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> Drinking one beer a night for a year is a lot less harmful than drinking 365 beers in one go. The same applies to radiation exposure, but regulation doesn’t a

by gurjeet 4mo ago

> Drinking one beer a night for a year is a lot less harmful than drinking 365 beers in one go. The same applies to radiation exposure, but regulation doesn’t agree. I know I may be overreacting, but when the dentists try to convince me that the annual x-ray of my family members is the same as being outside in the sun for a whole day, I try to explain it with a similar analogy; getting exposed to small amounts of x-ray over a long period is not the same as getting exposed to all of it in a fraction of a second. They insist it because it is covered by insurance, and that I shouldn't worry about the cost. I have to clarify that the monetary cost is not my primary concern. I have now learnt to simply say No, and agree to sign a waiver that's required by the insurance company. I am okay with getting the x-ray if a professional has a legitimate reason to suspect there's something hidden that can be better investigated by getting an x-ray. My family has received x-ray, MRI, CT scans, ultrasound, etc. but only when its benefits outweigh the risks; e.g. bone fracture, pregnancy, concussion, etc. As I said, I may be overreacting, but I'd like to err on the side of caution when it comes to my kids' and family's long-term health. edit: s/by I'd like/but I'd like/

the_af 4mo ago
> As I said, I may be overreacting, by I'd like to err on the side of caution when it comes to my kids' and family's long-term health. But isn't it a trade off, like many things in life? I don't think refusing the x-ray is necessarily erring on the side of caution. You may miss a relevant diagnostic. You have to weigh the probability and impact of the x-ray doing harm vs not getting the routine x-ray and failing to discover something harmful in time.
- gurjeet 4mo ago
  > But isn't it a trade off, like many things in life? It absolutely is. For example, as soon as I turned 45, I got colonoscopy done, because the benefit of getting tested outweighed the cost of getting tested. So if the dentist says, I suspect there's some rot, or my family member has started complaining of toothache, I would have no hesitation to get the x-ray, if recommended. But it is the regular, nonchalant nature of annual dental x-ray procedures that concerns me.
  - phil21 4mo ago
    YMMV on the annual x-ray thing. I used to mostly think the same as you. Expensive and unnecessary risk for no real benefit. I skipped my x-rays for 3-4 years due to dropping my long term dentist for unrelated reasons. I recently went to a new dentist due to a previous filling cracking and had the regular x-ray done as part of routine new patient intake. The x-ray caught the problem in another tooth done at the same time - rot behind a filling that was not visible just by looking. The same thing happened on the tooth that cracked, and had I caught it earlier I wouldn’t have had to have a crown done on it. It’s only a matter of time now until it needs a root canal due to how much material had rotted during those few years between x-rays. Most likely it was shoddy work on the two fillings be previous dentist, but in general fillings have a limited lifetime, they will generally fail at some point and need redoing. A small gap can let bacteria in and starting growing where you can’t see it and a brush won’t reach. The annual x-ray likely saved me from another crown since the material loss was less due to being caught relatively early. $70 to remove the old filling and refill it vs a $2200 crown. Xray also caught a pretty serious bone infection issue due to a birth defect combining in an unfortunate way with a sports injury from my teens. Although that one probably would have been done in time due to my two front teeth starting to wiggle I guess. Would have been a couple more years of bone loss though, and and even longer recovery time after the bone graft. And likely more than one implant needed vs the single one I have now. Your personal risk tolerance and how you weigh things of course is very individualistic and only you can set it. Just tossing one random datapoint out there.
pu_pe 4mo ago
The amount of radiation exposure on a dental x-ray is still tiny though, we are talking like 5 or 6 orders of magnitude lower than radiation poisoning thresholds. Plus there is extensive epidemiological data about their safety.
- ectospheno 4mo ago
  Agreed. My problem is that every dental association I’m aware of recommends dental X-rays on an individual, clinically justified basis and not a regular schedule. There are very few dental scenarios requiring yearly X-rays. They do them to get more money.
NetMageSCW 4mo ago
The ADA says annual X-rays are not best practice - perhaps ask your dentist why they don’t follow ADA guidelines?
- gurjeet 4mo ago
  I didn't know that. I feel somewhat vindicated :-) I'll cite the ADA guidelines next time they insist. edit: link to the latest ADA recommendation on x-rays. https://www.ada.org/about/press-releases/new-recommendations-confirm-dental-x-rays-most-effectively-used-in-moderation https://www.ada.org/about/press-releases/new-recommendations... > You wouldn’t get an X-ray of another part of your body unless the doctor believed there was reason to order one after an examination. Similarly, dental X-rays should be ordered only after first examining the patient’s medical and dental histories, prior X-ray images, and current clinical exam findings.

by gurjeet 4mo ago

the_af 4mo ago

> As I said, I may be overreacting, by I'd like to err on the side of caution when it comes to my kids' and family's long-term health. But isn't it a trade off, like many things in life? I don't think refusing the x-ray is necessarily erring on the side of caution. You may miss a relevant diagnostic. You have to weigh the probability and impact of the x-ray doing harm vs not getting the routine x-ray and failing to discover something harmful in time.

gurjeet 4mo ago
> But isn't it a trade off, like many things in life? It absolutely is. For example, as soon as I turned 45, I got colonoscopy done, because the benefit of getting tested outweighed the cost of getting tested. So if the dentist says, I suspect there's some rot, or my family member has started complaining of toothache, I would have no hesitation to get the x-ray, if recommended. But it is the regular, nonchalant nature of annual dental x-ray procedures that concerns me.
- phil21 4mo ago
  YMMV on the annual x-ray thing. I used to mostly think the same as you. Expensive and unnecessary risk for no real benefit. I skipped my x-rays for 3-4 years due to dropping my long term dentist for unrelated reasons. I recently went to a new dentist due to a previous filling cracking and had the regular x-ray done as part of routine new patient intake. The x-ray caught the problem in another tooth done at the same time - rot behind a filling that was not visible just by looking. The same thing happened on the tooth that cracked, and had I caught it earlier I wouldn’t have had to have a crown done on it. It’s only a matter of time now until it needs a root canal due to how much material had rotted during those few years between x-rays. Most likely it was shoddy work on the two fillings be previous dentist, but in general fillings have a limited lifetime, they will generally fail at some point and need redoing. A small gap can let bacteria in and starting growing where you can’t see it and a brush won’t reach. The annual x-ray likely saved me from another crown since the material loss was less due to being caught relatively early. $70 to remove the old filling and refill it vs a $2200 crown. Xray also caught a pretty serious bone infection issue due to a birth defect combining in an unfortunate way with a sports injury from my teens. Although that one probably would have been done in time due to my two front teeth starting to wiggle I guess. Would have been a couple more years of bone loss though, and and even longer recovery time after the bone graft. And likely more than one implant needed vs the single one I have now. Your personal risk tolerance and how you weigh things of course is very individualistic and only you can set it. Just tossing one random datapoint out there.

pu_pe 4mo ago

The amount of radiation exposure on a dental x-ray is still tiny though, we are talking like 5 or 6 orders of magnitude lower than radiation poisoning thresholds. Plus there is extensive epidemiological data about their safety.

ectospheno 4mo ago
Agreed. My problem is that every dental association I’m aware of recommends dental X-rays on an individual, clinically justified basis and not a regular schedule. There are very few dental scenarios requiring yearly X-rays. They do them to get more money.

NetMageSCW 4mo ago

The ADA says annual X-rays are not best practice - perhaps ask your dentist why they don’t follow ADA guidelines?

gurjeet 4mo ago
I didn't know that. I feel somewhat vindicated :-) I'll cite the ADA guidelines next time they insist. edit: link to the latest ADA recommendation on x-rays. https://www.ada.org/about/press-releases/new-recommendations-confirm-dental-x-rays-most-effectively-used-in-moderation https://www.ada.org/about/press-releases/new-recommendations... > You wouldn’t get an X-ray of another part of your body unless the doctor believed there was reason to order one after an examination. Similarly, dental X-rays should be ordered only after first examining the patient’s medical and dental histories, prior X-ray images, and current clinical exam findings.