Are Lead Aprons Necessary for Dental X-Rays?

Dental practitioners and their patients often ask, “Are lead aprons necessary for dental X-rays?” Even though modern X-ray equipment emits tiny doses and is optimized to produce minimal scatter radiation, the answer is most definitely, yes!

Even where lead aprons aren’t indicated, they are a reassuring, precautionary measure. Each patient has unknown variables, such as previous x-ray exposure, or pregnancy. For this reason, we support using lead aprons in all situations where they won’t interfere with the imaging process. Read on to find out why.


What Is a Dental Lead Apron?

A lead apron is a protective garment that shields radiation. It has a core material composed of rubber and lead (or a lead-free equivalent). Lead is an extremely effective attenuating material—it can block and absorb X-rays. This inner lining is encased in a suitable fabric. 

The function of a lead apron is to cover the vital organs in the torso, preventing potential damage by ionizing radiation emitted during X-ray imaging. Certain parts of the body, such as the reproductive organs and the thyroid gland, are particularly radiosensitive.

Lead aprons come in various styles, lengths, and weights. Dental X-ray aprons are long bibs that cover the front of the chest and neck area. Barrier Technologies® manufactures a high-necked, lightweight, flexible Dental Apron with our revolutionary Secure Shieldcrack-resistant core material. It’s covered in our impervious, anti-bacterial UltraFlex fabric and uses our Velcro-free MagnaGuard magnetic closure. Download our latest Apron Catalog here.


Are Lead Aprons Necessary for Dental X-Rays?

This question is a hot topic in the dental community. There is currently no consensus on the subject and all dental practices and their x-ray equipment are subject to state and local regulations.

The National Council on Radiation Protection and Measurements (NCRP) provides 61 best practice recommendations in its 2019 Report No.177. It states that radiation-protective aprons are not always required if all these recommendations are rigorously followed.

The numerous NCRP recommendations are based on the ALARA principle — keeping the radiation dose As Low As Reasonably Achievable. The use of a dental X-ray apron is also dependent on the type of imaging procedure done. 

The table below consolidates modern trends and provides a rough guide:

When to Use a Dental X-ray Apron
Intraoral Examinations:
1. Bitewing Yes
2. Occlusal Yes
3. Periapical Yes
Extraoral Examinations:
1. Panoramic Yes
2. Tomogram Yes
3. Cephalometric Yes
4. Sialogram Yes
5. Computed Tomography Yes
6. Cone Beam Computed Tomography Yes


What Could Happen Without a Lead Apron?

Dental X-rays are generally very safe. Routine dental imaging uses a very narrow beam to image a very small area—usually just a “snapshot” of a few teeth. Most dentists take digital X-rays, which have negligible risk.

However, any X-ray imaging equipment produces some scatter radiation that bounces off surfaces. High-energy electromagnetic radiation is a mutagen with the ability to damage DNA or cell metabolites.

Here are some problems that may result from exposure to ionizing radiation:

  • The development of cancers later in life.
  • Tissue damage such as cataracts.
  • Skin reddening (erythema).
  • Bone marrow damage and low blood cell counts.
  • Damage to sperm and eggs.
  • Harm to developing fetuses.

Any cellular damage can affect the recipient, or be passed on to their offspring. All doses of radiation are cumulative—the more doses received during your lifetime, the higher your overall risk profile. Wearing a dental lead apron offsets these risks.


Considerations for Dental Radiography

X-rays are indispensable in the diagnosis of oral damage and disease. However, every dental imaging procedure presents health and situational considerations that need to be addressed. The dental practitioner must scrupulously assess the pros and cons, by weighing factors such as oral health, age, and medical history.

The International Atomic Energy Agency (IAEA) is a forum committed to the safe and prudent uses of nuclear science and technology. Its guidelines on radiation protection of patients in dental radiology promote the ALARA principle.

Here are some scenarios where it recommends providing dental X-ray aprons for patients:

  • For any patient who requests a lead apron or thyroid collar.
  • For patients who are nervous about the procedure and need reassurance.
  • For anyone pregnant or possibly pregnant.
  • For patients with a history of extensive previous X-ray exposure.
  • For any patients who have, or have had, cancer or thyroid disease.
  • For growing children and adolescents, particularly those undergoing many repeated procedures.
  • For any carer, comforter, or assistant required to support a patient during the imaging procedure.
  • In all situations where equipment or technique hasn’t been verified by a radiation protection specialist.
  • When using non-digital apparatus (pre-1994) that lacks optimized exposure and dose calculations.


Lead Aprons for Dental Staff

The NCRP’s Code of Federal Regulations “Standards for Protection Against Radiation” (10 CFR Part 20) limits the total effective dose equivalent for radiation workers to 0.05 Sv per year. For reference, 1 Sv correlates with a 5.5% increased risk of cancer.

Most dental radiology uses minute doses of radiation, so it’s highly unlikely that a dental professional will reach this limit of exposure. Taken in context, the radiation dose from a single intraoral X-ray is the same as that from eating two bananas!

The table shows approximate dental examination doses:

Dental X-ray Dose in mSv
Single intraoral 0.2
Full mouth series 3.9
Cephalometric 9
Panoramic 10
CT scan 36


However, there’s always the risk of stochastic effects that are not dose-dependent. If you must stay in the examination room during exposure, wear a lead apron and stay at least 6–7 feet from the X-ray source.


Looking for Lead Apron for Dental Radiation Protection?

A burning question is, “Are lead aprons necessary for dental X-rays?” Diagnostics in dentistry have been greatly enhanced with the advent of digital imaging technology. Dental X-rays emit tiny doses of radiation but aren’t entirely risk-free. With increased use comes increased exposure.

Barrier Technologies helps dental practitioners minimize the dangerous effects of scatter radiation by offering the best dental X-ray protection products in the industry.

Our custom-designed dental aprons offer convenient frontal and thyroid protection to your patients. For your safety, browse our extensive catalog of X-ray lead aprons and thyroid shields. Contact us for expert advice and rapid service.