Dental radiographs are one of the oldest tools to help dentists diagnose and treat dental disease. In some cases, they may even help prevent problems from progressing to more severe conditions as they help with early detection. Everyone is worried and concerned about the radiation in any kind of X-ray due to the link with cancer. This worry increases exponentially when a dental radiograph is advised for a child. It is difficult for parents to consent to these X-rays without knowing much about them, so here are some details to help you understand better.
Dental X-rays are only taken if they are essential
Dental X-rays should only be carried out after clinical examination and a look at the patient's medical history. They allow the dentist to see areas of the teeth that are not visible to the eye — like in between teeth, or inside the tooth, or the bone under the gums. In many cases, the radiographic finding leads to early detection before the patient feels any symptom. The American Dental Association has given certain guidelines for situations in which X-rays for children are recommended so that unnecessary X-rays are not taken.
X-rays are crucial in the identification of many dental diseases
Dentists use X-rays of the teeth to help identify some of the following conditions:
- The presence of tooth decay
- Inherited diseases that affect the normal formation of the teeth
- Any indications of trauma to the teeth
- Any missing teeth which are not erupted
- The total number of teeth present in the mouth
- Infections underneath the roots, which can be very difficult to diagnose otherwise
Not all dental X-rays are the same
There are many types of dental X-rays, used for different purposes. Your dentist may ask for more than one type of X-ray depending on the clinical situation.
- Intraoral Periapical. This X-ray shows two to three whole teeth including the crown, root, permanent tooth bud (in case of a primary tooth), supporting bone, and other close structures.
- Bitewing. This X-ray shows crowns of multiple teeth in the same area and helps diagnose decay between teeth which may not have been visible in clinical examination.
- Panoramic. This shows all the teeth, upper as well as lower, in one X-ray and can be used to count the teeth, and see any unerupted or missing teeth.
- Occlusal. This shows either all the upper teeth or all the lower teeth and is used to check how the upper and lower teeth align when the child bites.
- Orthodontic. These are also called cephalometric and show the jaw and the head from the side and would be recommended before starting orthodontic treatment for the child.
- Cone Beam Computerised Tomography (CBCT). These give a three-dimensional view of the mouth while all the others give a two-dimensional view.
Dental X-rays are considered to be very safe
Dental X-rays deliver a very small dose of radiation, small enough to be even acceptable for a pregnant woman, although that is only done when there is no other option. We are all bombarded with radiation on a daily basis from the sun and a few dental X-rays are well within the most conservative safety standards regarding exposure to radiation.
There are various means to further increase X-ray safety which are routinely practiced by dentists. Most modern dental practices have access to digital sensors which allow a reduction of the radiation by 80 percent. These can also be stored as soft copies and hence have a longer life and are easier to maintain records.
Films and exposure techniques have advanced tremendously in recent times and so even those dental practices where traditional methods of dental X-rays are used are going to minimize the total radiation exposure.
Lead apron and thyroid collar are used for pregnant women and can also be used on a child to prevent exposure everywhere other than the desired area. However, in today’s times, these are not really required as the modern machines have hardly any scatter radiation.
Dental X-rays are very easy for children
Most children are able to get dental X-rays taken very easily. They just take a second and the new films/sensors are small enough in size to not be uncomfortable. If the child is apprehensive or has a gag reflex, then some sedation techniques can be used to make the child more comfortable as well.
Overall, the risk from the dental X-ray radiation is negligible and of no consequence when compared to the benefits offered in diagnosis and treatment planning. Allowing the dentist to practice with precision and accuracy should be much more important to parents.
These views have been emphasized by the most reputable dental associations around the world including the American Academy of Pediatric Dentistry, American Association of Dentistry, and the American Association of Pediatrics.