Under normal circumstances, many dental patients would rather not have dental x-rays due to their personal concerns about radiation, unless it’s absolutely necessary.
So you can imagine the panic that some patients might have if they undergo a dental X-ray and later discover they were pregnant at the very early stages, unknowingly. Similarly, dentists may have anxieties about the rare occasion in which they take radiographs of a patient before a pregnancy is realized.
In these situations, there are inevitable questions and doubts around if that one-time accidental dental X-ray so early on in the pregnancy could potentially harm the developing fetus. However, modern dental radiography equipment and stringent safeguards that are universal protocol in all dental offices now make the actual risks posed to the fetus from a one-time accidental X-ray exposure during very early pregnancy extremely minimal, based on ample scientific evidence.
Research studies consistently demonstrate that the fetal risks associated with a single necessary dental X-ray procedure done in a properly shielded patient before pregnancy is realized are negligible and should pose no need for termination or alterations in prenatal care.
Both patients and providers can be reassured that accidental exposure from a single dental radiograph during very early gestation poses only the most minimal of risks to fetal development and pregnancy outcomes when proper protocols are followed.
Importance of Dental X-Rays While Pregnant
Though X-rays are avoided during pregnancy when possible, some dental issues like infection may require them. The benefits outweigh minimal risks:
- Dental infections pose a greater risk to the pregnancy so X-rays are sometimes needed to effectively diagnose and treat oral health issues.
- Severe gum disease is associated with a higher risk of preterm birth. X-rays help evaluate this.
- Tooth decay left untreated increases the chance of passing cavity-causing bacteria to the baby. X-rays find decay.
- Abscesses, cysts and dental trauma may require acute X-ray diagnosis.
If X-rays during pregnancy are needed, the patient wears heavy abdominal shielding and exposures are kept minimal. However, avoiding truly needed X-rays puts mother and baby at greater risk than the X-rays themselves.
Why Early Pregnancy X-Rays Are Minimally Risky
The main reasons occasional accidental X-rays pose very little risk in early pregnancy include:
Very low radiation dose
Dental X-rays utilize the minimum dose needed for clear images. A full mouth series exposes the abdomen to only about 0.00008 mGy of radiation scatter.
Distance from fetus
Until 12 weeks gestation, the fetus is quite small and far from the radiation beam concentrated around the head and neck.
No directed pelvic radiation
Dental X-rays never intentionally aim radiation at the abdominal/pelvic region. Scatter is minimal.
Lead shielding
Lead aprons including thyroid shields are worn over the abdomen of all patients to block radiation exposure.
Research Regarding Safety
Numerous studies have found no increased risk of birth defects or miscarriage from an accidental one-time diagnostic X-ray, especially in very early pregnancy. Research indicates:
- No elevated miscarriage or anomaly risk from a dental X-ray before 7 weeks gestation.
- Typical radiation scatter from dental X-ray is hundreds of times lower than levels linked to fetal abnormalities.
- No difference in anomaly rates between infants with 1st trimester dental X-ray exposure compared to no exposure.
Precautions Taken by Dental Offices
Responsible dental offices take measures to prevent accidental X-rays on pregnant patients including:
- Usage of lead aprons on all patients regardless of pregnancy status to block scatter radiation from reaching the pelvic region. Thyroid shields also protect a vulnerable area.
- Digital X-ray sensors and collimation significantly reduce radiation exposure compared to old film X-rays.
- Questioning female patients of possible pregnancy prior to taking any X-rays. Pregnancy tests may be administered.
- Postponing any non-urgent dental X-rays for confirmed pregnant patients until after delivery.
- Dental staff training on using lowest X-ray dosages and speeds possible.
- Types of X-rays are tailored to minimize radiation based on individual need rather than blanket full mouth X-rays.
Despite precautions, the occasional early pregnancy may slip through screening. But following safety protocols minimizes any potential fetal risks.
What to Do if Exposed to Radiation during Pregnancy
While risks are extremely low, a patient who gets accidental dental X-rays in very early pregnancy can:
- Consult their physician to discuss risks versus benefits of continuing the pregnancy. Termination is not medically advised.
- Undergo a targeted prenatal ultrasound around 18-20 weeks to check fetal anatomy and development just for reassurance.
- Seek genetic counseling to discuss very minimal risks to the fetus and options like non-invasive prenatal testing.
- Avoid further elective X-rays during pregnancy like chest X-rays. Dental X-rays during the 2nd/3rd trimester are safe with abdominal shielding.
Final Note
Modern dental X-rays confer negligible risk for the tiny number of patients accidentally exposed in very early pregnancy due to strict dose regulations and shielding. However, discussing options with your OB-GYN can reassure you that continuing the pregnancy is extremely safe based on established research.
References
https://www.iaea.org/resources/rpop/health-professionals/dentistry/pregnant-women
