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Doses de radiação em medicina dentária : desmistificar definitivamente o tema
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Abstract(s)
A utilização de radiação ionizante na Medicina Dentária constitui um recurso essencial para o diagnóstico, planeamento e monitorização terapêutica. Embora, de um modo geral, as doses aplicadas sejam reduzidas, determinados casos podem implicar exposições cumulativas significativas. Por este motivo, a exposição a raios-X deve ser clinicamente justificada, proporcionando um benefício efetivo para o paciente.
As radiografias dentárias, ao permitirem a avaliação de estruturas que não são acessíveis ao exame clínico convencional, assumem um papel imprescindível na prática dentária. Estima-se que aproximadamente 33% da população nos países desenvolvidos realize anualmente, pelo menos, um exame radiográfico dentário. Este facto contribui para o aumento gradual da exposição global à radiação ionizante.
Apesar dos significativos avanços tecnológicos que possibilitaram a redução substancial das doses de radiação em exames de diagnóstico, persistem preocupações publicas relativamente aos riscos associados, frequentemente expressas sob a forma de ansiedade e radiofobia. Tal evidencia a existência de uma lacuna informativa sobre a real magnitude da exposição e os seus potenciais efeitos.
Do ponto de vista biológico, os efeitos da radiação ionizante dividem-se em determinísticos, com dose-limite estabelecida, e estocásticos, que incluem cancro e alterações hereditárias e não apresentam dose-limite segura. Por conseguinte, impõe-se a adoção rigorosa dos princípios de justificação, otimização e limite de dose, consagrados pelo princípio ALARA (As Low As Reasonably Achievable) e suas variações ALADA e
ALADAIP.
O atual enquadramento jurídico e regulamentar tem como objetivo fundamental a prevenção de exposições radiológicas evitáveis, assegurando a proteção radiobiológica de pacientes, profissionais de saúde e da população em geral. Neste contexto, cabe aos médicos dentistas a responsabilidade de aplicar e monitorizar medidas de radioproteção, garantindo a otimização das práticas radiológicas e a minimização dos riscos associados, em conformidade com os princípios internacionalmente estabelecidos para a segurança
radiológica.
The use of ionizing radiation in Dentistry represents an essential resourse for diagnosis, treatment planning, and therapeutic monitoring. Although the radiation doses typically employed are low, certain clinical situations may involve significant cumulative exposures. For this reason, dental X-ray examinations must be clinically justified, ensurinng an effective benefit for the patient. Dental radiographs play a crucial role in dental practice by enabling the assessment of anatomical structures inaccessible to conventional clinical examination. It is estimated that approximately 33% of the population in developed countries undergo at least one dental radiographic examination per year, contributing to the gradual increase in global exposure to ionizing radiation. Despite notable technological advances that have substantially reduced radiation doses in diagnostic procedures, public concerns regarding the potential risks persist, often manifesting as anxiety and radiophobia. This highlights an existing gap concerning the actual magnitude of exposure and its porential biological effects. From a biological standpoint, the effects of ionizing radiation are classified as deterministic with established dose thresholds, and stochastic, witch include carcinogenesis and heritable effects, for witch no safe dose limit exists. Consequently, the rigorous adoption of the principles of justification, optimization and dose limitation is imperative, as embodied in the ALARA (As Low As Reasonably Achievable) principle and its variations, ALADA and ALADAIP. The current legal and regulatory framework is fundamentally aimed at preventing avoidable radiological exposures, ensuring the radiobiological protection of patients, healthcare professionals and the general population. In this context, dentists are responsible for implementing and monitoring radioprotection measures, ensuring the optimization of radiological practices and minimizing associated risks, in accordance with internationally established principles for radiological safety.
The use of ionizing radiation in Dentistry represents an essential resourse for diagnosis, treatment planning, and therapeutic monitoring. Although the radiation doses typically employed are low, certain clinical situations may involve significant cumulative exposures. For this reason, dental X-ray examinations must be clinically justified, ensurinng an effective benefit for the patient. Dental radiographs play a crucial role in dental practice by enabling the assessment of anatomical structures inaccessible to conventional clinical examination. It is estimated that approximately 33% of the population in developed countries undergo at least one dental radiographic examination per year, contributing to the gradual increase in global exposure to ionizing radiation. Despite notable technological advances that have substantially reduced radiation doses in diagnostic procedures, public concerns regarding the potential risks persist, often manifesting as anxiety and radiophobia. This highlights an existing gap concerning the actual magnitude of exposure and its porential biological effects. From a biological standpoint, the effects of ionizing radiation are classified as deterministic with established dose thresholds, and stochastic, witch include carcinogenesis and heritable effects, for witch no safe dose limit exists. Consequently, the rigorous adoption of the principles of justification, optimization and dose limitation is imperative, as embodied in the ALARA (As Low As Reasonably Achievable) principle and its variations, ALADA and ALADAIP. The current legal and regulatory framework is fundamentally aimed at preventing avoidable radiological exposures, ensuring the radiobiological protection of patients, healthcare professionals and the general population. In this context, dentists are responsible for implementing and monitoring radioprotection measures, ensuring the optimization of radiological practices and minimizing associated risks, in accordance with internationally established principles for radiological safety.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Medicina dentária Radiologia dentária Radiação ionizante Proteção radiológica