a Consumer and Clinical Radiation Protection Bureau, Healthy Environments and Consumer Safety Branch , Health Canada , Ottawa , Canada.
Int J Radiat Biol. 2019 Feb;95(2):107-119. doi: 10.1080/09553002.2019.1547436. Epub 2019 Jan 24.
Routine dental X-rays are among the most common sources of ionizing radiation exposure for healthy individuals globally, with 300 examinations/1000 individuals/year as documented by the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) global survey of medical radiation usage and exposure. Furthermore, in the United States of America, an increased use of dental radiography is evident. However, with the shift from using film to digital image receptors, the dose of radiation per routine examination has decreased. Despite this, there remains public concern of dental X-rays. This continuing concern highlights the need to review the literature on biological and health effects related to exposure, from dental X-rays.
This report presents studies investigating biological and health effects related to exposures using dental X-rays in patients and provides a critical evaluation. Relevant studies specific to dental X-rays are reviewed from 1970 and onward with the bulk data in this field resulting from epidemiological and biomonitoring studies.
While, most epidemiological studies suggest a possible correlation between head/neck related tumors and exposure to dental X-rays, evidence for causation is lacking. Biomonitoring studies suggest that exposure to low-level radiation such as that of dental radiography may not be a factor in inducing long-term chromosomal damage, but may result in localized cytotoxicity in the irradiated region of the mouth, with no long-term harm.
In general, the total number of studies is low and the majority of the data has been generated from poorly designed experiments. This review will highlight shortcomings that could influence outcomes and provide a more balanced interpretation that could impact the public perception and the level of public concern on the health effects resulting from dental X-rays.
联合国原子辐射影响问题科学委员会（UNSCEAR）对全球医疗辐射使用和照射情况的全球调查记录，全球范围内，常规牙科 X 射线是健康人群接受电离辐射的最常见来源之一，每 1000 人中有 300 人接受检查/年。此外，在美国，牙科射线照相的使用明显增加。然而，随着从胶片向数字图像接收器的转变，每次常规检查的辐射剂量已经减少。尽管如此，公众仍然对牙科 X 射线表示担忧。这种持续的关注凸显了审查与牙科 X 射线照射相关的生物学和健康影响文献的必要性。
本报告介绍了调查与患者接受牙科 X 射线照射相关的生物学和健康影响的研究，并对其进行了批判性评估。本报告回顾了自 1970 年以来专门针对牙科 X 射线的相关研究，该领域的大部分数据来自流行病学和生物监测研究。
虽然大多数流行病学研究表明头部/颈部相关肿瘤与牙科 X 射线照射之间可能存在相关性，但缺乏因果关系的证据。生物监测研究表明，接触牙科放射摄影等低水平辐射可能不是引起长期染色体损伤的因素，但可能导致口腔照射区域的局部细胞毒性，而没有长期危害。
总体而言，研究数量较少，大多数数据来自设计不佳的实验。本综述将突出可能影响结果的缺点，并提供更平衡的解释，这可能会影响公众对牙科 X 射线产生的健康影响的看法和公众的关注程度。
