X-rays are used to diagnose between teeth cavities, periodontal disease, abscesses, abnormalities of teeth and jaw, developmental abnormalities, and other conditions, including some medical conditions. The most common diagnoses are cavities and periodontal disease.
At our office, we use a risk assessment for determining the need for x-rays. We do not tell a patient he or she is “due" for x rays based on a set policy. A patient may be at a high, medium, or low risk for dental problems, based on family dental history, personal habits regarding flossing and brushing, past history of periodontal disease or between teeth cavities, and diet habits as related to dental disease. Our risk assessment is based on guidelines developed by a task force of government and private agencies. These guidelines are based on specific criteria for the time it takes for decay to progress through teeth when various environmental factors are present.
Cavities that develop between back teeth are generally impossible to diagnose without x-rays, unless they are so large that the tooth is severely undermined. Other conditions such as periodontal disease or abscesses may display symptoms that show up without x-rays, but x-ray examination may be required to confirm the diagnosis. We occasionally find hidden pathology such as cysts in the jaw bone and abscesses on teeth that have died without any pain or discomfort. Calcifications in salivary ducts that impede the flow of saliva have also been found.
Patients at high risk for between teeth cavities or periodontal disease generally require bitewing x-rays once a year until risk factors are lowered.
Patients with specific developmental or medical conditions may need a panoramic x-ray every three years or as conditions warrant to diagnose or monitor condition.
High Risk for Between Teeth Cavities
- Patient does not floss regularly.
- Patient drinks sweetened beverages, including coffee or tea, regularly.
- Patient consumes hard candy, breath mints, or cough drops regularly.
- Patient has history of between teeth cavities.
- Patient is taking medications leading to dry mouth syndrome.
- Patients undergoing orthodontic care (braces).
- Patients with malpostioned or crowded teeth.
High Risk for Periodontal Disease
- Strong family history of periodontal disease.
- Patient has previously diagnosed problem areas.
- Patient previously treated for periodontal disease.
- Spouse or partner has periodontal condition.
- Patients who smoke or have a history of smoking.
- Patients with uncontrolled Diabetes
High Risk for Developmental or Medical Problems
- Wisdom teeth unerupted (teen-age years through adult).
- Impacted wisdom teeth present; need monitoring for cyst development.
- Generalized periodontal disease.
- TMJ symptoms.
With this risk assessment, patients can be assured that any x-rays taken are necessary to diagnose a condition for which there is a high risk. Patients can reduce the need for x-rays by reducing the risk factors in many cases - such as by changing diet habits, reducing sugar intake, and flossing every day.
Even if a patient is at high risk, our extra-oral bitewing x-ray system is state-of-the art, allowing us to take x-rays without the need for in-mouth sensors, with the lowest radiation exposure (even lower than digital intra-oral bitewings), and with greatly expanded visibility to view oral anatomy.