American Academy of Oral and Maxillofacial Radiology Recommends Discontinuing Routine Use of Gonadal and Thyroid Shielding
The American Academy of Oral and Maxillofacial Radiology has released new evidence-based guidelines that challenge long-standing practices in radiation shielding during dentomaxillofacial imaging. These guidelines are based on comprehensive reviews of existing studies and aim to provide dental professionals with updated recommendations on patient safety.
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HCN Medical Memo
These new guidelines signify a paradigm shift in how we approach radiation safety during dentomaxillofacial imaging. Although the recommendations are grounded in extensive research, implementing them will require not only updates to regulations but also a concerted effort to educate both dental teams and patients about the changes. The ultimate goal remains the same: to ensure the highest level of patient safety while obtaining the necessary diagnostic information.
Key Points:
- Recommendation Against Gonadal Shielding: The committee found no evidence of radiation-induced heritable effects in humans and negligible dose to gonads and fetuses. They recommend discontinuing the use of gonadal shielding.
- Thyroid Shielding Not Necessary: The risks from thyroid cancer due to dentomaxillofacial imaging are considered negligible, making thyroid shielding unnecessary during most dental radiographic procedures.
- State and Local Regulation Updates: The guidelines call for updates in state and local regulations to reflect these new recommendations.
- Dentist Perspectives: Although the guidelines are backed by scientific evidence, they may face resistance due to long-standing practices and patient expectations.
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The radiation dose from contemporary dentomaxillofacial imaging is several thousand-fold below the threshold doses for occurrence of tissue reactions, making the risk virtually negligible.
Additional Points:
- Pregnant and Pediatric Patients: Special considerations are advised for these groups, although the guidelines suggest that shielding is generally unnecessary.
- Infection Control and Artifacts: The use of shielding materials like lead aprons can pose infection control risks and may interfere with image quality.
- Global Consensus: Similar recommendations have been made by other organizations, including the British Institute of Radiology and the European consensus group.
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