I’m highly suspicious about articles like the one below or the latest sedation dentistry media blitz. I have to wonder if these are meant to drive home the request the ADA and the AAPD made to Centers for Medicare and Medicaid dated July 12, 2011 where they were crying and whining about the audits being “too aggressive”. Evidently they made a home run in NY since it was recently announced NY relaxing it’s audit.
- ADA letter to CMS whining about audits of children Medicaid programs.
- NY OIG forces out due to recovering too much of taxpayers money from fraud.
- New York eases Audits
- FDA Dental X-Ray Guide
Are Dental X-Rays Causing Brain Tumors?
(NEW YORK) -- “It’s time for your annual X-rays.” This is what millions of Americans are told when they visit the dentist. But new research out of Yale finds dental X-rays may be linked to increased rates of brain tumors.
Meningioma is the most common type of brain tumors that originate in the brain and spinal cord, making up one third of these. People who were diagnosed with meningioma were compared with healthy individuals. They were asked how often they had the most common type of dental X-ray, called a bitewing, which involves placing an X-ray film between the teeth and shooting the film from outside of your cheek. In those who reported having this type of X-ray once a year or more the risk for meningioma was 1.4-1.9 times increased depending on their age.
Another type of dental X-ray, called the Panorex, that rotates around your head taking a picture of all of your teeth from outside your mouth was associated with an almost five-fold increase in rates of meningioma when the X-ray was performed before age 10. For those older than 10 there was a 2.7 to 3 fold increased risk when this X-ray was performed once a year or more.
Current recommendations by the American Dental Association do admit that there is little use for dental X-rays in healthy people without any symptoms, but still recommends X-rays of healthy children be taken every 1-2 years and every 2-3 years for healthy adults. The authors think these guidelines may need to be reevaluated in the wake of their findings.
Reactions to the study have been mixed. For critics, the design of the study has some serious flaws. The main weakness is the failure of the researchers to obtain any of the patient’s dental records to verify that the number of X-rays they reported having was true, says Dr. Richard Besser, ABC News' chief health and medical editor.
“People with cancer are more likely to remember having dental X-rays,” explains Besser. “They are searching for some cause of their cancer and may incorrectly attribute it to any number of factors.” Dr. Besser also points out that the study failed to find any connection between having braces and risk for meningioma. “When you have braces you remember that clearly, and people who have braces on average undergo more x-rays than people without braces,” says Besser.
Dr. Alan G. Lurie, a Ph.D. radiation biologist who specializes in cancer induction and is president of the American Academy of Oral and Maxillofacial Radiology, agrees with Dr. Besser that the study has a serious flaw.
“They’re asking people to remember (in some cases) a couple of radiographs they had 30 years earlier when they were kids. They’re not going to be able to tell you what kind of X-ray machine was used…what kind of film, were there any retakes?" Lurie says.
Other doctors see this as a strong study and think that it raises valid concerns. “The current study is well-done and confirms that even in the ‘modern era’ radiation exposure from repeated dental X-rays conveys an increased risk of these tumors,” says Dr. David Schiff of the Neuro-Oncology Center at the University of Virginia.
Overall, doctors are not surprised that dental X-rays could cause this type of tumor because the type of radiation that X-rays give off is known to be associated with brain tumors. “Ionizing radiation is the only well-accepted environmental risk factor for development of meningiomas," says Dr. Schiff.
However they warn that this study cannot prove that dental X-rays cause brain tumors. It can only reveal a possible association between dental X-rays and tumors.
Still, there are some important things people can do to minimize their exposure to dental X-rays. For example, patients can ask their doctors whether X-rays are completely necessary, or how much radiation will be delivered by the various options available.
“All health professionals should be thinking that for our patients, each exposure must be beneficial and we should be of a mindset to do the fewest exposures possible to obtain needed diagnostic information," explains Paul Casamassimo DDS, professor and chair of pediatric dentistry at the Ohio State University College of Dentistry and chief of dentistry at Nationwide Children's.
Overall, experts hope that as a result of this study the public gains new awareness of a potential risk and will take their concerns to their dentist.
Dr. Paul Casamassimo is on the Advisory board of one of the nations worst offenders- Small Smiles Dental Centers, owned and operated by the bankrupt Church Street Health Management. Dr. Casamassimo should heed his own warnings!
He should be asking his colleague, Dr. Steven Adair about the unnecessary x-rays taken at the Small Smiles Dental centers, and the fraud involved in said unnecessary x-rays, especially at the Denver dental centers with Dr. Minh Tia and his office manager! I believe that amounted to some $200k between June 2010 and June 2011! Just saying….
In an article about “Dental Therapist” dated April 10, 2012, it mentions Dr. Paul Casamassimo is the AAPD Pediatric Oral Health Research and Policy Center Director.
Academy of General Dentistry Responds to Dental X-Ray Warning:
Thursday April 12, 2012
CHICAGO, April 12, 2012 /PRNewswire-USNewswire/ -- On Tuesday, April 10, 2012, in the journal Cancer, the American Cancer Society published an article entitled "Dental X-Rays and Risk of Meningioma," which summarized a study that sought to develop a correlation between dental radiographs and brain cancer.
According to the Academy of General Dentistry (AGD), a professional association of more than 37,000 general dentists dedicated to providing quality dental care and oral health information to the public, the study's findings are not applicable to modern dentistry because the study was based upon an examination of outdated radiographic techniques, which produced considerably more radiation than patients would be exposed to today.
"Modern radiographic techniques and equipment provide the narrowest beam and shortest exposure, thereby limiting the area and time of exposure and reducing any possible risks while providing the highest level of diagnostic benefits," said AGD President Howard Gamble, DMD, FAGD. "Today, patient safety is always maintained with the recommended use of thyroid collars and aprons."
The article from the American Cancer Society, which received attention from many reputable news outlets, could cause the public to decide to limit or even refuse X-rays in an effort to keep their families safe.
"It is regrettable to think that an article based on outdated technology could scare the public and cause them to avoid needed treatment," said Dr. Gamble. "With the radiography techniques in use today, the amount of radiation exposure is reduced and more controlled than it was in years past."
The AGD supports radiographic guidelines provided by the American Dental Association (ADA) and the U.S. Food & Drug Administration, and concurs with the ADA that dentists should order dental radiographs for patients only when necessary for diagnosis and treatment.
The AGD encourages patients to discuss their concerns with their dentists in order to determine what's best for them. The AGD also encourages dentists to communicate with their patients and address any unexpressed concerns of radiographic risks in order to reduce fear and promote a better understanding of the benefits and the risks associated with the specific needs of each patient.
"Neglecting one's oral health has serious oral and systemic risks," said Dr. Gamble. "Radiographs play an important role in improving the oral health of the public, and patients should not be deterred from seeking oral health care due to misperceptions from this study."
The Cancer study contained many inconsistencies and possibilities for error, including the fact that its findings were based upon a population-based case-control study. This means that it relied upon the patients themselves to recall and self-report past events, many of which were from decades earlier.
The AGD supports ongoing scientific research on any correlations between dental radiographs and incidents of disease in an effort to provide the most accurate information to the public and to correct any misperceptions created by the Cancer study.
About the Academy of General Dentistry
The Academy of General Dentistry (AGD) is a professional association of more than 37,000 general dentists dedicated to providing quality dental care and oral health education to the public. AGD members stay up-to-date in their profession through a commitment to continuing education. Founded in 1952, the AGD is the second largest dental association in the United States, and it is the only association that exclusively represents the needs and interests of general dentists. A general dentist is the primary care provider for patients of all ages and is responsible for the diagnosis, treatment, management, and overall coordination of services related to patients' oral health needs. For more information about the AGD, visit www.agd.org.
SOURCE Academy of General Dentistry
All I have to say here is that the AGD or any other of the D’s are not to quick to come out against reports that are loaded to the brim with “old” and “outdated” studies if it could possibly generate revenue.