Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
In Reply: We share the concerns about possible
confounding raised by Dr Reiman (lead poisoning) and Dr Pisaniello (smoking).
While restriction of the analysis to individuals with high socioeconomic status
and the elimination of self-reported smokers during pregnancy did not affect
our estimates of the relationship between dental radiation and LBW, smoking
cannot be entirely excluded as a residual confounder. To our knowledge, no
documented lead poisoning was reported in our study population, and lead poisoning
associated with using intraoral dental films would not explain our observed
association with extraoral films or orthodontic procedures. It nevertheless
remains an interesting alternative explanation for our findings.
Hujoel PP, Bollen A, Noonan CJ, del Aguila MA. Antepartum Dental Radiography and Low Birth Weight—Reply. JAMA. 2004;292(9):1019. doi:10.1001/jama.292.9.1020-b