Dentist Visit - X-ray guard

[mb008]

Hi

I've read that when visiting the Dentists that I should use a guard to protect thyroid area from x-rays. Can anyone recommend one and where I can buy it from?

Thanks very much

[SeasideSusie Remembering]

I believe the dentist should have them at the surgery but you'd have to ask them to use it.

[Clutter]

mb008,

If the x-ray equipment is modern you probably won't need a thyroid guard but your dentist should be able to produce one if you really want one.

[Shibby]

Hi mb008, I take x-rays for dentists and I have never given a thyroid shield to any patients purely because there is the potential for the shield to actually trap the radiation in the neck rather than prevent it because of the angle of the x-rays and radiation physics. I have found very little scientific publications providing data produced from testing that would warrant me to offer them to my patients, and I also tell this to patients I x-ray. However the radiation is extremely low level and so long as you are not getting too many x-rays you shouldn't worry

[helvella Administrator in reply to Shibby]

This paper suggests that at least in some circumstances a thyroid shield can be of significant benefit - and not just the dose the thyroid receives but that received by other tissue.

Wearing a thyroid collar was helpful when the direct digital panoramic imaging systems were in use, whereas for the indirect digital panoramic imaging systems, the thyroid collar did not have an extra protective effect on the thyroid gland and whole body.

ncbi.nlm.nih.gov/pmc/articl...

[Shibby in reply to helvella]

Hi helvella, thanks for this. The difference for this imaging (panoramic) compared with X-rays inside the mouth (infra-oral) is the direction of the beam of the X-ray-its not a straight tube and diverts away from the thyroid. Using thyroid shields for patients for panoramics and cbct's is something I have already read into and something I am considering discussing in our department. However I did assume that the above post concerned intra oral X-rays as panoramics should not be performed routinely-only if a certain clinical question is to be answered. They recommend even intra orals be done every two years unless symptomatic (on dentist websites etc) to prevent build up of dose to the patient (instead of every 6 month for example).

[helvella Administrator in reply to Shibby]

When I had my first panoramic, I suspect the machine they used was fifty years older than their ordinary one. (Some exaggeration! But not that much.) With hindsight, I really do wonder whether it should have been in use.

I ended up have several over a few years. Followed by becoming hypothyroid. I don't blame them - but wonder if it had some impact. Obviously I'll never know and I do not wish to fallen into assumptions not borne out by evidence.

[Shibby in reply to helvella]

I completely understand. I have had radiographers with thyroid complaints contact me before as they feel their workload everyday may have effected their function. Dentists are a lot better now at not over irradiating patients, but they don't have the regulations to follow like I do.

[Zephyrbear in reply to Shibby]

That is exactly what my dentist told me too and I was more than happy with his very in-depth explanation. Just wish doctors could be just as knowledgable...

[nightingale-56]

Shibby my Dentist also told me this a few years ago when I asked about it. There are quite a few posts about this on this site.

[Silver_Fairy]

I always (have to) ask for a thyroid shield.

[Lynneypin]

When I had my panoramic I asked for a shield and they said it could distort the image and then they would have to retake it, so I would get twice the amount of radiation.....

[Shibby in reply to Lynneypin]

Yeh unfortunately I have taken these X-rays before where even necklaces and collars have obscured the lower part of the jaw so I wouldn't want to X-ray a patient with a shield only to have to repeat it. There are publications about concerning thyroid shields with panoramics such as the one above from helvella, but the ones I have read have shown results with artefacts from the thyroid shields too. The placement of the shield has to be exact- sometimes it helps to have X-ray vision in order to get it right first time 😂

[mb008]

Thanks everyone for their comments. I will talk to my dentist on the day and make a decision from there as I have no idea what type of x-ray I will need. Walking into a dentists with some knowledge is useful though.

Incidentally, I read the recommendation for a thyroid shield in Izabella Wendtz's book.

Been really interesting seeing the comments. - always learning from this site.

Thank-you