This is a question I get from patients of all ages and many parents. The answer to the question MUST always be, “well, it depends.” We base the decision on the patient’s individual risk for disease, NOT based on insurance benefits. Even though the radiation from digital x-rays is much less than traditional film we aim to minimize exposure with lead shields and a frequency of x-rays based on your particular risk for dental disease detected by x-ray exam.
We have to weigh the risk of exposure to radiation with the benefit of catching disease early. People with a history of cavities or gum disease, history of root canals, fillings, or tooth loss, visible signs of disease, low saliva flow, or risky diet choices are all individuals with a higher risk of having new or recurring disease. X-rays would be indicated on these patients at a more frequent interval than a patient who hasn’t had a cavity in 10 years and follows recommended preventative measures.
In addition to decay, we detect early and progressing bone loss from gum disease and root problems as well. For instance, internal root resorption (below in red circle) is a condition that occurs spontaneously and without symptoms and can only be diagnosed on an x-ray. If found early enough, the tooth can be saved with a root canal, but if not, the most certain fate of the tooth affected by root resorption is extraction.
X-rays are an adjunct to our clinical exam, which means that x-rays help us see areas that we cannot perfectly see with our eyes. When I look in a patient’s mouth, I can see if the gums are red or swollen or receding, I can see if there is a cavity at the gumline, on the biting surface, and if it’s big enough I can see cavities between the teeth. I can’t see the roots or the bone or right in between the teeth (which is a common place for decay to start). Without an x-ray, small cavities between the teeth can be easily missed. If cavities between the teeth are visible to the naked eye, they’ve likely grown large enough to cause pain or require a crown instead of just a filling.
Are You At Risk For Gum Disease?
X-rays allow us to find conditions like periodontitis (gum disease), early decay, root resorption, or cysts before they worsen to the point that they require more extensive treatment or cannot be treated at all. The most common example of this is decay between the teeth. In the x-ray below we can see an early cavity on the left that we’d hope to remineralize and heal with fluoride to the tooth surface. The larger darker cavity on the molar would need to be fixed with a routine filling. None of these cavities would be visible with a visual exam.
In this next x-ray we see decay that has extended to the nerve on the inside of the upper tooth requiring a root canal and crown. The decay is also very close to the bone level between the two teeth. If the decay has traveled too far up the root and below the bone level, then the tooth cannot be fixed and will need to be extracted. Note that the biting surface of the decayed tooth looks just like the healthy tooth next door. Without an x-ray, this decay (even though extensive) could be missed until it grows this large and either needs much more than a filling or can’t be fixed at all and must be extracted.
X-rays on kids
With children, it’s very important to assess risk of disease or decay when deciding when to start taking x-rays, how often, and which ones to take. When children start seeing the dentist regularly for prevention and education at a very early age, decay risk can be minimized to an incredibly low rate. If we can be successful in teaching parents how to minimize risk of cavities and kids can be followed with regular visual exams, very few x-rays could be prescribed even up to teenage years. That’s why we think it is important for a Post Falls Dentist to promote oral health and PREVENTION from a very early age. We believe it is possible for all kids to never get a cavity and that’s why we provide FREE Prevention and Education visits for children up to their 4th birthday. For no charge your child will receive cleanings, exams, and fluoride if you want it to get them off to a healthy, early start and to learn from very early on that the dentist is a fun, easy place to visit rather than having their first visit be to fix a broken tooth or toothache.
If this article hasn’t answered all your questions about x-rays, please call our Post Falls Dentist Office, make an appointment to meet Dr. Frank, or email us with more questions. Our goal is to treat you as an individual and to genuinely listen to your biggest concerns. Our job is to help you reach your goals and to promote overall wellness.
Yours in oral health,
Whitney Frank, DDS