Dental X-rays are pictures of the teeth, bones, and soft tissues around them to help diagnose problems in the oral cavity that are not visible during your dental exam. X-rays are invisible beams of energy that pass through the body to make black and white pictures (1). They are used to diagnose cavities, show bone loss and missing teeth as well as hidden structures such as cysts & wisdom teeth. How often dental X-rays are taken is based on individual patient needs and risk. New patients are usually required to have X-rays taken to determine their present baseline status unless they provide current X-rays from their previous dental office. Digital X-rays make forwarding them to other offices much easier for the patient and the dentist. Digital X-rays have been a great addition to dental technology.
Digital technology began in 1988 with RVG (radio/visio/graphy) and the first film sensor came out in 1994 (2). Not only was there a decrease in exposure, but it allowed for efficient electronic communication and eliminated the environmental concern of silver and chemicals used to develop old traditional film. Many people are concerned about radiation exposure of X-rays. I will say it is important to watch how often you are exposed cumulatively with all forms, but “radiation exposure associated with dentistry represents a minor contribution to the total exposure from all sources, including natural and man-made” (2). X-rays are extremely important for proper chairside dental diagnosis, the ADA and the FDA have come up with proper guidelines for dentists to follow based on a patient’s risk, and their professional judgement. There are also additional radiation safety requirements that have been put in place to protect patients. These requirements are as follows; inspection and testing of X-rays units yearly, use of exposure monitoring badges, proper training or certification of staff, and lead aprons with thyroid collar. If you are pregnant be sure to tell your hygienist or dentist before X-rays are taken. Although, there has been no proof that X-rays effecting your baby (fetus) we like to take extra precaution and take them after the baby is born. “Dental X-rays do not need to be delayed if you are trying to become pregnant or are breastfeeding” (3). They also do not need to be delayed if you have a toothache during pregnancy as long as a lead apron and thyroid collar is worn. It’s better to have the dental problem diagnosed and treated during pregnancy than to leave it untreated and become a source of infection during pregnancy causing greater risk to the baby.
There are a few different types of dental X-rays you may hear dental professionals discussing. I am going to give a brief description of them below for you to have a better understanding.
Bitewings– Focus on posterior teeth, they show top and bottom teeth on the same film. They are used to check specifically for cavities between your posterior teeth and to check for bone loss.
Periapical (PA’s) – Are used to look at the roots of your front and back teeth and only show 2-3 teeth in one film.
Full Mouth Series – A series that is taken every 3-5 years depending on your periodontal status. It is a combination of bitewings and periapical’s that show the crowns of your teeth, roots of your teeth and the bone that hold your teeth in place. We use this as a baseline to monitor for any changes in your dental health.
Panoramic X-ray – This is the machine that rotates around the outside of your head and shows a street view of your mouth. It shows your jaw bone, teeth, roots, and sinuses. It is most commonly used by Orthodontists and Oral Surgeons.
Cone Beam CT- This is similar to a medical CT Scan but it uses less X-rays. It makes a 3D image needed for more difficult treatments. This is usually found in a specialist’s office.
Dental X-rays have given dental professionals the ability to diagnose interproximal decay, as well as other dental concerns in the early stages. If we wait until we can see the decay clinically, then the decay is usually deeper and the patient has a higher risk for the need for a crown or root canal. Our office is aware and considerate of our patients’ X-ray exposure, but we do believe in the importance of X-rays. We have seen firsthand many times how one’s mouth and risk of decay can change over a 12-month span. So, if you have any questions or concerns please feel free to discuss with your dental professional or please feel free to leave a comment.