Dental News - Dental X-rays increase risk of meningioma

Dental Tribune International

Mon. 16 April 2012

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NEW HAVEN, Conn., USA: In the largest case-control study to date, researchers have investigated the correlation between benign brain tumors and dental X-rays. They surveyed almost 1,500 individuals regarding the dental radiation procedures they had undergone in their lives and discovered that more frequent screening and screening at a young age are associated with an up to fivefold increase in the risk of meningioma.

Researchers from the Yale School of Public Health compared the dental radiation histories of 1,433 patients with those of a control group of 1,350 individuals matched for age, sex and state of residence. Onset, frequency and type of dental care received over their lifetime were investigated in both groups, as well as the number of times they had undergone bitewing, full-mouth or panorex films at different ages.

The findings of the study indicate a significantly elevated risk with bitewing and panorex films when taken yearly or more frequently at a young age. For instance, the researchers found that the risk of intracranial meningioma was almost five times higher for individuals who were under the age of ten at the time of screening.

The researchers concluded that radiation exposure is a risk factor that is in many instances avoidable. Since dental X-rays remain the most common artificial source of exposure to radiation, they suggested that dentists reduce dental X-rays to the absolute minimum. They further highlighted that there is little evidence to support the use of dental X-rays with asymptomatic patients or for routine dental examinations at preset intervals.

"The study highlights the need for increasing awareness regarding the optimal use of dental X-rays, which unlike many risk factors is modifiable," said lead author Elizabeth Claus, a neurosurgeon and professor at Yale University.

The study identified exposure to ionizing radiation as one of the major risk factors for developing the disease. While most studies in the past concentrated on high-level exposure from sources such as atomic bombs or oncological treatment, the researchers observed that there had been very limited research on lower dose exposure, which they thought is more likely to be experienced by the general population.

Meningiomas are the most common brain tumors in adults. According to the American Cancer Society, they account for about one out of three primary brain and spinal cord tumors diagnosed in the U.S.

The patients in the study were diagnosed with meningioma between May 2006 and April 2011. They were aged between 20 and 79 at the time of diagnosis (average age of 57) and were residents of the states of Connecticut, Massachusetts, North Carolina, California and Texas. The majority of the participants reported having had at least one bitewing in their life (95.8 percent of patients and 92.2 percent of controls) and 75 percent of both groups had undergone at least one full-mouth scan. Since there is no national database of dental treatment in existence in the U.S., the researchers had to rely on self-reporting by the patients.

According to the American Dental Association's 2006 guidelines on the use of dental radiographs, healthy children should have one X-ray every 12 to 24 months, teenagers every 18 to 36 months and adults every 24 to 36 months. The association recommends minimizing exposure to radiation where practicable. They urge dentists to weigh the benefits of dental radiographs against the consequences of increasing a patient's exposure to radiation.

The study was published online on Apr. 10 in Cancer, a journal of the American Cancer Society.

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