Thursday, April 12, 2012

Dental X-Rays And Cancer: A New Scare

Dental X-Rays And Cancer: A New “Study”

It hasn’t even been a year since I wrote an article about a statement by Dr. Oz saying that dental x-rays were related to an increase in the incidence of thyroid cancer.

Now a new study is being quoted saying that there is a higher incidence of meningioma, a benign brain tumor, in people that had dental x-rays and the media is running with it.

The study was based on answers to questions in a survey of over a thousand patients with meningioma. One of the questions asked was whether the patients remembered having dental x-rays taken. The implication here is that x-rays can cause cancer.

In my opinion, this type of study should not even be published, since it does not prove anything, and it only serves to fuel concerns in the general public that, although legitimate, they are often fuel for those that take an exaggerated or extremist point of view.

Let me explain why I say that the study is useless as a scientific paper.

The method by which the study was conducted was a survey where the author asked questions to patients diagnosed with meningioma about their recollection of how many dental x-rays they received during their life including childhood. Also what types of x-rays they received. This type of survey is prone to a tendency of overreporting by the participant. Take my office as an example. I routinely ask a new patient if they had recent x-rays done at another office to avoid unnecessary exposure to radiation and they typically say they had a full series of x-rays, but when we request them, it turns out that they only had two or four bitewings taken.

The study also says that the risk of meningioma rises 3 times more with panoramic x-rays compared to bitewings, but in the same article the author states that panoramic equipment and digital x-rays in use today (which significantly reduce the amount of radiation exposure to the patient) were not available for the participants of the study.

Please watch a news report about the study below:

The reporter correctly describes some of the faults in the reasoning behind the study such as asking persons to recollect the types of x-rays in childhood, getting data from memory and not dental records, subjects exposed to radiation from equipment from 30 years ago. I should add that a the author of the study (I read it!) admits that most data on radiation exposure she found was from exposure to nuclear blasts(atomic bomb) and radiation therapy for cancer, both of which are so much higher than the levels of exposure for diagnostic x-rays that it is ridiculous to even mention it.

I could understand the reason to conduct a study for persons exposed to CT scans of the head and neck, as this exposes them to a higher dosage of radiation and includes the brain, but the study does not involve CT scans, instead it focuses on bitewing x-rays that we as dentists rely on to diagnose cavities. These small x-rays are highly collimated (the beam is focused to a small circle in your mouth) and does not expose the brain or tissues around it to any levels of radiation worth worrying about.

As a dentist, I cannot overemphasize the importance of taking periodic x-rays to detect caries. Those small bitewing films allow me to find decay when it is small and has not damaged the tooth to the point where there is pain or other signs. What this means to the patient is that I can fix the tooth before it reaches the point where they may need more extensive work such as a root canal or a crown.

I should also mention that while reading the x-rays for a "routine" initial examination for my patients, I have discovered cancer in the mouth that the patient was never aware of because it was small and in doing so was able to help the patient avoid the radical disfiguring surgery that would have been needed it the tumor had been allowed to grow. Maybe even saved his life...

I try to be optimistic in my thinking and I think that something good can always be found in everything. This publicity should make us (dentists) more aware of the need to tailoring our treatment to the individual patient and not tend to fall in a routine that may lead to unnecessary exposure to radiation. Dentists should use their judgement in determining how often x-rays need to be taken, as dental conditions are different for every person, and recommend these radiographs only as necessary for diagnosis and treatment of their patients.

West Palm Beach Dentist
Carlos Boudet, DDS DICOI

Implants Blog:
Spanish Website:

1. Radiation exposure and dose evaluation in intraoral dental radiology. Radiat Prot Dosimetry (February 2007) 123(2): 262-267 first published online September 13, 2006.
2.American Cancer Society Guidelines for the Early Detection of Cancer.
3.Ionizing radiation exposure.
4. Imaging (Radiology) Tests. ntent/003177-pdf.pdf

Saturday, April 7, 2012

National Cancer Control Month

April is National Cancer Control Month

Dentists have always taken an important role in early cancer detection, since they are more likaly to see their patients more often than the physician.
In order to increase awarenes of the importance of early detection of cancer, I have written an article in VOXXI, an internet based newspaper/blog site.
Here is a copy of the article:

As general dentists we see patients that are healthy, feel fine and may not go to see their physician unless they get sick. Many individuals do not realize the importance of regular visits to the dentist to help them stay healthy.

One of the many services or added benefits that our office provides is oral cancer screening. As part of our initial and periodic exams, you may notice that Dr Boudet palpates your neck, looks at your throat, at the sides and under your tongue, and many other areas of your mouth that are not just the teeth.

As a
Dentist in West palm beach , Dr Carlos Boudet has been providing these services to the community for almost three decades now and in that time has been able to keep his patients healthy by detecting many lesions that would have gone undetected and untreated, resulting in more severe problems for the patient.

Cancer awarenes month was created to make individuals aware of the benefits of early detection. Dentists are in a position that allows them to detect oral cancer lesions early and this makes a big difference in the treatment of
oral cancer. Some oral cancer is very agressive and if not detected early can result in damage that can leave the patient disfigured and totally change his quality of life. The same cancer detected early can prevent those disfiguring surgeries and make a tremendous difference in the life of a person.

The most common causes of oral cancer were listed as tobacco and alcohol, but recent research has found a link between the
human papilloma virus (HPV) and cancer. The papilloma virus is a virus that produces papillomas or "warts" in squamous epithelial cells that cover the surfaces of many areas of the body, such as the inside of the mouth. Most papilloma viruses produce the benign warts, but there are several of these viruses that are "high risk" because they produce the pre-cancerous and cancerous lesions. The cancerous warts cannot be distinguished from the benign ones by simple visual observation, and the dentist needs to remove the lesion and send it to a pathology laboratory to be looked at under the microscope. A trained pathologist then makes the final diagnosis.

As part of the of modern technology that we have incorporated in our office, we can now detect and remove these lesions with the use of the
dental laser in a manner that is most comfortable for the patient. the removal is done without a scalpel, does not need sutures or stitches and results in faster, more comfortable healing for the patient.

Scientists working in biological research have developed two vaccines for the most common cancer producing human papilloma viruses. You may want to go to the
american cancer society website if you would like to read about the proposed guidelines for recommending and administering the vaccines. They also have information about the individuals at a higher risk, the cost of the vaccine, insurance coverage and how it is administered.

Yours for healthy living,

West Palm Beach Dentist
Carlos Boudet, DDS

Enhanced by Zemanta

Sunday, April 1, 2012

West Palm Beach Dentist Does Porcelain Crowns In One Day

Dr. Carlos Boudet, a West Palm Beach Dentist has been using the latest Cad/Cam technology for several years now to fabricate porcelain crowns in one day.

The Cad/Cam technology that he uses is not new.  It has been available for over a decade, but due to the high cost of the equipment needed to produce these crowns, few dentist are willing to invest in the technology.

Normally crowns have to be made in the laboratory, a process that takes about two weeks and requires the patient to wear a temporary that could loosen or fall out and would require a second visit to remove the temporary, try the new crown and if all goes well, cement it.

Dr. Carlos Boudet also does porcelain crowns in the laboratory for special cases that require it, but for those that want the convenience of not having to take time to schedule a second appointment having their porcelain crowns done in one day is great service.

The equipment that Cosmetic Dentist Carlos Boudet uses is Cerec from Sirona, which was the  first cad cam system to be designed for dentists.  With more than a decade of research and improvements, it is the system with the most experience and best track record in the market.

The way the system works is this:
The dentist prepares the tooth or teeth the same way, but instead of taking an impression with a paste inside a tray, a small camera takes a digital impression and transmits it to the computer, where the dentist designs the crown for the patient.  Once the design is done, it is sent wirelessly to a milling machine that uses diamond bits to carve the crown out of a solid block of porcelain.  Then when the crown is finished and polished, the dentist bonds it in place in the mouth and the whole procedure is done in one visit.

As a general dentist Dr. Boudet provides a variety of services for his patients such as dental implants with many years of experience both placing and restoring dental implants with great success.  Dr. Boudet also provides orthodontic services including Invisalign clear aligners and laser dentistry that increases the comfort and speeds healing in many cases where surgery would be needed.

Dr. Boudet has been providing caring expert dental care for his patients since 1983 in the area of West Palm Beach and adjacent communities such as Palm Beach, Palm Springs, Wellington, Lake Worth, Royal Palm Beach and surrounding areas.

West Palm Beach Dentist
Carlos Boudet, DDS, DICOI
1840 Forest Hill Blvd, Suite 204
West Palm Beach, Florida  33406
Phone: (561) 968 6022