I think there is a frustrating balance here. Yes, Dentists are probably over x-raying, but I'm not sure I want to live in a world where it is difficult to get insurance to agree to an x-ray if I...
I think there is a frustrating balance here. Yes, Dentists are probably over x-raying, but I'm not sure I want to live in a world where it is difficult to get insurance to agree to an x-ray if I need it. I feel like that is where we live right now in terms of MRIs. I tore my achilles tendon in 2020 - only the half that connects to the bottom of the heel so it didn't fully rupture - but they were unsure of what I had actually done until I got an MRI. I was given 3 different set of x-rays that were all "inconclusive" and had to fight really hard to get a MRI. It took 3 doctor visits, 2 visits to the insurance office (I was in grad school at the time), and had to pay $500 out of pocket for it as a co-pay. It verified that it was torn and completely changed the recovery advice. 2 years prior to that I had a nodule in my hand from climbing. I heard 4 times that it was an A-1 pully partial tear that would heal in a few months of disuse. After a frustrating full year of not climbing and no change on the nodule I finally convinced a doctor to order an MRI. It was fucking dupuytren's contracture and again had a very different treatment and recovery regime.
So while I too am sick of excessive x-rays, I don't want to have to fight tooth and nail with my provider or insurance company to get them covered. And while it is annoying that dentists are making more money by ordering them, the alternative in my mind is worse. This is a systematic issue with our healthcare systems, not one we should be taking on in a targeted, isolated way.
On my most recent visit, I asked if we really needed X-Rays every year, and they hygenist told me "There is no risk, and they come in handy, even when scaling. They also told me to come back every...
On my most recent visit, I asked if we really needed X-Rays every year, and they hygenist told me "There is no risk, and they come in handy, even when scaling.
They also told me to come back every 4 months for cleaning, despite my mouth being in good shape.
Oh, also, there's a Canadian doctor shortage. But there's a dentist office on every block.
It's every 12 months here.. I don't know if that's good or if six months is good, but people are definitely getting exploited with that 4 month thing. Just not necessary
It's every 12 months here.. I don't know if that's good or if six months is good, but people are definitely getting exploited with that 4 month thing. Just not necessary
I should say, what I pay is 20 bucks, and the national health insurance pays the other 2/3rds so the dentist is billing about 60ish, 75 if I count the fluoride addition I always get.
I should say, what I pay is 20 bucks, and the national health insurance pays the other 2/3rds so the dentist is billing about 60ish, 75 if I count the fluoride addition I always get.
It's every six months here in Germany (though that's just recommended ofc, iirc there is some sort of card you can get where you get some sort of benefits for going for checkups/cleanings...
It's every six months here in Germany (though that's just recommended ofc, iirc there is some sort of card you can get where you get some sort of benefits for going for checkups/cleanings regularly? never dug into the details there), and it costs about the same as for you I think -- but they absolutely don't x-ray you every session, I think the frequency of x-rays I've gotten has been closer to every two years.
At least here, supplemental private dental insurance is super cheap, so I pay a little per month for that and always get it reimbursed. Honestly it's dumb af that dental stuff isn't just covered entirely by public health insurance here like every other doctor's visit.
I used to get cleanings every 3 months when I was a kid. My teeth were disgusting, but never had cavities. Now I go every 6 months, but occasionally get a third one in for the year if my hygienist...
I used to get cleanings every 3 months when I was a kid. My teeth were disgusting, but never had cavities.
Now I go every 6 months, but occasionally get a third one in for the year if my hygienist (who is a family friend) thinks I could use it to prevent cavities (which I never had until I was an adult).
Even then, they only do x-rays once a year for me.
Unfortunately I have a family history of poor dental health and I'm also prone to cavities so they recommended I come every 3 months. However, out of all the dentists I've gone to, none of them...
Unfortunately I have a family history of poor dental health and I'm also prone to cavities so they recommended I come every 3 months. However, out of all the dentists I've gone to, none of them have done X rays after the initial consultation.
Interestingly, the article definitely doesn't even support the six month interval:
Interestingly, the article definitely doesn't even support the six month interval:
The problem has bubbled up again in a series of commentary pieces published in JAMA Internal Medicine today. The pieces were all sparked by a viewpoint that Ars reported on in May, in which three dental and health experts highlighted that many routine aspects of dentistry, including biannual cleanings, are not evidence-based and that the industry is rife with overdiagnosis and overtreatment.
That's a terrific share, as during my visit when I scoffed at the 4 month recommendation, they acted defensive and said they were just sharing "the colleges viewpoint". I lumped it into the "I...
That's a terrific share, as during my visit when I scoffed at the 4 month recommendation, they acted defensive and said they were just sharing "the colleges viewpoint".
I lumped it into the "I don't care" pile, but now my inner pedant wants to be able to confront a claim like that.
Edit: My immediate reaction to seeing the author of this story being the same author as OP's story has me wondering if there's a vendetta...
Last I checked, the evidence in favour of flossing regularly is very weak. Dentistry is in need of some more good population level studies. Those are very expensive to run, so they haven't been done.
Last I checked, the evidence in favour of flossing regularly is very weak. Dentistry is in need of some more good population level studies. Those are very expensive to run, so they haven't been done.
I’m hesitant to agree with this because it further injects insurance companies (and their bottom lines) into decisions that should really be between a patient and their doctor. It’s a shame that...
I’m hesitant to agree with this because it further injects insurance companies (and their bottom lines) into decisions that should really be between a patient and their doctor. It’s a shame that the incentives for the system are this way.
First off let me preface all of what I'm about to say that these are just my observations. I do not work in dentistry (have worked in optometry before and it's a similar situation to dentistry)...
First off let me preface all of what I'm about to say that these are just my observations. I do not work in dentistry (have worked in optometry before and it's a similar situation to dentistry) and only have my own personal knowledge of insurance and laws, etc.
That said, I would agree with you, but the nature of our (USA) current healthcare system puts this much power in the hands of private insurance companies.
Dentistry as a medical practice is itself in a weird place (see this NBC News article for a bit of background) - probably due to lobbying by the dental and insurance industries in addition to any historical holdovers from where the practice of dentistry comes from.
I am not trying to denigrate dentists or say they are incompetent or have anything but the best in mind for their patients - however they operate in a system that gives them somewhat contradictory goals - make money AND provide a robust medical service. I think if you look at the way dentist's offices are setup (think basically they are all individual small businesses vs. a large hospital system or medical practice conglomerate) and they are working more in the margins where profit becomes more important. I also think this shows why you can find dentists that do what I call "ancillary" medical things like Botox and non-medically necessary cosmetics (veneers - and probably to a lesser extent braces and invisalign). This is to help keep their practices (i.e. their business) afloat and profitable. Dental school is not cheap, and neither are the required medical devices, training, insurance, staff, etc.
I tend to take a bit of a realist view of these things, and for now that means to adjust how some medical businesses are run (or in other words, to insure that we as patients get the best care) you have to adjust the flow of the money. Some people would call it a cynical view, I'm sure, but I think it is the most realistic today. If we "took the money out of" medical care, then I think the entire ecosystem would look much different and probably be better overall for us as patients. But that's not the society we have today, unfortunately.
But at the end of the day do I want a for profit insurance company throwing it's weight around to change the way medicine is practiced? Absolutely not! That should be up to medical professionals and their professional organizations, not bean counters.
That's really more what I was getting at with my comment. Yes, it's the society we live in today, but it doesn't have to be the one we live in tomorrow.
If we "took the money out of" medical care, then I think the entire ecosystem would look much different and probably be better overall for us as patients. But that's not the society we have today, unfortunately.
That's really more what I was getting at with my comment. Yes, it's the society we live in today, but it doesn't have to be the one we live in tomorrow.
Giving insurance companies authority over doctors on what's "medically necessary" is already absolutely disgusting and harmful when it comes to regular health care in the US. Giving them that...
Giving insurance companies authority over doctors on what's "medically necessary" is already absolutely disgusting and harmful when it comes to regular health care in the US. Giving them that decision making power in even more domains is not better.
This seems like the weirdest thing to push back on. In my experience insurance will deny anything and everything they can and claim whatever it takes to do so. X ray's aren't at all that difficult...
This seems like the weirdest thing to push back on.
In my experience insurance will deny anything and everything they can and claim whatever it takes to do so. X ray's aren't at all that difficult to do, are probably over-costed (at least in the US where the whole insurance thing is messed up), and have essentially no downside so I don't get why we want to do them less?
The radiation is negligible and the potential catches are important? Like yeah it probably could be done less, but the last thing I want is insurance having any more say in my health.
Edit:
The main argument of the article seems to be that there's an over diagnosis issue with xrays being used, which I guess I can see, but that's not exactly new to dentistry, and something I'm suspect will suddenly slow down should you limit X rays.
In general a lot of this seems to point to "do more studies" and "enforce higher standards"?
Radiation exposure is a downside. Yes, it's not very much radiation exposure, but it's still some - so if there's no upside to go along with it, doing a procedure that is only downside, even if it...
and have essentially no downside
Radiation exposure is a downside. Yes, it's not very much radiation exposure, but it's still some - so if there's no upside to go along with it, doing a procedure that is only downside, even if it is minimal downside, is unethical.
Radiation exposure is not the only downside. Overtreatment based on false positives is another downside. This can be a real issue, and is the reason we don't just do whole population screenings for every disease we know about.
Like yeah it probably could be done less, but the last thing I want is insurance having any more say in my health.
This is a false dichotomy. Everyone in this discussion seems to be jumping straight to the idea that insurance not paying for it is the only way to lower the rates of use. Strong evidence-based guidelines from a professional group, and then dentists actually following those guidelines, is another non-insurance-based way to get the industry to conform to best practices. This is how much of medicine works already - for instance, the guidelines for mammography changing to start at age 40 after lots of back-and-forth about whether it was useful or not.
Which is why I said essentially no downside, because you get more radiation going to the top of a building or on a plane than you do in a dental xray. So if there is literally any benefit at all,...
Radiation exposure is a downside.
Which is why I said essentially no downside, because you get more radiation going to the top of a building or on a plane than you do in a dental xray. So if there is literally any benefit at all, it will easily outweigh the supposed downside of the additional radiation. You get about as much radiation in a 12 hour period as you do in a dental x ray(or at least the kind being discussed. The full teeth stuff with the fancier equipment is more) by just existing.
If you don't like it because of bad practices, overcharged insurance, or false positives I can at least get that, but the dose is scientifically and statistically insignificant.
Everyone in this discussion seems to be jumping straight to the idea that insurance not paying for it is the only way to lower the rates of use.
Because the alternative you mention is already supposed to exist and is not actually doing anything. Mostly because you need someone who:
Actually believes the xray's are required
Can actually be taught they aren't
Decides to make that change even though their patients might think they're bad at their job because of it
All with little to no change to the actual patient health EXCEPT maybe lowering false positives/over diagnosing. There's already much larger issues with dentists just saying you need X or Y when it's straight up 100% fraudulent, and I suspect anyone in between the outright criminals and the "i must do the absolute best practices" is going to err on the side of "meh fuck it" for basically any patient on insurance.
Maybe this is unworkable, but suppose dentists couldn't charge separately for X-rays? How often would they do them anyway? I'm reminded of the various eye test machines that optometrists have. At...
Maybe this is unworkable, but suppose dentists couldn't charge separately for X-rays? How often would they do them anyway?
I'm reminded of the various eye test machines that optometrists have. At the optometrist I go to, they don't charge extra for them, they just have you do them all. Since they have the machines, why not? (I haven't looked into how effective they are.)
Contrast with Kaiser. They don't do those eye tests except if the doctor thinks it's needed, and then they have you come back to do them as a separate procedure, with its own co-pay. It's pretty inconvenient to come back again. I don't recommend Kaiser for eyecare.
That bit about Kaiser doesn’t surprise me in the slightest. I’ve never had the misfortune of using them for eye care, but every other interaction I have had with them has been mediocre or worse. I...
That bit about Kaiser doesn’t surprise me in the slightest. I’ve never had the misfortune of using them for eye care, but every other interaction I have had with them has been mediocre or worse. I can say for sure that they are awful at mental health. Despite my mental health insurance system being difficult to manage, my sister going through Kaiser was somehow worse. The best thing I have heard about Kaiser is that, if you are healthy and don’t really need medical care, it’s okay.
I have never had to deal with hearing aids, but I actually agree about vaccinations. When it works, (and it usually does) vaccines are pretty smooth at Kaiser. My complaint with vaccines is that...
I have never had to deal with hearing aids, but I actually agree about vaccinations. When it works, (and it usually does) vaccines are pretty smooth at Kaiser. My complaint with vaccines is that learning the non-Kaiser method after my insurance changed was long and difficult. It would have been much easier if Kaiser did it the way everyone else does, so I didn’t have to relearn an entire new system.
I really hate this argument towards radiation exposure from x-rays. It is comparable to the chance of dying if you travel via airplane. You're right in that it's a non-zero chance for a bad...
Radiation exposure is a downside. Yes, it's not very much radiation exposure, but it's still some - so if there's no upside to go along with it, doing a procedure that is only downside, even if it is minimal downside, is unethical.
I really hate this argument towards radiation exposure from x-rays. It is comparable to the chance of dying if you travel via airplane. You're right in that it's a non-zero chance for a bad outcome to occur, but the chances are incredibly low. I think it's important to put some numbers to these things: A radiation worker in the US is allowed to receive 5000 rem per year. This is considered a safe value for workers in the radiation sector. If I recall correctly, this value is 1000 rem per year for anybody not in that sector. A dental x-ray gives off 0.8 rem at worst. That means you would have to receive 1250 of the worst dental x-rays in a single year to break your yearly radiation limit, and this is in addition to the natural background radiation you are exposed to on a daily basis.
I agree that it seems mostly harmless to do them, particularly since the exposure to radiation has gone down over time, probably more than enough to compensate for the increase in frequency. But...
I agree that it seems mostly harmless to do them, particularly since the exposure to radiation has gone down over time, probably more than enough to compensate for the increase in frequency.
But it's a direct cost if you pay for the X-rays yourself like I do. It's an indirect cost if insurance pays for it. Not a very big cost, but it all adds up.
I feel like my dentist only does these because insurance will pay for it. It becomes a once a year thing for me because they know these things; I still like my dentist, I've had way worse, but if...
I feel like my dentist only does these because insurance will pay for it. It becomes a once a year thing for me because they know these things; I still like my dentist, I've had way worse, but if the insurance is paying for it, there seems to be an incentive for the dentist to do it.
I don’t use dental insurance (teeth are in good health and paying for checkups is cheaper). I have asked them to delay X-rays before and will probably do that more.
I don’t use dental insurance (teeth are in good health and paying for checkups is cheaper). I have asked them to delay X-rays before and will probably do that more.
The association's guidelines from 2012 recommended that adults who don't have an increased risk of dental caries (myself included) need only bitewing X-rays of the back teeth every two to three years. Even people with a higher risk of caries can go as long as 18 months between bitewings. The guidelines also note that X-rays should not be preemptively used to look for problems: "Radiographic screening for the purpose of detecting disease before clinical examination should not be performed," the guidelines read. In other words, dentists are supposed to examine your teeth before they take any X-rays.
But, of course, the 2012 guidelines are outdated—the latest ones go further. In updated guidance published in April, the ADA doesn't recommend any specific time window for X-rays at all. Rather, it emphasizes that patient exposure to X-rays should be minimized, and any X-rays should be clinically justified.
I think there is a frustrating balance here. Yes, Dentists are probably over x-raying, but I'm not sure I want to live in a world where it is difficult to get insurance to agree to an x-ray if I need it. I feel like that is where we live right now in terms of MRIs. I tore my achilles tendon in 2020 - only the half that connects to the bottom of the heel so it didn't fully rupture - but they were unsure of what I had actually done until I got an MRI. I was given 3 different set of x-rays that were all "inconclusive" and had to fight really hard to get a MRI. It took 3 doctor visits, 2 visits to the insurance office (I was in grad school at the time), and had to pay $500 out of pocket for it as a co-pay. It verified that it was torn and completely changed the recovery advice. 2 years prior to that I had a nodule in my hand from climbing. I heard 4 times that it was an A-1 pully partial tear that would heal in a few months of disuse. After a frustrating full year of not climbing and no change on the nodule I finally convinced a doctor to order an MRI. It was fucking dupuytren's contracture and again had a very different treatment and recovery regime.
So while I too am sick of excessive x-rays, I don't want to have to fight tooth and nail with my provider or insurance company to get them covered. And while it is annoying that dentists are making more money by ordering them, the alternative in my mind is worse. This is a systematic issue with our healthcare systems, not one we should be taking on in a targeted, isolated way.
On my most recent visit, I asked if we really needed X-Rays every year, and they hygenist told me "There is no risk, and they come in handy, even when scaling.
They also told me to come back every 4 months for cleaning, despite my mouth being in good shape.
Oh, also, there's a Canadian doctor shortage. But there's a dentist office on every block.
That seems like a situation where it makes sense to push back and say, no, six months is fine.
It's every 12 months here.. I don't know if that's good or if six months is good, but people are definitely getting exploited with that 4 month thing. Just not necessary
And here my cleanings are every 3 months...
They're also the equivalent of like 20 bucks so i don't really mind though.
Wow okay, that's crazy cheap. Using a currency converter.. you're looking at anywhere between 75 and 150 dollars here.
I should say, what I pay is 20 bucks, and the national health insurance pays the other 2/3rds so the dentist is billing about 60ish, 75 if I count the fluoride addition I always get.
It's every six months here in Germany (though that's just recommended ofc, iirc there is some sort of card you can get where you get some sort of benefits for going for checkups/cleanings regularly? never dug into the details there), and it costs about the same as for you I think -- but they absolutely don't x-ray you every session, I think the frequency of x-rays I've gotten has been closer to every two years.
At least here, supplemental private dental insurance is super cheap, so I pay a little per month for that and always get it reimbursed. Honestly it's dumb af that dental stuff isn't just covered entirely by public health insurance here like every other doctor's visit.
I used to get cleanings every 3 months when I was a kid. My teeth were disgusting, but never had cavities.
Now I go every 6 months, but occasionally get a third one in for the year if my hygienist (who is a family friend) thinks I could use it to prevent cavities (which I never had until I was an adult).
Even then, they only do x-rays once a year for me.
Unfortunately I have a family history of poor dental health and I'm also prone to cavities so they recommended I come every 3 months. However, out of all the dentists I've gone to, none of them have done X rays after the initial consultation.
Interestingly, the article definitely doesn't even support the six month interval:
That's a terrific share, as during my visit when I scoffed at the 4 month recommendation, they acted defensive and said they were just sharing "the colleges viewpoint".
I lumped it into the "I don't care" pile, but now my inner pedant wants to be able to confront a claim like that.
Edit: My immediate reaction to seeing the author of this story being the same author as OP's story has me wondering if there's a vendetta...
Last I checked, the evidence in favour of flossing regularly is very weak. Dentistry is in need of some more good population level studies. Those are very expensive to run, so they haven't been done.
Dentists won't change their tune until insurance companies stop paying out for non-medically necessary x-rays.
I’m hesitant to agree with this because it further injects insurance companies (and their bottom lines) into decisions that should really be between a patient and their doctor. It’s a shame that the incentives for the system are this way.
Yes, I wouldn't use insurance companies' unwillingness to pay for a procedure as any kind of reliable indicator of whether it is necessary.
First off let me preface all of what I'm about to say that these are just my observations. I do not work in dentistry (have worked in optometry before and it's a similar situation to dentistry) and only have my own personal knowledge of insurance and laws, etc.
That said, I would agree with you, but the nature of our (USA) current healthcare system puts this much power in the hands of private insurance companies.
Dentistry as a medical practice is itself in a weird place (see this NBC News article for a bit of background) - probably due to lobbying by the dental and insurance industries in addition to any historical holdovers from where the practice of dentistry comes from.
I am not trying to denigrate dentists or say they are incompetent or have anything but the best in mind for their patients - however they operate in a system that gives them somewhat contradictory goals - make money AND provide a robust medical service. I think if you look at the way dentist's offices are setup (think basically they are all individual small businesses vs. a large hospital system or medical practice conglomerate) and they are working more in the margins where profit becomes more important. I also think this shows why you can find dentists that do what I call "ancillary" medical things like Botox and non-medically necessary cosmetics (veneers - and probably to a lesser extent braces and invisalign). This is to help keep their practices (i.e. their business) afloat and profitable. Dental school is not cheap, and neither are the required medical devices, training, insurance, staff, etc.
I tend to take a bit of a realist view of these things, and for now that means to adjust how some medical businesses are run (or in other words, to insure that we as patients get the best care) you have to adjust the flow of the money. Some people would call it a cynical view, I'm sure, but I think it is the most realistic today. If we "took the money out of" medical care, then I think the entire ecosystem would look much different and probably be better overall for us as patients. But that's not the society we have today, unfortunately.
But at the end of the day do I want a for profit insurance company throwing it's weight around to change the way medicine is practiced? Absolutely not! That should be up to medical professionals and their professional organizations, not bean counters.
That's really more what I was getting at with my comment. Yes, it's the society we live in today, but it doesn't have to be the one we live in tomorrow.
Giving insurance companies authority over doctors on what's "medically necessary" is already absolutely disgusting and harmful when it comes to regular health care in the US. Giving them that decision making power in even more domains is not better.
This seems like the weirdest thing to push back on.
In my experience insurance will deny anything and everything they can and claim whatever it takes to do so. X ray's aren't at all that difficult to do, are probably over-costed (at least in the US where the whole insurance thing is messed up), and have essentially no downside so I don't get why we want to do them less?
The radiation is negligible and the potential catches are important? Like yeah it probably could be done less, but the last thing I want is insurance having any more say in my health.
Edit:
The main argument of the article seems to be that there's an over diagnosis issue with xrays being used, which I guess I can see, but that's not exactly new to dentistry, and something I'm suspect will suddenly slow down should you limit X rays.
In general a lot of this seems to point to "do more studies" and "enforce higher standards"?
Radiation exposure is a downside. Yes, it's not very much radiation exposure, but it's still some - so if there's no upside to go along with it, doing a procedure that is only downside, even if it is minimal downside, is unethical.
Radiation exposure is not the only downside. Overtreatment based on false positives is another downside. This can be a real issue, and is the reason we don't just do whole population screenings for every disease we know about.
This is a false dichotomy. Everyone in this discussion seems to be jumping straight to the idea that insurance not paying for it is the only way to lower the rates of use. Strong evidence-based guidelines from a professional group, and then dentists actually following those guidelines, is another non-insurance-based way to get the industry to conform to best practices. This is how much of medicine works already - for instance, the guidelines for mammography changing to start at age 40 after lots of back-and-forth about whether it was useful or not.
Which is why I said essentially no downside, because you get more radiation going to the top of a building or on a plane than you do in a dental xray. So if there is literally any benefit at all, it will easily outweigh the supposed downside of the additional radiation. You get about as much radiation in a 12 hour period as you do in a dental x ray(or at least the kind being discussed. The full teeth stuff with the fancier equipment is more) by just existing.
If you don't like it because of bad practices, overcharged insurance, or false positives I can at least get that, but the dose is scientifically and statistically insignificant.
Because the alternative you mention is already supposed to exist and is not actually doing anything. Mostly because you need someone who:
All with little to no change to the actual patient health EXCEPT maybe lowering false positives/over diagnosing. There's already much larger issues with dentists just saying you need X or Y when it's straight up 100% fraudulent, and I suspect anyone in between the outright criminals and the "i must do the absolute best practices" is going to err on the side of "meh fuck it" for basically any patient on insurance.
Maybe this is unworkable, but suppose dentists couldn't charge separately for X-rays? How often would they do them anyway?
I'm reminded of the various eye test machines that optometrists have. At the optometrist I go to, they don't charge extra for them, they just have you do them all. Since they have the machines, why not? (I haven't looked into how effective they are.)
Contrast with Kaiser. They don't do those eye tests except if the doctor thinks it's needed, and then they have you come back to do them as a separate procedure, with its own co-pay. It's pretty inconvenient to come back again. I don't recommend Kaiser for eyecare.
That bit about Kaiser doesn’t surprise me in the slightest. I’ve never had the misfortune of using them for eye care, but every other interaction I have had with them has been mediocre or worse. I can say for sure that they are awful at mental health. Despite my mental health insurance system being difficult to manage, my sister going through Kaiser was somehow worse. The best thing I have heard about Kaiser is that, if you are healthy and don’t really need medical care, it’s okay.
I think they’re okay for hearing aids. Getting flu and covid shots went pretty smoothly. It depends what you’re doing.
I have never had to deal with hearing aids, but I actually agree about vaccinations. When it works, (and it usually does) vaccines are pretty smooth at Kaiser. My complaint with vaccines is that learning the non-Kaiser method after my insurance changed was long and difficult. It would have been much easier if Kaiser did it the way everyone else does, so I didn’t have to relearn an entire new system.
I really hate this argument towards radiation exposure from x-rays. It is comparable to the chance of dying if you travel via airplane. You're right in that it's a non-zero chance for a bad outcome to occur, but the chances are incredibly low. I think it's important to put some numbers to these things: A radiation worker in the US is allowed to receive 5000 rem per year. This is considered a safe value for workers in the radiation sector. If I recall correctly, this value is 1000 rem per year for anybody not in that sector. A dental x-ray gives off 0.8 rem at worst. That means you would have to receive 1250 of the worst dental x-rays in a single year to break your yearly radiation limit, and this is in addition to the natural background radiation you are exposed to on a daily basis.
I agree that it seems mostly harmless to do them, particularly since the exposure to radiation has gone down over time, probably more than enough to compensate for the increase in frequency.
But it's a direct cost if you pay for the X-rays yourself like I do. It's an indirect cost if insurance pays for it. Not a very big cost, but it all adds up.
I feel like my dentist only does these because insurance will pay for it. It becomes a once a year thing for me because they know these things; I still like my dentist, I've had way worse, but if the insurance is paying for it, there seems to be an incentive for the dentist to do it.
I don’t use dental insurance (teeth are in good health and paying for checkups is cheaper). I have asked them to delay X-rays before and will probably do that more.
From the article: