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According to “Dr. Wo” Wm. Randol Womack, DDS, Board Certified Orthodontist Editorial Director, Orthotown Magazine

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Continuing the CBCT Debate
by Wm. Randol Womack, DDS, Board Certified Orthodontist
Editorial Director, Orthotown Magazine

Dental X-rays sensationalized by a media report of a seriously flawed study with major funding provided by a Meningioma Foundation reported that dental Xrays increase the risk of formation of a brain tumor. This was the topic of a message board that was reviewed in the May issue of Orthotown Magazine.

The study showed that those with the brain tumor reported significantly higher rates of having dental Xrays than the control (from their own memory of the past, not dental records). What's weird is that it was shown to be significant in those that had reported bitewings and panoramics but not in those reporting a history of full-mouth series. That makes no sense.

The American Academy of Oral Maxillofacial Radiology (AAOMR) issued a response to this study restating its commitment to “the responsible use of ionizing radiation in dentistry.” In its response it noted: One major weakness of this study was the requirement for subjects to recall their dental radiography history from decades ago when they were children. Second, bitewing radiographs were reported to place patients at a higher risk of meningioma than a full-mouth series of radiographs (up to 20 exposures, two to four of which are bitewings); a finding that cannot be rationally reconciled from a radiobiological standpoint. Its conclusion was: “A number of irreconcilable data collection and consistency problems highlight serious flaws in the study and render the conclusions invalid.”

The April 2012 press release from the American Dental Association (ADA) states: “Studies have shown that the ability to recall information is often imperfect. Therefore, the results of studies that use this design can be unreliable because they are affected by what scientists call ‘recall bias.’”

One can also factor in that the study subjects received dental X-rays decades ago when radiation rates were higher due to the use of old X-ray technology and slower-speed film producing greater radiation exposure.

The question now might be: “Have patients or friends recently asked you about radiation from dental X-rays?” And, more importantly, have patients (or parents) refused having a panorex taken on their initial visit or during treatment? Another Townie responded: “If a patient refuses a panorex, I won't treat them. Who knows what pathology can be hiding in the jaws somewhere.” Even Dr. Oz is adding fuel to the fire, via his nationally syndicated TV show, by relating thyroid cancer to having dental X-rays. Another Townie stated: “Our specialty has to have an evidence-based pow wow on the use of radiographs in orthodontics and figure out if the standard of care needs to be revised.”

Have you had these issues arise in your office? And if you have, how have you answered the questions and supported your response to the need for radiographs to diagnose and treat your patients?

Orthotown Magazine has published many articles regarding CBCT and its associated radiation facts, the most recent in the September 2011 issue titled, “The Truth about CBCT Radiation.” The authors are practicing orthodontists who have made a prudent decision about the application of cone beam images in their practices, within the ALARA principles set forth by the ADA and the AAOMR, to balance patient benefit with risk.

You can download the September 2011 digital issue of Orthotown Magazine from Orthotown.com and find the article, complete with dosimetry graphs, charts, definitions and comparisons starting on page 62.

To continue our commitment to provide our readers with the most current information regarding radiation in dentistry and with a focus on CBCT, we are pleased to present this 2012 CBCT issue of Orthotown Magazine.

Orthotown Magazine
September 2025
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