ZAPP THEM 

From Chaos to Clarity: My Journey into Radiographic Safety in Dentistry

First Impressions of the Dental Clinic

Walking through the clinics on the first week, I was amazed at the organized chaos unfolding on the floor.
It was early in the hour, and patients were just arriving and registering.
The student doctors were approaching the patients to greet them and escort them to their designated treatment cubicles.
Some cubicles were tucked in a corner, and everyone had to walk past the X-ray rooms to reach them.
Some students had already seated their patients and begun taking ‘pictures’.

Being from India, I casually walked past the cubicles without a second thought—without any fear.
As I passed in front of the first X-ray room, I heard a distinct “beep.”
I had unknowingly exposed myself to unnecessary radiation!
Strangely, I didn’t seem to care.

The Wake-Up Call

My professor, who had been observing my carefree stroll, gently called me aside and initiated a casual conversation.
He asked me where I was from and inquired about my family and background.
At the end of our chat, he asked, “Do you plan to have more children in the future?”
I replied, “Yes, I do.”
He said, “Well, if you keep zapping yourself unnecessarily without lead protection, you may want to rethink that.”
What exactly was he talking about?

Theory vs. Practice

Later, my mentor, who had witnessed this interaction, took time to speak with me.
He asked about personal protective equipment while taking dental radiographs.
I realized that while I knew all the theoretical information, I wasn’t applying it in clinical practice.
Personal protection didn’t come naturally to me—perhaps because in India, we rarely emphasized it.

I did take radiographs in a lead-lined chamber back home.
But I don’t recall patients wearing lead aprons regularly to shield other parts of their body from exposure.
I don’t recall wearing gloves consistently during the procedure either.
Often, patients held their own films inside their mouths for positioning.
Sometimes, we even held the films for them—without wearing lead aprons.
It never felt wrong, because it was just a “small dose” of radiation each time.

But in retrospect, I did the math:
Those small doses, accumulated over a lifetime, add up to a significant amount of radiation exposure.

Embracing a Culture of Safety

I began keenly observing the practices in the U.S.
Yes, at first glance, it did feel like they were “freaking out” more than necessary!
But today, we constantly hear about new diseases emerging from unexplained causes.
So I decided to follow the rules—to understand the reasoning behind them.

Here, every patient wears a lead apron before a radiograph is taken.
The apron must cover the body from neck downward, protecting vital organs susceptible to radiation-induced mutations.
Students and radiologists here are efficient in capturing images using position-indicating devices.
Patients never place their fingers inside their mouths to position films!

Plastic wraps on the films often made it uncomfortable for patients to bite down.
But once we explained that it helped prevent contamination, most were willing to tolerate the brief discomfort.
Gloves and masks were non-negotiable—mandatory—during the radiographic process.
And above all, no one ever stood in the same room when the radiograph was being taken.
Even someone walking down the hallway was stopped until the “beep” had passed.
Everyone seemed conscious. Everyone was alert.

Radiology for Children: Extra Caution, Extra Care

Children, of course, were the most challenging patients to capture radiographs on.
Radiologists wore lead aprons themselves and ensured that the little ones wore custom-fitted aprons too.
The caregiver assisting the child was also protected with a lead apron.
Some children cooperated. Some didn’t.
But the radiologist remained safe while assisting, with both mask and apron in place.

Reflecting on the Difference

Looking back at this transformation and comparing it with stories from home often gives me pause.
A friend of mine recently underwent dental treatment in India.
The same old practices were still in place—no personal protection.
What once seemed “normal” now feels deeply unsettling.

In my corporate practice now, I’m proud to say that we place great importance on personal protective equipment.
Most private practices across the U.S. strictly adhere to these protocols.
This standardization fosters a sense of safety and confidence.

I truly believe it is the system—and the standardization—that brings about meaningful change.
When dentists take full responsibility for their own safety and their patients’ safety, everything changes for the better.

Patient Concerns and Communication

“Stop! Stop!” my patient screamed.
I was taking dental radiographs—X-rays—and she appeared visibly upset.
I couldn’t understand why, until she burst out, “You’re exposing me to too much radiation! I could get cancer from all this!”

I thought to myself, “Here goes another one!”
By now, I had become used to such reactions.
But I was also prepared—with an explanation ready.

Educating and Reassuring Patients

Most patients visit the dentist with pain or discomfort and end up getting radiographs for just the affected tooth.
They get the issue treated and usually don’t return until something else starts bothering them.

Ideally, though, patients should return for a comprehensive exam—one that includes a full set of radiographs to evaluate the health of all their teeth.
In this instance, my patient had come back for exactly that.
She was understandably hesitant to undergo a full mouth series of radiographs.
She had some awareness about radiation hazards, which I appreciated.
I knew she would understand if I provided the right reasoning.

She had a few fillings and a couple of root canals, done two or three years ago.
She also had new cavities.
I explained that a full-mouth series—eighteen radiographs—was essential to evaluate the extent of decay and assess the condition of her existing restorations.

I reassured her that the radiation dose involved in capturing the entire series was minimal.
Such low exposure levels posed no real threat of cancer.
I also emphasized that the lead apron protected vital organs against any possible radiation effects.
My patient felt reassured and allowed me to proceed with the radiographs.

The Bigger Picture: Prevention and Awareness

Radiation exposure is a growing concern, and patients today are more informed than ever.
When I meet patients with few or no cavities, we typically take four radiographs every six months to a year.
This depends on their risk for new decay.
The more the cavities, the more radiographs are required.
Usually, radiographs are repeated every six to twelve months based on caries risk.

There’s also a large radiograph called a panoramic X-ray, which captures the wisdom teeth and jaw.
Ideally, this should be done once every three years as part of a routine exam.

The Role of the Internet and Empowered Patients

As digital awareness expands, patients grow increasingly mindful of what is being done and why.
Providing rational, science-backed explanations helps patients feel more at ease—
and ultimately leads to better compliance, better care, and better outcomes.

Author: Dr. Meenakshi Umapathy, a dedicated General Dentist, embarked on her professional journey in India before expanding her horizons in the United States. She earned her Doctor of Dental Surgery (DDS) from the esteemed New York University College of Dentistry and now specializes in pediatric dentistry in Indiana. Since 2017, she has been a valued practitioner at Monarch Dental, bringing her expertise and compassionate care to young patients.

Through her evocative narratives, Dr. Umapathy shares her rich experiences practicing in both India and the U.S., offering profound insights into the evolving landscape of dentistry. Her blog, originally published on DentistryUnited.com in 2012, has been thoughtfully republished, ensuring that her wisdom continues to educate and inspire dental professionals and enthusiasts alike.