Update on Lead Shielding in Dental Offices
ADA issued recent ecommendations to improve radiation safety in dental radiography and cone-beam computed tomography( CBCT).
A key takeaway advises discontinuing the routine use of lead abdominal aprons and thyroid collars during dental imaging.
ADA’ s guidance was based on recommendations from the American Academy of Oral and Maxillofacial Radiology in an article titled Patient shielding during dentomaxillofacial radiography published in JADA 2023:154( 9): 826-835. It applies to all patients, regardless of age or health; on the basis that radiation doses from modern digital X-ray systems and techniques such as limiting the beam to only the necessary area, provide sufficient protection thereby eliminating the need for lead shielding.
ADA recommendations to reduce unnecessary radiation include:
Ordering radiographs to optimize diagnostic information and making an effort to use images acquired at previous dental exams
Using digital technology instead of conventional film for imaging
Restricting the beam size to the area of interest( rectangular collimation)
Proper patient positioning
Incorporating CBCT only when lower-exposure options will not provide the necessary diagnostic information
Adhering to all applicable federal, state and local regulations on radiation safety
Notwithstanding ADA recommendations, many states continue to require shielding by law.
In Pennsylvania, PDA has confirmed that lead aprons are not required for dental radiography, although thyroid collars are still recommended as an industry standard unless they interfere with the diagnostic procedure. See NCRP Report No. 177; Recommendation # 18. PDA has been informed that an update to the recommendation will be issued in the near future.
30 NOVEMBER / DECEMBER 2025 | PENNSYLVANIA DENTAL JOURNAL