To the Editor: I am concerned about 2 possible
confounding factors in the study by Dr Hujoel and colleagues.1 First,
in December 2000 the Washington State Department of Health alerted state health
departments throughout the United States to the discovery of lead oxide powder
in shielded boxes used to store radiographic films in dental offices. Subsequent
testing demonstrated the possibility of the transfer of substantial amounts
of lead to patients' mouths from contaminated film and the technicians' hands.2 Because maternal lead exposure has been associated
with low birth weight (LBW), and because the study population was located
in Washington state, the possibility that lead exposure was contributory to
LBW in this study cannot be excluded.
Reiman RE. Antepartum Dental Radiography and Low Birth Weight. JAMA. 2004;292(9):1019. doi:10.1001/jama.292.9.1019-a
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