest-dose examination we perform.
That is why it is never a screening test: it is prescribed when three-dimensional information is needed that a two-dimensional radiograph cannot provide.
What we do to reduce exposure
- We prescribe only on clinical indication, never as routine.
- We always ask whether you have recent images, and use them rather than repeating them.
- We use digital sensors and set the smallest useful field.
- We apply dedicated protection and precautions, especially with children.
If you are pregnant
Tell us straight away, even if you only suspect it. Deferrable examinations are postponed; non-deferrable ones are performed with specific precautions. In every case the decision is taken together, informed.
What you can ask
Always ask why that examination is needed and what will change in your care depending on the result. If the answer is clear, the examination is justified. It is the best way to protect yourself.
Sources
- WHO — Ionizing radiation and health effects fact sheet — natural background exposure and effects of ionising radiation.
- EpiCentro — Italian National Institute of Health (ISS) — national reference on radiation protection and public health.
- Italian Ministry of Health — Dental health — appropriate prescribing and the diagnostic pathway.