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Radiation protection of pregnant women in dental radiology

» What are the typical foetal doses in dental radiographic procedures?

The foetal dose from a dental X ray exam, including CBCT, has been estimated to be between 0.009 μSv and 7.97 μSv. This is usually less than the estimated daily natural background dose received by the foetus. The use of an apron with lead shielding and/or a thyroid shield can reduce the dose to the foetus even further. However, the use of shielding should be done with proper care, to assure that the radiograph is of adequate diagnostic quality (i.e. keeping the shielding outside of the X ray beam) and that it does not lead to overexposure (for equipment using some form of automatic exposure control).  

» How should one deal with possible pregnancy of a woman before performing a dental radiological procedure?

Information on possible pregnancy should be obtained from the patient. A female of reproductive capacity should be considered pregnant unless proved otherwise. 
If the patient is pregnant the possibility of obtaining information from a non-radiological investigation should be considered. If the radiological examination is considered essential it should be performed and due consideration should be given to optimisation. Because of the widespread fears of radiation induced damage to the unborn child, it is reasonable to counsel the woman on level of radiation exposure and associated risks prior to performing the procedure. It is essential to have pregnancy warning signs in the waiting rooms.

» If a dental X-ray procedure has been performed on a pregnant woman, what is the risk to the foetus and what advice may be provided?

The risk to the foetus from a few µSv of radiation exposure arising from a dental radiographic procedure is extremely small. 
The cancer risk to the unborn child resulting from a 10 µSv foetal dose is several thousand times less than the background risk of childhood cancer. The risk of inducing a genetic abnormality is an even smaller fraction of the background risk of genetic disorder. Hence patient doses received in the normal practice of dental radiology would never warrant consideration of a termination, and patients with concerns in this regard should be counselled accordingly.

Read more:

  • BUCH B, FENSHAM R, MARITZ MP. An assessment of the relative safety of dental x-ray equipment. SADJ. 2009 Sep;64(8):348-50.
  • KELARANTA A, EKHOLM M, TOROI P, KORTESNIEMI M. Radiation exposure to foetus and breasts from dental X-ray examinations: effect of lead shields. Dentomaxillofac Radiol. 2016;45(1):20150095. 
  • •    OKANO T, HARATA Y, SUGIHARA Y, SAKAINO R, TSUCHIDA R, IWAI K, et al. Absorbed and effective doses from cone beam volumetric imaging for implant planning. Dentomaxillofac Radiol 2009; 38: 79–85.
  • OKANO T, MATSUO A, GOTOH K, YOKOI M, HIRUKAWA A, OKUMURA S, et al. Comparison of absorbed and effective dose from two dental cone beam computed tomography scanners. [In Japanese.] Nihon Hoshasen Gijutsu Gakkai Zasshi 2012; 68: 216–25. 
  • WAGNER, et al., Exposure of the pregnant patient to diagnostic radiations: A Guide to Medical Management, 2nd Edition, Publisher: Medical Physics Publishing, Madison, WI (1997).