Dental radiographs and pregnancy

[Byron Benson]

Good Morning Dr. Chen:

The answer to this question is found in Patient Selection Criteria for
dental radiography which was adopted by the AAOMR, ADA, AAOM, AGD, AAP, AAPD
under the sponsorship of the FDAin 1988.  It has not be superceded.

The selection criteria conclude that "the guidelines do not need to be
altered for a pregnant patient ... the concept of avoiding radiography
during pregnancy generally applies to procedure in which the fetus or embryo
would be in or near the primary x-ray beam."  Thus, this is not an issue
with dental radiography.  However, the criteria do suggest that "radiography
may be arbitrarily deferred during pregnancy for purely psychological
reasons".

It should also be noted that many women do not know they are pregnant until
they are half-way through the first trimester (sometimes longer).  If
pregnancy were an issue, we would apply the ten-day rule to all women of
child-bearing age for all radiographs (which, of course, we do not).

References:

Council on Dental Materials, Instruments, and Equipment.  Recommendation in
radiographic practices: an update, 1988.  JADA 118:115-117, 1989.

The selection of patients for x-ray examinations: dental radiographic
examinations. Rockville, Maryland: Food and Drug Administration, 1987; HHS
Publication No. 88-8273.

Atchison DA and Brooks, SL.  Guidelines for prescribing dental radiographs.
In: Oral Radiology Principles and Interpretation (White, SC, Pharoah, MJ).
St. Louis: Mosby.  2000, pp 241-254.


I hope this is helpful.

Pete Benson
______________________________________________
Byron W. (Pete) Benson, D.D.S., M.S.
Professor, Dept. of Diagnostic Sciences
Baylor College of Dentistry
Texas A & M University System Health Science Center
3302 Gaston Avenue
Dallas, TX 75246
Telephone: (214) 828-8393
Telefax:     (214) 874-4551


> ----------
> From:         Ying Chen
> Sent:         Wednesday, January 31, 2001 7:38 PM
> To:   ORADLIST at listserv.ucla.edu
> Subject:      Dental radiographs and pregnancy
>
> I need expert advice on taking dental radiographs during pregnancy.
>
> We have a female patient who is 3 month postpartum and breatfeeding and
> presented to our clinic for an exam (her first dental exam in two years).
> Her dentist presribed 4 bitewings and 3 PAs. This patient is not in pain
> but
> do have caries and need restorative works done. The DA asked the patients
> about possible pregnancy before taking the radiographs. Patient anwered
> she
> has not had a period yet after the delivery so she could not be absolutely
> sure that she is not pregnant. The DA asked the opinion of one faculty
> member and she was instructed to take the radiographs as prescribed. But
> one
> of the senior faculty member opposed taking the radiographs because
> patient
> was not 100% sure that she is not pregnant. Patient was asked to leave and
> have a pregnancy test done and return for the radiograph if not pregnant.
> Patient was not happy. This patient is a physician, knowledgeble about the
> minimal amount of radiation from dental x-rays and does not have the
> psychological concerns even if she is pregnant.
>
> So, my questions to the experts on the oradlist are:
> 1. is there a guideline available with regard to taking dental radiographs
> while preganant?
> 2. are bitewings radiographs, as in this patient, contraindicated in the
> first trimester?
> 3. is a pregnancy test required before taking 4 BWs and 3PAs as in this
> patient if she is not sure that she is not preganant?
> 4. is there evidence to show that it is beneficial to postpone dental
> radiographic exam and dental treatment to second trimester if patient is
> pregnant?
>
> Any input is appreciated.
>
>
> JY Chen DDS MS
>