Patients with acoustic neuromas reported significantly more exposure x-rays

[annamaria]

Patients with acoustic neuromas reported significantly more exposure to dental x-rays than a matched cohort control group. Reducing the frequency of dental x-ray examinations may decrease the potential risk of VS.

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Special Supplements

Dec 2012 / Vol. 117 / No. Special Suppl / Pages 78-83

Article
Are frequent dental x-ray examinations associated with increased risk of vestibular schwannoma?
Clinical article

    Yueh-Ying Han, Ph.D.1,
    Oren Berkowitz, Ph.D., M.S.P.H., P.A.-C.1,2,
    Evelyn Talbott, Dr.P.H.1,
    Douglas Kondziolka, M.D.2,
    Maryann Donovan, Ph.D., M.P.H.3, and
    L. Dade Lunsford, M.D.2

1Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh; 2Department of Neurological Surgery, Center for Image Guided Neurological Surgery, School of Medicine, University of Pittsburgh and University of Pittsburgh Medical Center; and 3Department of Pathology, School of Medicine, University of Pittsburgh and University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
Abbreviations used in this paper: aOR = adjusted odds ratio; VS = vestibular schwannoma.
Address correspondence to: L. Dade Lunsford, M.D., Department of Neurological Surgery, Suite B-400, UPMC Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, Pennsylvania 15213. email: lunsfordld@upmc.edu.

Object

The authors evaluated the potential role of environmental risk factors, including exposure to diagnostic or therapeutic radiation and to wireless phones that emit nonionizing radiation, in the etiology of vestibular schwannoma (VS).

Methods

A total of 343 patients with VSs who underwent Gamma Knife surgery performed between 1997 and 2007 were age and sex matched to 343 control patients from the outpatient degenerative spinal disorders service at the University of Pittsburgh Medical Center. The authors obtained information on previous exposure to medical radiation, use of wireless phone technologies, and other environmental factors thought to be associated with the development of a VS. Conditional multivariate logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).

Results

After adjusting for race, education, cigarette smoking, alcohol consumption, occupational exposure to noise, use of cell phones, and family history of cancer, the authors identified only a single factor that was associated with a higher risk of VS: individuals exposed to dental x-rays once a year (aOR = 2.27, 95% CI = 1.01–5.09) or once every 2–5 years (aOR = 2.65, 95% CI = 1.20–5.85), compared with those exposed less than once every 5 years. Of interest, a history of exposure to radiation related to head or head-and-neck computed tomography was associated with a reduced risk of VS (aOR = 0.52, 95% CI = 0.30–0.90). No relationship was found between the use of cell phones or cordless phones and VS.

Conclusions

Patients with acoustic neuromas reported significantly more exposure to dental x-rays than a matched cohort control group. Reducing the frequency of dental x-ray examinations may decrease the potential risk of VS.

[lrobie]

I had tons of dental x-rays as a kid.  Not only for cavities, but for two teeth that had broken off from a car accident where I went thru the rear window.  Thus, I think there is something to this study.

Lisa

[jsanders1379]

I definitely agree... I had massive radiation as part of my treatment for a bone marrow transplant and the transplant center told me it was likely the cause for my AN......the story of my life-one medical treatment leading to another problem-over & over....

[JLR]

Very interesting article.  I, too, had sooooo many dental x-rays as a kid.. Had alot of problems especially on the right side..and now I have a right sided AN.,Hmmm I think we have something.....

[Chances3]

When you consider the heavy useage of x-rays and dental x-rays, you would think the incident of AN would be much higher.  But in reality the AN is rare, which leads me to think that those of us who contract them do so because we are predisposed to it.  The heavy or regular use of x-rays might just be the tipping point to ignite the growth of the schwan cells.

[CHD63]

Large amounts of ionizing radiation are the only known potential cause of acoustic neuromas, but I agree, not everyone who had such exposure will automatically form an AN.  However, I do now regularly refuse dental x-rays unless I have a problem, even though the amount per x-ray is teeny.  (My dentist said one bite-wing x-ray is the equivalent of standing out in bright sunlight for 5 minutes with no sunscreen.)

I had massive doses of ionizing radiation to my naso-pharyngeal area when I was a kid and it took that long to manifest itself in an AN!

Clarice

[cherrypiper]

didnt have many xrays dental wize at all until very late in life..............might have been a cause who knows.........

it was maybe 10 yrs post dental stuff i got my AN

[millie]

I have had so very much dental work, starting when I was a child (and they didn't use anesthesia when they drilled! Yikes!) 
Always dental work...all my life, with a five year gap here and there.  Fillings, root canals, caps,extractions...and alls kinds of x-rays, always x-rays.  I feel so foolish, but that was then, and this is now.
I believe x-rays can tip the scales too.

[nftwoed]

Hi;

  Well, they are x-raying the TMJ area in many cases. I don't think one study is conclusive, however. Look how many cell phone usage studies have been presented and there's still no consensus.

[leapyrtwins]

Interesting, but this doesn't really apply to me.

I didn't have lots of dental x-rays as a kid or as an adult.

Didn't have a filling until I was 16 and probably only have 3 in my entire mouth.

I had braces as a teenager and my wisdom teeth were removed, but that's about it.

Nothing I'd classify as "extensive" dental work.

Jan

[Jim Scott]

A thought-provoking thread but a somewhat speculative conclusion.

Like many, I had regular dental X-rays as a child.  Still do.  They may have 'triggered' the AN but there is no way to be certain of that so I do not attribute my AN to dental X-rays and still have them every two years, as my dentist recommends.  Of course this is an individual choice and as such, one that we should make with as much information as possible and with the understanding that these types of scientific findings are interesting but not exactly conclusive.  That having been stated, the information is welcomed.

Jim