THE PATIENT'S PRIMER FOR DENTAL X-RAYS
Dear Dr. Reichwage,
I know dental x-rays are necessary sometimes, but I'm concerned about radiation and how often they should be taken. At least once a year, my dentist wants to take some, and I have refused for the past 3-4 years. Amanda P., Fort Wayne
Amanda, while you are right to question the need for any x-ray, you are unnecessarily concerned and may be harming yourself by your decision. Your dentist cannot diagnose what he/she cannot see, and many problems start where they cannot be seen.
By the time you are experiencing pain, or the problem is large enough to be seen, it may be far advanced and costly to return to health.
This is such a common concern and I appreciate this opportunity to provide some guidelines. Following is an explanation of the different kinds of x-rays (properly called radiographs) dentists need, and the American Dental Association's frequency recommendations.
You need to know that, of all medical x-rays, dental x-rays have the lowest levels of radiation exposure. In 10 minutes out in the sunshine, you have gotten more radiation than in a basic dental x-ray.
WHAT X-RAYS REVEAL ABOUT YOUR HEALTH
Every dentist takes radiographs to diagnose decay, bone loss from periodontal disease, the presence of unemerged or impacted teeth, abscesses (infection in a tooth), bone fractures, tooth fractures, malocclusion (improperly aligned teeth and jaws) and inflammation in or disintegration of the jaw joints.
TYPES/FREQUENCIES OF DENTAL X-RAYS
PERIAPICAL: A "problem-focused" x-ray, used to identify an issue such as decay in a tooth or pair of teeth, normally taken if you have a symptom of a problem.
FULL MOUTH SERIES: A full set of periapical x-rays taken of all teeth, necessary to document their internal structure, surrounding bone and soft tissue, and necessary for adequate oral diagnosis. This series should be taken at least every 3 years to monitor current health and against future changes. It should be used in coordination with a panoramic x-ray, since a full mouth series cannot diagnose the jaw joint or, normally, issues associated with wisdom teeth.
BITE-WINGS: A series of either 2 or 4 x-rays taken of your areas of highest decay, your molars, located at the rear of your upper and lower jaws. This series is normally taken once a year to monitor for decay and bone support.
PANORAMIC: A head-encircling x-ray, necessary to locate wisdom teeth and associated problems, and to assist in diagnosing temporo-mandibular (jaw) joint health or dysfunction. This is also a foundational x-ray, taken every 2-3 years, and must be used in coordination with a full mouth series, since a panoramic x-ray cannot adequately diagnose decay.
Because your needs are individual, Amanda, the guidelines I have provided are customized by your dentist to optimize your health. A reminder that the health of your mouth affects the health of your entire body, and denying your dentist appropriate diagnostic tools is as important as denying them to your physician.