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Answer to Question #292 Submitted to "Ask the Experts"Category: Pregnancy and Radiation — Exposures not directly to embryo/fetus The following question was answered by an expert in the appropriate field: Q
Does the Society have a position or recommendation regarding
clinically necessary dental x rays and/or medical x rays for the female
patient of childbearing age? I lecture on dental radiology and am
constantly being asked this very question. Any assistance you can
provide in the way of a position paper, statistics, etc., would be
greatly appreciated.
A
At the present time the Health Physics Society (HPS) does not have such a position paper. Many years ago, the British Institute of Radiology instituted the 10-day rule. This stated that diagnostic exposure of female patients of childbearing age be limited to the 10 days following the onset of each menstrual period—unless there was compelling medical urgency or unequivocal evidence that she could not be pregnant. This rule applies only to diagnostic exposure of the pelvic region such that the uterus would be in the primary beam. Many nations adopted this rule; the United States did not. It has now been repealed in all (I believe) of the countries that originally adopted it. Our National Council on Radiation Protection (NCRP)
recommended that management of current illness should take precedence
over the possibility of pregnancy—specially considering the small doses
from most diagnostic exposures (including dental) and the remote
possibility of adverse effect. At present I know of no recognized
authority or responsible body that recommends cancellation,
postponement, or modification of dental radiographic procedures for any
patient—except the known pregnant. Dental x-ray exposures for the
pregnant patient should be limited to those required for treatment to
be rendered immediately (while pregnant). If treatment is to be
deferred to term, then x rays should also be deferred. Radiation dose
to the pelvic region from a full-mouth series of dental radiographs,
done properly, is about 1 microgray (0.1 mrad). Done properly means E
speed film, rectangular collimation, time-temperature processing in
fresh solutions, etc. This should be compared with average annual
genetically significant dose to the US population of about 0.8
milligray (80 mrad) per year from natural environmental sources.
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