This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on ISI (4)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Pediatrics  • Neonatology and Infant Care  • Radiation Therapy  • Statistics and Research Methods  • Pregnancy and Breast Feeding  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 135 words of the full text and any section headings.

To the Editor: We have several concerns about the study by Dr Hujoel and colleagues.¹ First, their estimates of thyroid radiation doses from panoramic and bitewing imaging are 3 to 5 times higher than published estimates for these procedures.^2-3 We believe that the authors similarly overestimated the cephalometric dosage by as much as an order of magnitude.^4-5

Second, although the authors assumed that thyroid collars were not used with these women, a study of 159 general dentists found that 65% used both lap and thyroid protection.⁶ Third, the authors point out that they did not account for the level of dental disease or the specific dental procedures performed. Given the increasing concern about a proposed link between LBW infants and maternal dental disease, their results might reflect an increased frequency of naturally occurring oral bacteremia.⁷

Peter B. Lockhart, DDS
peter.lockhart@carolinashealthcare.org

Michael T. Brennan, DDS, MHS
Department of Oral Medicine

Howell Sasser, PhD
Dickson Institute for Health Studies
Carolinas Medical Center
Charlotte, NC

John Ludlow, DDS, MS
Department of Diagnostic Sciences & General Dentistry
University of North Carolina School of Dentistry
Chapel Hill

1. Hujoel PP, Bollen AM, Noonan CJ, del Aguila MA. Antepartum dental radiography and infant low birth weight. JAMA. 2004;291:1987-1993. FREE FULL TEXT 2. Ludlow JB, Davies-Ludlow LE, Brooks SL. Dosimetry of two extraoral direct digital imaging devices: NewTom cone beam CT and Orthophos Plus DS panoramic unit. Dentomaxillofac Radiol. 2003;32:229-234. FREE FULL TEXT 3. Velders XL, van Aken J, van der Stelt PF. Absorbed dose to organs in the head and neck from bitewing radiography. Dentomaxillofac Radiol. 1991;20:161-165. ABSTRACT 4. Gibels F, Sanderink G, Wyatt J, Van Dam J, Nowak B, Jacobs R. Radiation doses of collimated vs non-collimated cephalometric exposures. Dentomaxillofac Radiol. 2003;32:128-133. FREE FULL TEXT 5. Gibbs SJ. Effective dose equivalent and effective dose: comparison for common projections in oral and maxillofacial radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90:538-545. PUBMED 6. Platin E, Ludlow JB. Knowledge and adoption of radiographic quality assurance guidelines by general dentists in North Carolina. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79:122-126. PUBMED 7. Offenbacher S, Katz V, Fertik G, et al. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol. 1996;67:1103-1113. ISI | PUBMED

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292:1020.

RELATED ARTICLES

Antepartum Dental Radiography and Low Birth Weight
Robert E. Reiman
JAMA. 2004;292(9):1019.
EXTRACT | FULL TEXT  

Antepartum Dental Radiography and Low Birth Weight
M. Lynn Pisaniello
JAMA. 2004;292(9):1019.
EXTRACT | FULL TEXT  

Antepartum Dental Radiography and Low Birth Weight
Cassandra E. Henderson and Hany Ahmed
JAMA. 2004;292(9):1019.
EXTRACT | FULL TEXT  

Antepartum Dental Radiography and Low Birth Weight
James Welsh
JAMA. 2004;292(9):1019-1020.
EXTRACT | FULL TEXT  

Antepartum Dental Radiography and Low Birth Weight—Reply
Philippe P. Hujoel, Anne-Marie Bollen, Carolyn J. Noonan, and Michael A. del Aguila
JAMA. 2004;292(9):1020-1021.
EXTRACT | FULL TEXT  

Antepartum Dental Radiography and Infant Low Birth Weight
Philippe P. Hujoel, Anne-Marie Bollen, Carolyn J. Noonan, and Michael A. del Aguila
JAMA. 2004;291(16):1987-1993.
ABSTRACT | FULL TEXT