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X-Rays

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Why Dentists Take X-Rays
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Many people wonder why it’s so important for their dentist to take x-rays of their teeth.  To understand why, let’s take a quick look at what x-rays do.

You can think of x-rays as invisible light that passes through your mouth and is projected onto a sensor.  As the x-rays pass through your mouth, they are absorbed differently depending on what they pass through.  For example, the x-rays pass through teeth differently than they pass through gum tissue.

This difference is what allows dentists to see the different parts of your mouth on an x-ray.  X-rays are able to detect hidden things that your dentist cannot see by simply looking in your mouth.

There are several reasons why your dentist may want to take x-rays of your mouth.  Hopefully the list below will clue you in on why exactly your dentist wants to get dental x-rays taken.

10 Reasons Why Dentists Take X-Rays

Why Dentists Take Dental X-Rays1 – To Check for Cavities

X-rays allow dentists to see cavities that are between two teeth, which might otherwise remain undiagnosed.  X-rays also allow dentists to see cavities that have formed where a previous dental restoration such as a filling (they don’t last forever) or a crown (yep, you can get a cavity under a crown.)

Learn about six common places where you can get a cavity.

2 – To Determine If You Have Gum Disease

Gum disease, also known as periodontal disease is the leading cause of tooth loss for older adults.

3 – To Check for Abscesses and Cysts

An x-ray can show your dentist if you have any abscesses or cysts in your jawbone near the roots of your teeth.

4 – To Monitor Wisdom Teeth

A panoramic dental x-ray is a great way to see all four of your wisdom teeth.  It can help the dentist determine if there will be any problems with them when they come in or if your wisdom teeth need to be extracted.

Learn why dentists extract wisdom teeth.

Lateral Cephalometic X-Ray
A lateral cephalometric x-ray used to evaluate jaw growth

5 – To Detect Oral Diseases & Tumors

Many diseases remain hidden to the naked eye.  X-rays allow dentists to get an inside look at your jawbone to detect any hidden tumors or diseases that may be lurking under the bone.  For example, an odontogenic keratocyst, is a tumor in the jaw bone shows up on an x-ray.

Also, a panoramic x-ray gives the dentist a good view of the sinuses, which can help the dentist determine if the true cause of your toothache is a sinus infection.

6 – To Make Sure They are Providing Quality Dental Work

Dentists take x-rays at various points during certain dental procedures to ensure that you get the best treatment possible.  For example, during a root canal, your dentist may take a few different x-rays to ensure that they have fully cleaned out your infected root canal and put in a root filling that will allow your tooth to remain healthy for many years into the future.

7 – To Evaluate Injured Teeth

When ever a tooth gets knocked loose or even knocked out, it can often be stabilized.  Dental x-rays are a vital part of this process as they let the dentist know whether or not the tooth was stabilized in its proper position.  Dental x-rays also allow your dentist to monitor the injured tooth over the next several years to ensure that it remains healthy.

In the case of an injured baby tooth, dental x-rays can also allow a dentist to see if it’s likely that the developing permanent tooth under the baby tooth was damaged.

8 – To See Developmental Abnormalities of the Teeth

X-rays can help a dentist visualize any developmental abnormalities of the teeth, such as gemination or fusion, commonly known as double teeth.

9 – To Evaluate Jaw Growth

Orthodontists use x-rays a lot to make sure that the jaws are growing to their proper size.  If abnormal growth patterns are caught in time, orthodontists can manipulate jaw growth to a more normal growth pattern through the use of appliances such as head gear.

10 – To Evaluate You For Dental Work

Many dentists take x-rays to ensure that you can receive certain types of dental work.  For example, a dentist wouldn’t want to give you a bridge if the adjacent teeth aren’t strong enough to support it.

Also, x-rays can be used to evaluate patients before they receive dental implants to ensure that there is an adequate amount of bone present and that the bone is healthy.

Conclusion

Your dentist may want to take x-rays of your mouth for a variety of reasons.

I think that the American Dental Association best sums up the importance of dental x-rays when they state, “Finding and treating dental problems at an early stage can save time, money and unnecessary discomfort. Radiographs can help your dentist detect problems in your mouth that otherwise would not be seen.”

Do you have any questions about why dentists take x-rays? Go ahead and leave them in the comments section below. Thanks for reading!

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How Much Radiation Do You Get from Dental X-Rays?
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In order for dentists to see hidden problems in your jaws and in your teeth, it is necessary to take x-rays.  It goes without saying that the more dental x-rays you get, the more radiation exposure your body receives.  Extensive exposure to radiation can increase your risk of getting certain types of cancer — this is why it is important to only get needed dental x-rays.

How many dental x-rays you need and how often you need them largely depends on your risk for oral disease.  You can find out how often you should get dental x-rays taken here.

The purpose of this article is to simply let you know how much radiation various types of dental x-rays give you.

Radiation from Dental X-Rays

Radiation from Dental X-RaysRadiation is measured in units called Sieverts, named after Rolf Sievert, a highly-regarded medical physicist known for his work on measuring radiation dosage.  It is estimated that people living in the United States receive 3 milli sieverts of radiation per year from background radiation sources.

The radiation dose received from dental x-rays is measured in micro sieverts.  To help you relate the following numbers to your life, the background radiation that someone living in the United States receives per day is around 9 micro sieverts.

Radiation from Routine Dental X-Rays

A regular dental x-ray, like the one being taken in the picture above, exposes the patient to roughly 10 micro sieverts of radiation.  If the dentist is using an old-style dental film, then more radiation is needed and that number can climb to around 22 micro sieverts.  If the dentist is using a newer-style of x-ray unit that has a rectangular end instead of the round end (as is pictured above), then the radiation dose decreases drastically to around 2 to 5 micro sieverts.

If you get a full mouth series of dental x-rays (usually 18 x-rays), then you’ll be exposed to around 180 micro sieverts of radiation.

Radiation from Panoramic Dental X-Rays

A panoramic or panorex dental x-ray exposes the patient to anywhere from 9 to 26 micro sieverts of radiation.

If you went in to your dentist for a visit and they took four routine dental x-rays along with a panoramic x-ray, you would end up getting about 50-60 micro sieverts of radiation, or the equivalent amount of radiation exposure that you get from living on this earth for 6 days.

Radiation from a Lateral Cephalometric Dental X-Ray

Many adolescents get lateral cephalometric (or lateral ceph) x-rays when they get braces.  A lateral cephalometric x-ray exposes the patient to around 5 micro sieverts of radiation, or the equivalent of 1/2 day of background radiation exposure.

Radiation from a Cone Beam CT Dental X-Ray

Cone beam CT scans can be used to visualize the jaw bones in three dimensions. This aids dentists in diagnosing fractures and oral pathology and can also aid in evaluating patients to receive dental implants.

Depending on the brand of the cone beam CT unit, they emit anywhere from 20 to 600 micro sieverts of radiation, or the equivalent of 3 to 75 days of background radiation.

Questions about Radiation from Dental X-Rays?

For the record, I got the numbers above from the textbook Oral Radiology by White.

Do you have any questions, comments, or concerns about the amount of radiation that you get from dental x-rays? I’d love to hear what you have to say in the comments section below.

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Comprehensive Dental Exam
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Have you ever wondered how thorough your routine dental exams are?

A dentist that I shadowed prior to dental school told me that he used to rush through patient exams trying to get as much done as he could.  Eventually, he got tired of this because he really wanted to spend more time with his patients.  He doubled the price of his exams and spent twice as much time with each patient, being as thorough as he could.  Rather than losing patients, he said that he gained many more patients because his exams were complete and his patients felt they were getting a quality exam at each visit.

What Is a Dental Exam?

At my dental school, we do our exams by-the-book — we’re pretty thorough!  We examine just about every possible thing that a dentist can.  I thought I’d write a post about what our comprehensive dental examination includes, so you can gauge thorough your dentist’s exams are.

What Is a Dental Exam?

A dental exam consists of several different parts.  Each part helps to ensure that you and your dentist understand what is going on with your oral health.  In order to better describe a routine dental exam, I’ve simply written what I do when I see a new patient at the dental school.

I’ve divided it into 10 parts.  You can read over them all to see what we do, or simply jump to the sections that interest you.  If you have any questions when you’re done, scroll to the bottom to leave a comment, and I’ll get back with you.

1 – Introduction

I meet the patient in the waiting area, introduce myself and then ask them a little bit about themselves to get to know them better and put them at ease with me as their student-dentist.

2 – What Does the Patient Want?

I ask the patient why they came to the school for treatment.  I also ask what they expect from their treatment and what kind of dental work they want to have done.

3 – Medical History

I next obtain a very detailed health history, including which medications they are taking and any past or current medical conditions.  I then take a blood pressure and pulse.  It’s important to get the patient’s health history because certain things, like joint replacements and certain heart conditions can affect your dental treatment.  Also, there are over 300 medications that can cause dry mouth, affecting dental health.  Finally, an accurate health history is important because the dentist needs to ensure that there are no systemic problems that will affect the dental treatment that will be provided.

4 – Dietary Survey

We then complete a dietary form that indicates whether their diet places them at a high risk of getting cavities.  Although there are many things that can influence your risk of getting cavities, (here’s 25 things that increase your risk of cavities), diet is one of the most important factors.

5 – Risk Factors

We complete a “risk factors” form that tells us the patient’s risk for developing certain diseases, such as periodontal disease and oral cancer.  This form also gives us a general idea about the patient’s risk for fracturing or knocking out a tooth.

Another part of the form discusses the patient’s dental phobia.  We ask what kinds of things make the patient anxious about their dental treatment.  If you want to pinpoint your dental phobia, take a look at 15 common reasons why people are scared of the dentist.

The “risk factors” form also discusses other risk factors.  For example, this is the form I talked about in a previous article about how wearing your seat belt affects your dental health.

6 – Head and Neck Exam

6 – After that, we perform what we call a head and neck exam.  We feel the neck to note any enlarged lymph nodes or any suspicious lumps or bumps that could be cancerous.  We also feel the TMJ to evaluate whether or not the patient has any joint problems.  We note any popping or clicking in the jaw, which is fairly normal but which can cause problems.

7 – Oral Soft Tissue Exam

Next, we move on to the intraoral soft tissue exam.  The soft tissue exam consists of looking at every area in your mouth.  We look at the lips, the cheeks, the gums, the roof of the mouth, every side of the tongue, under the tongue, in the back of the mouth, the throat and the tonsil area.  Your tonsils can tell us if your body is fighting off a disease and sometimes your tonsils can cause bad breath if there is a tonsillolith present.

It is necessary to perform a very thorough soft tissue exam because this is where dentists check for oral cancer.  If your dentist isn’t very attentive during the soft tissue exam, he or she may miss the beginning stages of oral cancer.  It is important to catch cancer early because it improves your chances of beating it.  If something looks suspicious, your dentist may biopsy the area and/or refer you to an oral pathologist, one of the nine types of dental specialists.

8 – Periodontal (Gum) Health

Another part of the dental exam is periodontal probing.  This consists of sticking a little instrument between your teeth and your gums to see how healthy your gums are.  We measure the space between the top of the gums and where your gums attach to your teeth.  If it’s too deep, you won’t be able to clean it out well and it could indicate that you have periodontal disease, which is a leading cause of tooth loss in people over age 30.  If you do have periodontal disease, your dentist may recommend getting a deep dental cleaning, which is technically known as scaling and root planing.

9 – Hard Tissue Exam: We Finally Check Your Teeth

Next we perform a hard tissue (teeth) exam where we look at every side of your teeth and note any existing fillings, crowns, implants, root canals, cavities, fractures, or if there are any problems with your bite.  We also look at all of your dental work to make sure that it is still in good shape.  Depending on the health of your teeth, we may order x-rays to better diagnose any problems with the teeth and the area around the tooth.  Want to know if you need x-rays?  Read the article How Often Should You Get Dental X-Rays Taken?

During the hard tissue exam, we will also evaluate the patient’s bite.  If we will be making any crowns or dentures for the patient, we usually take dental impressions as part of the dental exam so that we can evaluate the patient’s bite and make sure we don’t cause any problems with the way that their teeth come together when we place crowns.

 10 – Treatment Planning

After gathering all of the above information, we create a treatment plan with all of the dental work that we recommend having done.   Sometimes this is as simple as getting a regular cleaning and providing instructions on how to maintain better oral hygiene or it can be as complex as getting dentures, crowns, bridges, root canals, implants, veneers, braces, and other dental treatment.

Conclusion

This is the comprehensive dental exam that each patient receives initially at my dental school.  Your dentist may choose to do things differently.  For example, some patients hate the “risk assessment” form and the dietary questionnaire.  At my dental school, we are required to complete these forms with the patient.  If you don’t seem interested in those things, then your dentist may choose to omit those parts of the exam.

Remember, all dentists are different, and most dentists want what’s best for their patients and will try to provide you with optimal dental treatment.  However, some dentists aren’t thorough, and hopefully this list will help you evaluate what you want your dentist to address during a dental exam.

If you have any questions, comments, or concerns about your dental exams, feel free to leave a comment below.  Thanks for reading!

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How Often You Should Get Dental X-Rays Taken
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I’ve gotten a few emails lately asking about how often dental x-rays should be taken.  An extreme example involved a young girl who had nearly 50 x-rays taken of one tooth over the course of a few years.

Another common example involves an adult who has never had a cavity.  Her dentist wants to take x-rays of her teeth every year.

Dental Panoramic X-RayThe main problem with getting so many x-rays is that whenever your body gets exposed to radiation, there is a risk of damaging your DNA, which could lead to cancer.  The amount of radiation from x-rays is very small, so this isn’t something to worry about, but getting lots of dental x-rays every year can add up to a lot of radiation exposure over your whole life!

Do people really need to have x-rays taken this often?  Let’s find out below!

How Often You Should Have Dental X-Rays Taken

The answer really depends on your oral health and your age.  For example, a 35-year old woman who has never had a cavity would require x-rays less often than than an 8-year old boy who has had several cavities in the past and doesn’t brush his teeth.

In order to provide the best answer to the question of how often to have x-rays taken, I will break it down into five different answers based on age and oral health.  Hopefully you can identify the category that  most closely resembles your situation to get a general idea of how often you need to have dental x-rays taken.

One more note: To figure out whether you fall into the low cavity risk or high cavity risk category, think about how many cavities you’ve had in the past, whether you’ve had any recent cavities, the amount of sugar you eat or drink, and whether or not you brush and floss daily.  People with previous cavities and poor oral hygiene are usually at a higher risk for getting cavities and would need to have x-rays taken more often.

How Often www.health-canada-pharmacy.com Does a Child (Under 18) with a High Cavity Risk Need Dental X-Rays?

A child with cavities or at a high risk for getting cavities would generally need dental x-rays taken every 6 to 12 months.

If there are spaces between your child’s teeth and the dentist can clinically inspect those teeth, then x-rays are generally not necessary.  It is always important to weigh the benefits and risks of having x-rays taken.

How Often Does an Adult (Over 18) with a High Cavity Risk Need Dental X-Rays?

An adult with frequent cavities or at a high risk of getting cavities would need dental x-rays taken every 6 to 18 months.

How Often Does a Child (Under 12) with a Low Cavity Risk Need Dental X-Rays?

A child younger than 12 years old with no current cavities and at a low risk of getting cavities would need dental x-rays taken every 12 to 24 months.  Again, many children have spaces between their teeth.  If this is the case, the dentist can usually detect cavities simply by looking in the mouth and would not need to take x-rays on those teeth.

How Often Does a Teenager (12-18) with a Low Cavity Risk Need Dental X-Rays?

A teenager with no current cavities and at a low risk of getting cavities would need dental x-rays taken every 18 to 36 months.

How Often Does an Adult (Over 18) with a Low Cavity Risk Need Dental X-Rays?

An adult with no current cavities and at a low risk of getting cavities would need dental x-rays taken every 24 to 36 months.

Other Scenarios Where Dental X-Rays May Be Necessary

The scenarios above are mainly to diagnose cavities and refer to the routine bitewing radiographs that dentists take.  There are many other situations when a dentist would want to take different x-rays where I couldn’t find clear guidelines, such as for monitoring periodontal disease, monitoring teeth that are at an increased risk for developing disease, and for monitoring growth in adolescents.

However the situation that I described above in which a young girl had nearly 50 x-rays taken on one tooth over a few years is definitely too many!

At my dental school, we used the book Treatment Planning in Dentistry by Stefanac and Nesbitt to learn about when and how often to prescribe dental x-rays.  I am basing the recommendations for the timing of dental x-rays found above on information found in that textbook, which coincide with the recommendations from the American Dental Association (PDF).

Conclusion

As you can see, dentists may recommend x-rays for diagnosing cavities anywhere from every six months to every three years — depending on your oral health.

Keep in mind that the above guidelines are just that — guidelines.  You may need x-rays taken more or less often depending on what you and your dentist think is best for you.  For example, if you have spaces between all of your teeth and the dentist can see whether or not you have cavities just by looking in your mouth, then there probably isn’t a need for dental x-rays.

Do you have any questions or comments on the timing of dental x-rays?  I’d love to hear what you have to say in the comments section below.  Thanks for reading!

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