1992 assessment of radiation risk from dental radiography

Recent studies suggest that the lifetime cancer risks from exposure to low levels of ionizing radiation may be greater than previously estimated. This review first summarizes the findings of these studies as they pertain to dental radiology, then uses their concepts in combination with dosimetry from the dental literature to estimate the radiation risk from dental radiology. Estimation of risk from groups of exposed individuals requires use of mathematical models that fit the epidemiological data. The ICRP estimates that a single brief whole-body exposure of 1 Gy to 10,000 people results in about 500 additional cancer deaths over the lifetime of the exposed individuals, assuming a dose rate effectiveness factor of 2 for cancers other than leukaemia. Leukaemias are seen as a wave from 5 to 30 years following exposure. Cancers other than leukaemia typically start to appear about 10 years following exposure and remain in excess for as long as most exposed populations are followed, presumably for the lifetime of the exposed individuals. The gonadal dose is so small from dental radiography that the risk of heritable defects is negligible in comparison with the somatic risk. The dental literature contains several studies reporting sufficient dosimetric data for radiosensitive sites in the head and neck to allow estimation of the risk of fatal cancers from intra-oral and panoramic radiography. The highest estimated risks (using the ICRP data) are for leukaemia (bone marrow), thyroid and bone surface cancer. The total risk is estimated to be 2.5 fatal malignancies per 10(6) full-mouth examinations made with D-speed film and round collimation.(ABSTRACT TRUNCATED AT 250 WORDS)