[X-ray examinations in orthodontic diagnostics as a source of ionizing radiation]

Orthodontics increasingly depends on X-ray examinations in the therapy and diagnosis of dento-facial anomalies. In the choice of roentgenologic diagnostic methods attempts are made to select a method that provides maximum information with the least irradiation of the patient. Insufficient knowledge of the biological effects of ionizing radiation may result in undue precaution by the doctor or utter indifference. Therefore, literature data were analyzed to cast more light on the risks of ionizing radiation. The following conclusions have been reached: orthodontists are obligated to expose their patients to a minimal possible radiation; it is not possible to define the safety threshold of X-ray radiation because of unpredictable stochastic effects, although the incidence of damage due to the lowest doses is negligible; the doses of radiation due to orthodontic X-ray examinations are within the range of natural, environmental doses. However, because of their cumulative effects, they should not be underestimated; stomatologic X-ray examinations account for 8 to 25% of all X-ray examinations, yet their contribution to genetically significant doses is the smallest; since the effects of genetically significant doses have not been scientifically elucidated to a sufficient extent, X-ray radiation should be maximally reduced, modern roentgenologic techniques should be used and the safety instructions should be strictly followed; if all safety measures are adhered to, it is not necessary to impose limitations with regard to the performance of orthodontic X-ray examinations; it is important to obtain from the patient history of his previous X-ray examinations; a favorable relationship should exist between medically warranted needs and possible damages to the patient; standardization of orthodontic X-ray diagnosis will facilitate recording of relevant data and the calculation of radiation doses.