Why take dental x-rays?
“Do I really need x-rays?” When a patient asks this question, often times what they are actually saying, not so subtly is: “I do not want x-rays.” I am reminded of the line in the famous Rolling Stones song “you can’t always get want you want, but if you try sometimes you might find what you need.” So, before we get into the reasons why patients do not want x-rays I would like to explain to you why as your dentist we need x-rays. The answer is simple: So I can do a good job for you. Without x-rays I am largely blind to a lot of what is going on, like hidden decay, cysts or infections.
I can only visually see so much. If the problem is on your lip, superficially on your gums or teeth or easily explainable without x-rays, you probably do not need them. But, if there is a problem or question that is not easy to diagnose, I can’t see bone levels. I can’t see in between the teeth, I can’t see things growing in the bone or infections at the end of the root. Here is an example of problem that I cannot see.
Deep decay or just stain?
To drill or not to drill that is the question. One of the ways to determine if this is a problem that needs to be addressed or can simply be monitored, is with an x-ray. Here is a good example: the x-ray reveals deep decay (outlined in red) below what looks like a small stain in the groove of the tooth. When exposed the photo shows a huge area of decay close to the nerve. We were able to save and restore the tooth but it was close.
How many dental xrays and when?
Here at Divine Expressions Family Dentistry we take x-rays every 6 months at your cleaning visit to ensure we catch anything that changes or happens in your mouth very early.
Why can’t we just use the old x-rays?
First, things change and sometimes rapidly. Second previous film xrays are often duplicates of originals and much detail is lost in the duplication process. Even with the transition to digital xrays some systems do not seem to be as compatible as we would like to enable us to read them well. Printed out digital x-rays are often almost unreadable.
What are the routine dental x-rays?
We do not routinely take the same x-rays on every patient. We evaluate each patients risk for disease, previous history and the benefit and risk of taking x-rays. If a person has a history of very high risk of cavities, i.e., they have a lot of dental work and/or habits such as drinking soda that often lead to rapid decay between the teeth the benefit of detecting the decay before it becomes catastrophic makes x-rays more beneficial. A patient who has little dental work, good oral hygiene and good habit doesn’t need as many x-rays.
Do I have to have dental x-rays?
Our job is to inform you as our patient that what we recommend is reasonable and necessary. Ultimately it is your body and your decision and we respect your right to decide. Very occasionally I will insist that an xray be taken when I feel that other visual examination signs or symptoms indicate that may be jeopardizing the tooth, your health or a potential acute infection may be present. We are at times caught between you and your insurance company who often insist on x-rays prior to treatment or they will refuse to pay benefits. Keep in mind however, that without x-rays we can’t do a complete exam on your mouth.
The most common reasons people refuse x-rays are either the expense of x-rays or the fear of radiation exposure. So let’s talk about both.
How much do dental x-rays cost?
X-rays are expensive. I can’t afford them.
The cost of dental x-rays depends on how many we need to take to give you good advice about your dental health. The real emphasis should be how much can dental xrays save you!
First if an x-ray saves you from one root canal and crown, you just saved not only the tooth but one hundred times the cost of one x-ray. We would much rather detect a problem while it is small and relatively inexpensive and easy to fix than dealing with a disaster later that requires expensive dental heroics or the loss of a tooth. The reality is that by finding problems early when fixes are simple save YOU money. I treat my patients like I would treat my family.
I am afraid of dental radiation causing cancer.
We completely understand some fears of radiation and cancer. Life is about risk and benefits. Every day we live we risk staying alive. In fact every day you are alive you are exposed to background radiation from natural sources. Every time you fly in a plane or go to a higher elevation you increase your radiation exposure and risk because cosmic radiation which are the same as(x-rays) from space are less blocked by the thinner atmosphere. No detectable increase has been found in cancer rates or disease from living in Denver with its increased cosmic radiation. I’ve never heard someone tell me they moved to Carlsbad to reduce their cancer risk. Perhaps the immeasurable risk is there but it may be worth the benefit of being closer to great skiing. Every time you fly in an airplane you are taking a risk equivalent of several dental x-rays and I have never heard a person refuse to get on a plane to go on vacation because of the increased radiation risk.
Dental radiation compared to other sources
We of course use digital x-rays and lead shields to reduce your radiation exposure even further.
To give some perspective here are some examples:
A set of four bite wing x-rays is the same increased exposure as going on a two week ski trip to Colorado; that is if you didn’t fly. If you took a plane you received the equivalent of three sets of bite wings, checkup x-rays, while you were on the plane.
A set of four bite wings is the equivalent of one day of background radiation that you receive each day just from being on the earth.
A set of four bite wings is the equivalent of living in a brick house for a year vs living is a wood house because masonry gives off more background radiation.
Sleeping next to someone for a year is the equivalent of one dental x-ray as we all give off small amounts of radiation.
Make an informed decision
So the question becomes is if very small amounts of exposure matter that much are you going to stop: taking airplanes, going to the mountains, sleeping with your wife/husband/ mate, and move out of your brick house? Is a small amount of radiation worth the information the dental x-ray provides so that we can do a thorough job for you? As your dentist I think so but it is your decision.