Back then, people used to get their teeth pulled when it hurt.
Now, thanks to dental X-rays, clinicians can catch the disease in its early stage and treat it before it compromises your quality of life,
Dental X-rays allow dentists to see the parts of your mouth that aren’t visible clinically because these parts are submerged within the bone or beneath the tongue. Xrays are the beam of energy absorbed differently when passed through different body parts.
The difference in absorption is due to some parts of your mouth being denser than others. Denser areas, such as teeth, absorb more radiation (x-rays), resulting in whiter images on a film or a computer screen with traditional and digital X-rays, respectively. Less dense parts like muscles and nerves will appear grey on the image.
Digital dentistry and X-rays are widely accepted with the evolution of dentistry. However, today, we’ll learn about modern and traditional X-rays together so you can clearly understand how X-rays work in a dental setting.
From explaining the different purposes of X-rays to highlighting their differences, this comprehensive article is tailored to help dental patients gain a deeper understanding of this crucial aspect of dental care.
What is the purpose of dental x-rays?
Dental x-rays are taken at a routine dental checkup to see the oral structures in detail like:
- Jawbone
- Nerves
- Teeth
- Tooth Pockets
- Tooth Roots
- Sinuses
It helps your dentist diagnose a wide range of oral problems:
- Dental cavities between the tooth
- Root cavities on the root
- Dental decay beneath the existing dental fillings
- Abscess around the tooth root of dental infection
- Bone loss in your jaw
- Site of infection
- Position of the unerupted or impacted wisdom tooth
- Cysts or some tumor-like ameloblastoma.
3) Dentists also take X-rays to know your eligibility for specific treatments like:
These diagnostics help assist the fate of the treatment:
– the position of the dental implant after its placement in the jaw bone.
– Healing of the bone after bone grafts
– Accuracy of root canal treatment
Intraoral Vs. Extraoral X-Rays
Different X-rays are meant to record other parts of your mouth per your needs.
Broadly, we can classify dental x-rays as intraoral and extra-oral. Intraoral X-rays are where the Xray films are kept inside the mouth, while in extra-oral X-rays, the radiographic film is kept outside the mouth.
Intraoral X-rays
Intraoral X-rays are more common and frequently taken in a dental setting. They include the following:
Periapical X-rays: Periapical X-rays are taken to see the complete tooth from crown to root. These X-rays allow dentists to detect decay, gum disease, Bone loss, and any other abnormality. Each periapical x-ray shows two to four teeth and provides detailed information about the teeth and the surrounding bone.
Bitewing X-rays: Bitewing X-rays show upper and lower teeth together in one mouth segment. These X-rays don’t show the tooth’s roots and allow you to detect the decay between your teeth. These Xrays are called bitewings because a patient must bite on a small wing attached to an intraoral film. These typically detect carious lesions between teeth, monitoring the progression of caries and existing restoration.
Occlusal X-Rays: Occlusal X-rays allow dentists to detect any dental issues in the floor or the roof of the mouth. These radiographs are essential in diagnosing fractured or impacted teeth, especially the canines.
These help identify cysts, abscesses, and jaw fractures. Pediatric dentists use Occlusal X-Rays to evaluate developing teeth in children.
Extraoral X-rays
Panoramic X-rays: These X-rays show a broad view of jaws, all teeth in one, sinuses, and joints. These X-rays don’t reveal cavities in your entire mouth, but these are best at identifying problems like impacted teeth, bone abnormalities, cysts, tumors, infections, and fractures. It provides a 2D image of your upper or lower jaws.
Cephalometric X-rays: A cephalometric X-ray shows the X-ray of the lateral side of your head. It shows the orientation of your jaw to your teeth. The orthodontist takes this special radiograph to plan the treatment.
Cone beam CT Scan: Such an X-ray captures cross-sectional images of specific areas of your mouth. A single scan allows detailed teeth, soft tissues, and nerve pathways inspection. Pictures obtained with a CT scan allow for accurate treatment planning.
Digital Vs. Traditional X-rays
There are two methods to conduct X-rays: digital and traditional. Digital X-rays are considered safer than traditional ones because they give off less radiation exposure and provide better image quality without the need to be repeated.
The sharper, more explicit images allow the practitioner to diagnose the pathology or dental problem without missing it.
We all remember the old-school X-rays still used in some places where the X-ray films were developed in a darker room with some fixtures. Gone are those days because 90% of practices in the US use digital radiography.
The best part is that digital dentistry doesn’t require formal training on how these systems work.
“Largely, the education learned on digital radiography in dentistry was based upon vendor-supplied sales brochures, salespeople, and learning through trial and error. Also, the digital radiographic information that was promulgated varied from one source to another with little to no scientific validation,” said Peter Mah, D.M.D., a diplomate of the American Board of Oral and Maxillofacial Radiology.
Unarguable, digital dentistry allows on-spot digital diagnosis of even the pin-point cavity, which was previously missed in traditional films as they weren’t as straightforward as modern ones.
Moreover, digital X-rays appear conveniently on computer screens without the need to be developed with harsh chemicals. So, the benefit is there’s no material and chemical waste.
Are Dental X-Rays Safe?
Sometimes, people refuse to take X-rays because of the fear of being exposed to radiation. Lesser do they know that we all are exposed to radiation daily, like walking in the sun, flying in an airplane, and eating food.
Eating a banana is equivalent to taking two digital X-rays. The rule of thumb for radiation exposure is ALARA – As Low As Reasonably Possible. Dental radiography will only be conducted when the benefits and needs outweigh the risks.
Skipping dental X-rays won’t allow your dentist to look beneath your gums, inside your bone, and between the teeth, leading to tooth decay, bone loss, hidden gum disease, cysts, or cancers. By the time these conditions start to manifest their signs clinically, they’ve gone worse and sometimes appear life-threatening.
Digital X-rays give off less radiation than traditional X-rays. Taking full mouth X-rays equivalent to 18 to 24 individual X-rays with less radiation is possible. This means if you’re flying 2700 miles, you’ll be exposed to a similar amount of radiation that you’re exposed to during a full-mouth radiography.
Why do patients refuse to take X-rays?
X-rays let the dentist peek into what is inside your mouth that’s not visible on an oral examination. Not allowing dentists to conduct X-rays is like asking an auto technician to correct your car’s engine without opening the hood.
From a legal perspective, some practices dismiss patients who refuse to take necessary X-rays to recover from the potential liability they may face soon.
Dentists will record the refusal after effectively communicating the safety of X-rays to help mitigate objections. People fear having dental X-rays for a few of the following reasons:
Fear of Radiation
Despite digital radiography, which exposes an individual to minimum radiation, the fear of radiation exposure persists. Patient counseling about newer methods that employ lower radiation doses might mitigate the concerns as we are exposed to radiation daily.
Financial Concerns
Many people refuse to have X-rays because they find the cost of X-rays prohibitive, especially if they lack dental insurance coverage. Flexible payment plans and scheduling x-rays later can help address this concern.
Discomfort or Gagging
Unfortunately, dental X-rays lead you to some discomfort when the dental assistant asks you to bite on a big piece of plastic.
Although it is taken within a minute or two, the discomfort won’t last for long, but you may still feel uncomfortable if you have certain anomalies in your mouth, like palatal or lingual tori.
Some people have a severe gag reflex, which causes them to resist x-rays and impressions as well. Techniques like bending films, smaller films, or anesthesia can help address this problem.
Pregnancy & Dental X-Rays
First and foremost, you must inform about your pregnancy to your dentist so that you’re only advised to take an x-ray if necessary. Pregnant ladies must prioritize oral health because about 40% of women suffer from gum diseases and oral problems during pregnancy.
The American Dental Association states dental treatments are safe for nine months. They say that an X-ray of the upper torso, head, and neck region does not expose the fetus to radiation, thus not putting it at any risk.
Pregnant patients may refuse X-rays concerning its side effects on their fetus. It’s important to explain that dental X-rays are generally safe and made safer using a lead apron.
Children & Dental X-Rays
Dental X-rays in children have significant benefits because they allow pediatric dentists to closely examine the oral anatomy, growth, and associated problems.
The X-rays allow early detection of dental caries even before the symptoms are evident. This will keep your child safe from unwanted pain and discomfort.
The X-rays also allow the dentist to monitor the growth and tooth eruption sequences, which might need an early orthodontic treatment if impaired.
Sometimes, x-rays are taken to know the jaw abnormalities that might appear in the overall appearance of an individual once the growing stage is passed.
Children are provided with lead aprons and thyroid shields to prevent unnecessary radiation exposure. Special positioning aids are also used to maintain children’s posture during the x-ray.
