Patient knowledge and misconceptions about imaging exams and X-rays: the need for clearer guidance in dental care

To assess patients' knowledge and possible misconceptions regarding imaging exams and their association to ionizing radiation.

Patients who sought dental care at the Federal University of Santa Maria Dental School (Brazil) were invited to enroll in the study. Patients filled out a questionnaire that covered demographic information, knowledge regarding imaging exams, X-rays, dental radiographs, and information sources (internet or dentist/physician). Data analysis was performed using descriptive statistics and chi-square test.

Two hundred thirty-five participants were enrolled (mean age 44 ± 15 years), of whom 60% were female and 68% had at least 8 years of formal education. Most participants (74.5%) reported knowing what X-rays are. When questioned if the following exams used X-rays, the majority said radiographs used X-rays (91.5%), but mistakes were revealed for tomography (51.7%), mammography (59.4%), and magnetic resonance imaging (MRI) (40.2%). Gender, educational level, and reported knowledge about X-rays were not associated with correct answers (P > 0.05). Younger patients answered more accurately that ultrasound (P = 0.009) and MRI (P = 0.025) do not use X-rays, and older patients correctly associated mammography with X-rays (P < 0.001). Patients whose information source was the internet tended to incorrectly state that mammography (P = 0.007) and tomography (P = 0.063) did not use X-rays.

Patients often fail to differentiate the imaging exams that use X-rays, despite reporting that they understand what X-rays are. Dentists should be aware of the misconceptions patients may encounter when using the internet as a source of information and provide clearer guidance about acquisition and purpose of imaging exams, with emphasis on radiation protection.