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Dental X-Ray Exams

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Types of Dental Radiographs

Bitewing Radiograph shows several upper and lower teeth from one side of the mouth on one small image. Periapical Radiograph shows several teeth and their roots and the jawbone they are in in a certain area of the mouth.

P re V e N t I V e

Dental X-Ray Exams


Dental X-Ray Examinations

Answers to Common Questions


Bitewing This X-ray shows decay between the teeth (interproximal decay). Periapical This X-ray shows the crown of an impacted molar.

Complete Series is a series of bitewing and periapical radiographs that shows all the teeth, roots and related areas of the jaws. Panoramic Radiograph shows all the upper and lower teeth, large portions of the jaws and other structures on one large image. When this kind of x-ray image is taken, no film is put inside your mouth. But this kind of x-ray image does not provide as much detail as smaller images.

Answers to Common Questions


X-rays can provide important information about your oral health. They are used to create images called radiographs. Dentists can use the images to see the bones, the roots of the teeth, unerupted teeth and the areas where the teeth touch each another. X-ray images also can reveal a condition at an early stage.

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Produced in cooperation with the American Academy of Oral and Maxillofacial Radiology, www.aaomr.org

Panoramic This X-ray shows developing permanent teeth that have not yet erupted.

Digital Radiograph
All of these types of images can be obtained digitally. The electronic image can be saved to a computer where the dentist can view it on the screen, store it in a patients computer file and transmit it electronically to an insurance carrier or another dental office.

Some people have questions about the need for dental x-ray exams and wonder if they bring any health risk. This brochure will answer these questions and describe some common x-ray images used in dentistry. This brochure does not include information about computed tomography (CT) or cone-beam CT imaging.

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2010 American Dental Association. All rights reserved.

What are x-rays?


X-rays are a form of radiation. They create an image by penetrating an area the dentist wants to examine and striking film or a digital sensor on the other side. Dense tissues (teeth and bone) are lighter (white) on x-ray images because fewer x-rays reach the film or sensor. Soft tissues (the cheeks and gums) are darker because more x-rays reach the film or sensor.

How often should I have dental x-ray exams?


Your dentist will decide if x-ray images are needed after completing a clinical exam. He or she will also review your health history, evaluate your risk for dental diseases and look at previous x-ray images when available. If you are a new patient, your dentist may wish to see your x-ray images from previous dentists. How often x-ray exams are done varies by the patients age and the risks, signs and symptoms of disease. Your dentist may need new x-ray images to see decay, assess gum disease, or evaluate growth and development. This is important for children since their teeth are changing and their bones are growing. In addition to helping diagnose tooth decay, x-ray images in children can help the dentist chart the progress of this growth and development and see if permanent teeth will come in normally. As in adults, x-ray images in children should be taken only after a dentist has examined the child and determined that they are necessary.

Tell your dentist if you are or might be pregnant. If an x-ray is needed, the leaded apron and thyroid collar you wear during x-rays will help protect you and your fetus.

If Ive had radiation therapy for cancer of the head or neck, should I avoid dental x-rays?
The dose of radiation required for dental x-ray exams is very small compared with that used for radiation therapy. Receiving radiation therapy for cancer may increase your risk for diseases such as tooth decay. Therefore, its important to have x-ray exams as needed to detect and treat oral problems at an early stage.

Are dental x-rays safe?


The main concern about being exposed to radiation is the risk of getting cancer years later. While the risk of radiation-related cancer is hard to measure, it is believed that with smaller amounts of x-rays the risk is smaller. Dental x-ray exams use very low doses of radiation, making the risk of harmful effects very small. X-ray exams have radiation levels equal to 2 to 3 days of naturally occurring background radiation or a fourhour flight on an airplane. Chest and spine x-rays and CT scans have higher levels. Even though radiation risk is small, dental x-ray machines and techniques are designed to limit your exposure. Your dentist can reduce your exposure during an exam by:  limiting the size of the x-ray beam to that of the film or digital sensor  having you wear a leaded apron and thyroid shield  using the fastest speed film Although the risk of any harmful effects is small, x-ray exams should be done only when the results are necessary to make a diagnosis and sometimes to determine your treatment.

What are the benefits of a dental x-ray exam?

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If I change dentists, can I have my previous x-ray images sent to the new dentist?
The dentist who treated you in the past generally is considered to be the owner of your records, including x-ray images. And he or she may be required by law to keep your records for a certain amount of time. But, you usually can arrange to have copies sent to your new dentist. The ADAs guidelines recommend that x-ray images be transferred to avoid unneeded x-ray exposure to you.

Many diseases of the teeth and surrounding tissues cannot be seen when your dentist examines your mouth. An x-ray exam may reveal:  small areas of decay in the teeth and below fillings  bone diseases  abscesses or cysts  signs of periodontal (gum) disease  developmental and other defects  some types of tumors  signs of trauma  signs of systemic illnesses  positions of tooth roots and jaw bones

Why do the dentist and other members of the dental staff leave the room when they take x-rays of my teeth?
If your dentist or dental staff member does not leave the room or stand behind a barrier, he or she will be exposed to radiation many times a day. Although the amount of radiation he or she receives each time is quite small, over time it could add up to a large amount.

What scientific groups and governmental agencies advise dentists about x-rays?
Many organizations have developed recommendations or regulations on the proper, safe and effective use of x-rays in dentistry. They include the U.S. Food and Drug Administrations Centers for Devices and Radiological Health, the American Dental Association, the American Academy of Oral and Maxillofacial Radiology and the National Council on Radiation Protection and Measurements. State governments also have regulations about x-ray exposure and the use of x-ray machines.

If Im pregnant, or think I may be pregnant, should I ask that x-rays be postponed?


Current guidelines say it is more risky for a pregnant woman to postpone dental treatment than to have an x-ray. This is because dental disease not treated during pregnancy can lead to problems for you and your fetus.

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