Protective aprons required during dental radiography

January 30, 2020
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Dec. 7, 2023: More studies are leading researchers to conclude that radiation doses from dentomaxillofacial imaging pose negligible risk. The mounting evidence has led some organizations to recommend patient shielding be discontinued as routine practice during dental X-rays. However, for now, the California regulation requiring the use of lead or lead-equivalent aprons during dental radiography remains in effect. Read CDA's latest article.

Jan. 30, 2020: Some hospitals in the U.S. have stopped the practice of covering patients’ reproductive organs during radiographic examinations, but CDA reminds dentists that current state regulation requires that protective aprons be used during dental radiography.

The move by hospitals follows an April 2019 recommendation by the American College of Radiology and other medical groups, Kaiser Health News reported last month. The article, which was picked up recently in an ADA Morning Huddle, also reported that the National Council of Radiation Protection and Measurements “is expected to release a statement supporting a halt to patient shielding.”

According to the AAPM statement, lead shields provide “negligible, or no, benefit to patients’ health” with the potential to “negatively affect the efficacy of the exam” by obscuring anatomy, for example, or by “drastically” increasing X-ray output and radiation dose due to modern imaging systems’ use of automatic exposure control.

Additionally, NCRP recently published “Report No. 177 – Radiation Protection in Dentistry and Oral & Maxillofacial Imaging.” Regarding protective aprons, it states, “Technological and procedural improvements have eliminated the requirement for the radiation protective apron, provided all other recommendations of this Report are rigorously followed, unless required by state regulation. However, some patients have come to expect the apron and may request that it be used.”

NCRP endorses the use of thyroid shielding when it will not interfere with imaging.

While radiographic experts are reassessing the need for protective aprons in light of current evidence and advances in technology, dentists should continue to use them until state regulation changes.

Title 17, California Code of Regulations Section 30311, requires that a protective apron of not less than 0.25 millimeter lead-equivalent be used to cover the gonadal area during dental radiography.

CDA will keep members informed of any developments in state regulations via the newsroom and weekly member newsletter.

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