Like with any radiation producing device, it is unsafe if not properly used. The safe operation of the handheld x-ray requires that operator must understand what the radiation is and where it comes from, and where it is going to.

There are two kind of radiation that may get to operator. One is the leakage radiation. This is the radiation that leaks through the covers of the devise 360 degrees. Even though there is radiation leaking from the device, the amount is so minuscule that operator gets more radiation from other sources. The OSHA annual limit to hands and forearms; feet and ankles is 75 rem (1) and the handheld x-ray device leakage per exposure is anywhere 0 (not measurable) to 0.0005 mrem depending the device. This means that operator would need to take over million x-rays before reaching OSHA annual safety limit.

The other kind of radiation to operator is scatter radiation. This is the radiation that scatters backwards when the main radiation beam hits harder objects than the teeth and bone, for example fillings and implants. The key for safe operation is to stay behind the scatter radiation shield when making the exposure. The shield blocks all radiation that scatters backwards from patient towards the operator. This scatter of course varies from patient to patients and is nearly impossible to determine consistently because there are just too many variables. Maybe that is the reason we haven’t seen any reliable, consistent studies done on scatter radiation. 

Remember, the dental intra-oral x-rays are very low radiation to patient to beginning with. All leakage and scatter radiation to operator is only a tiny fraction that the patient receives. FDA would not approve a device to be used in USA if deemed unsafe to operator.   When operator safety is such a concern that it causes fear of using the equipment, all dental supplies dealers sell multiple different kind of safety clothing, aprons, gloves etc.      

Other sources of everyday radiation (2)

The earth is filled with radiation producing substances. Only 5% of radiation that humans normally get comes from conventional medical/dental radiation x-rays. The dominant source of radiation comes from earth itself and from space. The higher elevation you live in, more cosmic radiation you receive. Nearly 50% of the radiation humans receive comes from the background. and is no way avoidable. If you’ve ever had a CT taken on you as a patient, you’ve been exposured 5x more radiation than as a dental patient. And as an operator of a handheld x-ray device, you been exposured far less than patients in any dental/medical clinic environment.

Perception of risk by Professional Society (3)

Interestingly the Professional Society does not consider x-ray radiation harmful in normal medical/dental care. There are far more life threatening activities in our daily lives. On their voting, handguns was rated No 1 dangerous activity, X-rays in general was ranked 24. In between are activities such as motor vehicles, alcohol, surgery, pesticides, aviation, contraceptives, police and fire fighting, football, and skiing.