A Catholic case for Prudence in dental & other x-rays

Ionizing radiation damages DNA by causing strand breaks, oxidation and disruption to chromosomal stability. Telomeres are protective DNA caps at chromosome ends. During x-rays, they are especially vulnerable because of limited repair capacity. Think of telomeres as protective aglets on shoestring ends, that prevent unraveling. Radiation-induced telomere shortening elevates disease risk, cancer, accelerates cellular aging and increases genomic instability. Medical ethics require non-maleficence or do no harm. Patients should never be exposed to harm when no benefits exist.

Background.

In 2008, this published evidenced changed imaging standards for minor head trauma in Emergency Departments. While larger radiation doses were involved, studies demonstrated that unnecessary imaging exposed patients — needlessly — to the risks of radiation-induced malignancies.

• For minor head injuries, concussion observation protocols replaced imaging, especially for major league sports.

• For more trauma, magnetic imaging or MRIs replaced ionizing radiation.

Dental X-rays. While amounts vary, dental x-rays deliver smaller doses of radiation. The costs (not charges) below include fixed, variable and depreciation. 

• Bitewing x-ray charges to the patient are $100-200 with exposure rates up to 5 μSv. Cost to the dentist is $50.

• A panoramic x-ray charges to the patient are $200-300 with exposure to 14–24 μSv, depending on machine and technique. Cost to dentist is $100.

• Natural background radiation exposes each person to about 17 μSv per day.

These numbers show dental imaging is low-dose, but not zero-dose. If ionizing radiation damages DNA and telomeres at low levels, the Catholic virtue of prudence supports minimal exposure without benefit. From a Catholic perspective, the body is a gift entrusted to us to be stewarded as a temple of the Holy Spirit. The Church teaches that medical interventions should be proportionate to outcome; meaning the benefit should outweigh the risk.

When we have no pain, no neuropathies, no swelling and no clinical signs of disease; the benefit of routine imaging is minimal. Meanwhile, it encourages insurance fraud, which increases premium rates for all consumers. If x-rays are not medically necessary, we have the right to discern, be prudent, and decline them. Unwarranted x-rays are not a reasonable request. Our providers’ duty is to avoid all harm to us.

Put not your trust in Princes.

Psalm 146 cautions us that human institutions, including medical and commercial, have temptations.

• Dentistry is a profession filled with good people, but it is a business. Dental x-ray insurance loopholes enable up-charging, offering financial incentives to image more often than medically necessary.

• Catholic teaching does not assume bad intent, but it does encourage discernment. Trust but verify, that all provider recommendations are delivered in good faith and not for secondary gain.

ALARA principles.

As Low as Reasonably Achievable (ALARA) principles are published by the CDC, to reflect moral agency. In 2012, the American Dental Association recommended x-rays — only when clinically indicated — and NOT on a fixed, annual or other schedule. This is entirely compatible with Catholic ethics, as technology should serve the person and not the alternative. Pope Leo’s recent AI encyclical emphasizes the potential temptations of technology. This does not imply that all dentists are untrustworthy. It simply acknowledges that:

• Ionizing radiation has biological costs

• The human body deserves protection from unnecessary harm

• Professional recommendations can be influenced by financial structures

• Prudence is a virtue, not a suspicion and

• Patients have a right to informed consent.

In sensitive situations, it is scientifically, ethically, and theologically appropriate to say: 

“I respect your expertise,

but I also have a duty to steward my health and conscience.

Let us proceed in a way that honors both. 

If I have no symptoms or clinical concerns,

it is morally, financially and medically sound for me to avoid these dental X-rays.

If symptoms arise, I acknowledge that imaging may be reasonable and beneficial.”

This approach honors science and the Catholic commitment to safeguard our well-being. This is not refusing care; it is declining unnecessary exposure. We honor the Catholic principle of non-maleficence — do not incur harm without benefit. Maleficence is a sin against the 5th commandment, thou shalt not kill.

With kindness, please ask for a radiation-exposure waiver. This is a written acknowledgment that we understand all recommendations but choose to decline imaging at this time. Many firms have forms for those who decline fluoride or other optional procedures. It protects both parties and keeps the relationship transparent. Avoid providers that use shaming verbiage on these forms.

Is it legal for a dentist to refuse treatment if we decline non-emergent X-rays? Yes, in certain U.S. states. Yet, we have a right to establish safe boundaries in our care. How much do we trust our provider?

• If the practitioner can point to a problem and explain how imaging is necessary to provide safe, competent care, then maybe. We can get a second opinion.

• Many dentists will continue with a signed waiver; others will not. It depends on their tolerance for risk and professional judgment.

• If a dentist believes they cannot diagnose or treat without imaging, they are legally allowed to decline to provide non-emergency care.

• If dubious, a provider could ask us not to return. This is a red flag, especially when we have attempted in good faith to negotiate the interests of both parties fairly. It may be a needed wake-up call for all, including office staff and patients in earshot.

Summary.

As Catholics, we must protect our health, dignity and moral agency through prudence and drawing boundaries to care that offers no benefit.

• To do no harm, because every person bears the image and likeness of God.
• To trust not in princes, because only Christ can help us.

Together, these call us to act with courage, to resist harm, injustice and refuse to surrender our conscience to any earthly power. They remind us that our true citizenship is in heaven and our true King is Christ.

Sources:

CDC. 2024. ALARA radiation safety principles. Retrieved from https://www.cdc.gov/radiation-health/safety/alara.html

National Library of Medicine. 2008. Oxidative stress and DNA damage in medical workers exposed to low-dose radiation. Retrieved from https://pubmed.ncbi.nlm.nih.gov/18810402/

USCCB. 2026. First encyclical of Pope Leo urges world to disarm AI amid increased reliance. Retrieved from https://www.usccb.org/news/2026/first-encyclical-pope-leo-urges-world-disarm-ai-amid-increased-reliance

USCCB. 2024. Psalm 146. Retrieved from https://bible.usccb.org/bible/psalms/146