Radiation protection devices in dentistry: recent positions on x-rays

In recent years, the use of x-rays in dental practices has undergone radical changes thanks to major technological advancements in radiological equipment. Historically, radiation protection devices in dentistry, such as lead aprons or thyroid collars, were considered essential tools to protect highly sensitive organs such as the thyroid, reproductive organs, and the crystalline lens from ionizing radiation. X-ray protection was absolutely necessary due to the high radiation doses required by older equipment. Today’s modern devices allow diagnostic exams to be carried out with significantly lower doses, thus questioning the actual need for traditional shielding.
Radiation protection devices used in modern dental practices

TABLE OF CONTENTS

  1. X-ray protection, new evidence
  2. Protection of reproductive organs and the fetus
  3. Thyroid lead collar: when to use it?
  4. Radiation dose optimization for effective diagnostic imaging
  5. Radiation protection in dentistry: conclusions and recommendations

1. X-ray protection, new evidence ⇧

The international scientific community has recently revised the use of radiation protection devices in dentistry. Recent studies have shown that thanks to the introduction of low-energy x-rays and highly precise systems for beam alignment, radiation doses are drastically reduced while maintaining high-quality diagnostic images. Radiation protection devices such as thyroid collars can even be problematic if not properly positioned or if moved unintentionally. This often increases the risk of image interference and may require repeat radiographs, which inevitably raise overall x-ray exposure.

Issues associated with traditional radiation protection devices

Traditional shielding devices can sometimes interfere with automatic exposure control systems, resulting in increased rather than reduced doses. The most frequently reported issues include:

  • reduced image quality due to artifacts or improper shielding;
  • need to repeat exams because of poor initial image quality;
  • incorrect positioning that hinders adequate visualization of the anatomical area of interest.

These issues suggest that their routine use is no longer recommended with modern equipment.

2. Protection of reproductive organs and the fetus ⇧

The use of devices to protect reproductive organs and the fetus has long been considered essential. However, recent international and national studies—including those promoted by respected institutions such as the Italian Association of Medical Physics (AIFM) and the Italian Society of Medical and Interventional Radiology (SIRM)—have clarified that the use of shielding for these areas provides no significant benefit. The effectiveness of protection is negligible, as reproductive organs are generally far from the direct exposure field in radiographs of other parts of the body, such as the oral cavity. Moreover, the genetic effects of ionizing radiation—even at higher doses—have never been observed in humans.

3. Thyroid lead collar: when to use it? ⇧

The thyroid represents a significant exception to the above, as it is one of the most radiosensitive organs, especially in pediatric patients and young adults. Although the new European guidelines of 2024 have reduced the general recommendation for its use, the thyroid lead collar can still play an important role in specific cases:

  1. in pediatric and young patients undergoing cephalometric or panoramic radiographs;
  2. when full visualization of the cervical area is not required;
  3. in situations where the collar does not interfere with the diagnostic image or with automatic radiation control systems.

4. Radiation dose optimization for effective diagnostic imaging ⇧

Thanks to the latest generation dental equipment, it is now possible to ensure maximum patient protection without compromising diagnostic quality. X-ray exposure optimization is achieved through:

  • use of advanced digital technologies that minimize the required dose;
  • highly focused x-ray beams that limit irradiation to only the necessary areas;
  • enhanced sensitivity of digital detectors, capable of capturing high-resolution images with low exposure levels.

5. Radiation protection in dentistry: conclusions and recommendations ⇧

Recent scientific positions on dental radiation protection confirm that traditional shielding devices are generally no longer necessary with modern radiological technology. However, specific exceptions—such as thyroid protection in younger patients—require case-by-case evaluation. It is therefore essential that patients choose dental practices equipped with state-of-the-art technologies, such as Studio Motta Jones Rossi & Associati, which ensure the highest levels of safety and diagnostic quality.