Planmeca Ultra Low Dose Radiation Technology

Dr. Todd Welsh and Bucks County Orthodontics have recently added The ProMax X-ray Machine to our office, which brings new possibilities for treatment planning and maximizes the safety of our imaging procedures. This unit complies with the best practices in dentistry by following the American Dental Association’s ALARA (As Low As Reasonably Achievable) radiation principle to minimize the effective radiation dose to our patients. The unique features of this unit allow us to choose what area of the teeth and facial anatomy we need to capture, which significantly reduces any unnecessary exposure. Our staff can also adjust the unit’s settings, allowing us to capture only the details we need. We will be using this unit with state-of-the-art software applications for the best possible care using the latest technology.

Radiation in Everyday Life

What is Radiation?

Radiation is a form of energy in waves. It exists on a spectrum, with low-frequency radiation (from radio waves and microwaves) on the low end and high-frequency radiation (from gamma rays and x-rays) on the high end. All radiation affects the cells in our bodies to some extent, but the lower the frequency of the waves and the lower the exposure, the less dangerous it is.

Types of Radiation?

The term "radiation" is very broad, and includes such things as light and radio waves. In our context it refers to "ionizing" radiation, which means that because such radiation passes through matter, it can cause it to become electrically charged or ionized. In living tissues, the electrical ions produced by radiation can affect normal biological processes.

How are we exposed to Radiation?

We encounter radiation each day from a variety of sources. The average American is exposed to about 6 millisieverts (mSv) of radiation annually, according to the United States Nuclear Regulatory Commission (USNRC). Half of this typically comes from background radiation that occurs naturally in the environment, and half comes from medical tests, such as X-rays, mammograms, and CT scans.

According to Kelly Classic, MS, spokesperson for the Health Physics Society, sources of environmental radiation include:

  • Radioactive compounds in soil and building materials like concrete, brick, and stone
  • Radiation from outer space that you encounter when you fly on airplanes or visit high-altitude places
  • The mineral potassium in your own body (a small fraction of potassium, which our bodies need to function, is radioactive)
  • Radon gas in the home, which accounts for about 2 mSv of exposure each year, and is the largest contributor of background radiation

Finally, there's the kind of radiation released during nuclear reactions, such as what's disseminating from Japan's Fukushima Daiichi plant.

Here's a look at various sources of radiation exposure, according to data from the Health Physics Society and the U.S. Environmental Protection Agency (EPA).

By way of comparison, a single dose of radiation below 0.01 mSv is considered negligible by the National Council on Radiation Protection and Measurements.

Item Dose of Radiation in MicroSieverts
Banana .1 mSv
Planmeca ProMax Panoramic Bitewing 4.6 mSv
Living within 50 miles of a nuclear power plant 10 mSv per year
Planmeca ProMax Panoramic Image 15 mSv
A flight from New York to Los Angeles 40 mSv
Smoking 1 1/2 packs of cigarettes 80 mSv
Chest X-ray 100 mSv
Living at sea level 250 mSv per year
Mammogram 300 mSv
Living in Denver 500 mSv per year
Abdominal CT scan 1,400 mSv

According to theWorld Nuclear Association, annual exposure to 100 mSv or greater carries a measurable, though small, increase in cancer risk. Below that level, it's believed that your body's cells are able to heal themselves from radiation. "There are enzyme systems in the body that repair damage from these low levels of background radiation.

The use of radiation and nuclear techniques in medicine, industry, agriculture, energy and other scientific and technological fields has brought tremendous benefits to society. The benefits in medicine for diagnosis and treatment in terms of human lives saved are enormous. Radiation is a key tool in the treatment of certain kinds of cancer. Three out of every four patients hospitalized in the industrial countries benefit from some form of nuclear medicine. The beneficial impacts in other fields are similar.

No human activity or practice is totally devoid of associated risks. Radiation should be viewed from the perspective that the benefit from it to mankind is less harmful than from many other agents.*

*IAEA International Atomic Energy Agency

PLANMECA and the ALARA Principle (As Low As Reasonably Achievable)

PLANMECA’s follows the clinical values that emphasize the use of the least amount of radiation to achieve the best results possible. This commitment to “As Low As Reasonably Achievable”or the ALARA radiation principle keeps both dentist and patient safe and is the premise of PLANMECA’s X-ray equipment. The ability to use the least amount of radiation possible is made possible by PLANMECA’s patented Selectively Compliant Articulated Robotic Arm technology built into its ProMax platform. This robotic arm allows for precise imaging anywhere in the maxillofacial/cranial region and eliminates exposure to areas not needed for diagnosis.

The ThreeMost Common Types Of X-rays Are:

  • Extraoral Bitewing – Bitewing X-rays are the most common form of X-rays taken during a dental exam as they show dental cavities between teeth. However, not all bitewing X-rays are created equal: those taken with the PLANMECA ProMax may reduce radiation up to 40% in comparison with intraoral bitewings. The ProMax is statistically proven to detect more dental caries than those taken with traditional intraoral bitewing X-rays. Extraoral bitewings offer better infection control and diagnostic quality than bitewing’s taken with intraoral sensors. The ProMax Extraoral Bitewing eliminates a patient from gagging and provide a better patient experience.
  • Panoramic – The Panoramic X-ray gives a broad overview of the entire mouth. This X-ray supplies information about the teeth, upper and lower jawbone, sinuses and the other hard and soft tissues of the head and neck.
  • Periapical or (PA) – Periapical X-rays show the entire tooth, including the roots as well as the bone surrounding them. These X-rays are useful to diagnose a dental abcess as well as periodontal gum disease.

What Are 3D X-rays?

3D CBCT X-rays are a compact, safer, faster version of a regular CAT scan or CT. In 3D dental X-rays, a cone shaped X-ray beam used during rotation, produces cross sectional images of bone and some soft tissues in varying degrees of detail depending on pre-determined level of resolution. Though there are many other imaging techniques, some more detailed, 3D CBCT imaging has the unique ability to offer clear images with limited patient exposure to radiation and provides only the necessary detail needed to make a proper diagnosis. Your doctor would use 3D X-ray for a variety of diagnostic tests including:

  • Oral surgery
  • Implant planning
  • Orthodontic planning & implant anchorage
  • Cephalometric analysis
  • TMJ analysis
  • Airway study (sleep apnea)
  • Jaw tumors
  • Impacted teeth
  • Periodontal diseases
  • Endodontic anomalies implants, oral surgery, and problems related to gums

What Is A Cephalometric Scan?

A cephalometric x-ray, also simply known as a ceph, is a diagnostic radiograph used primarily for orthodontic treatment planning, and is taken during the orthodontic records appointment. Cephalometric x-rays are also used by otolaryngologists -- doctors who specialize in the treatment of ear, nose and throat (ENT) disorders such as sleep apnea -- because these x-rays can provide a view of the patient's airways.

How Often Should Radiographs Be Taken?

How often X-rays (radiographs) should be taken depends on your present oral health, your age, your risk for disease, and any signs and symptoms of oral disease you may be experiencing. For example, children may require X-rays more often than adults. This is because their teeth and jaws are still developing. Also their teeth are more likely to be affected by tooth decay than those of adults.

If you are a new patient, the dentist may recommend radiographs to determine the present status of your oral health and to help identify changes that may occur later. A new set of X-rays may be needed to help your dentist detect any new cavities, determine the status of your gum health or evaluate the growth and development of your teeth. If a previous dentist has any radiographs of you, your new dentist may ask you for copies of them. Ask both dentists to help you with forwarding your X-rays.

What If I'm Pregnant And Need A Dental Radiograph Examination?

A radiograph may be needed for dental treatment that can’t wait until after the baby is born. Because untreated dental infections can pose a risk to the fetus, dental treatment may be necessary to maintain the health of the mother and child. Radiation exposure resulting from dental X-rays is low. However, every precaution is taken to ensure that radiation exposure is As Low As Reasonably Achievable (the ALARA principle). A leaded apron minimizes exposure to the abdomen and should be used when any dental radiograph is taken. Also, a leaded thyroid collar can protect the thyroid from radiation, and should also be used whenever possible. The use of a leaded thyroid collar is recommended for women of childbearing age, pregnant women and children. Dental X-ray exams do not need to be delayed if you are trying to become pregnant or are breast feeding.