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Overview: Dental X-rays

Dental X-rays allow dentists and healthcare providers to check the condition of your teeth, roots, jaw placement, and facial bone structure.

Dental X-rays also help to find and treat dental issues that are early in development. They are often taken if your dentist believes you may need orthodontic treatment. 

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Finding and treating oral issues early in their progression can help you improve the quality of your dental care, save money, prevent discomfort, and in extreme cases, save your life.

If you are visiting a new dentist, you'll probably undergo a dental X-ray at your first visit to the dentist's office. This helps them improve the quality of their dental practice and provide you with personalized oral care.

Common Types of Dental X-rays

There are two main types of X-rays used in dentistry. These include intraoral X-rays and extraoral X-rays. Intraoral X-rays refer to when the X-ray film is in the mouth. Extraoral X-rays have a film outside the mouth. 

dental xray

What are Intraoral X-rays?

Of the two types of dental X-rays, intraoral X-rays are the most popular. Intraoral X-rays offer a lot of detail of the teeth. Dentists can use intraoral X-rays to do the following:

  • Find cavities
  • Assess the health of the tooth root
  • Check the health of the bone surrounding the tooth
  • Assess developing teeth
  • Determine if a patient is at risk for periodontal disease
  • Monitor the general oral health of the mouth

There are several types of intraoral X-rays. Each displays various aspects of the teeth.

1. Bitewing X-ray 

Bitewing X-rays display details of the upper and lower teeth in a particular area of the mouth. Every bitewing scan shows a tooth from its crown to around the level of the supporting bone.

Bitewing X-rays detect tooth decay, bone loss, and adjustments in bone density caused by gum disease. Bitewing X-rays also help to assess the best fit of a crown or cast restoration.

2. Occlusal X-ray 

Occlusal X-rays are bigger scans that display full tooth development and placement. Every X-ray shows the complete arch of the teeth in either the upper or lower jaw.

Occlusal X-rays discover extra teeth, jaw fractures, a cleft palate, cysts, dental abscesses, or growths. They also find foreign objects lost in the mouth.

3. Periapical X-ray

Periapical X-Rays reveal the entire tooth from the crown down to where the tooth anchors in the jaw. Every periapical X-ray displays this full tooth dimension and shows all the teeth in one portion of the mouth, either in the upper or lower jaw.

Periapical X-rays assess any teeth root abnormalities and the surrounding bone.

What are Extraoral X-rays?

Extraoral X-rays also show teeth. But unlike intraoral X-rays, they focus on the jaw and skull.

Extraoral X-rays do not show the in-depth detail that intraoral X-rays do, so they aren’t used for finding cavities or identifying issues with individual teeth. Instead, dentists use extraoral X-rays for the following:

  • Discover an impacted tooth or teeth
  • Assess the growth and development of the jaw bones
  • Identify issues between the teeth and the jaws
  • Check for any problems relating to the facial bones

There are a few types of extraoral X-rays available, including:.

1. Panoramic X-ray

A panoramic X-ray reveals the whole mouth area. This type of X-ray identifies impacted teeth, shows the progression of your wisdom teeth, and also helps diagnose tumors.

2. Tomogram X-ray

A tomogram X-ray displays a specific layer or ‘slice’ of the mouth while softening the focus on all other segments. This X-ray helps to assess structures that are difficult to observe.

3. Cephalometric X-ray

This type of X-ray displays the complete side of the head. Cephalometric X-rays examine the teeth in relation to the jaw and the patient’s profile.  Orthodontists commonly use cephalometric x-rays in diagnosis of malocclusions.

4. Sialography X-ray

A sialography X-ray scans the salivary glands after a special dye called contrast medium is injected into the salivary duct. The dye shows your salivary glands, which are soft tissues that don't normally display on an X-ray. This procedure detects salivary gland issues, such as blockages or Sjögren's syndrome.

5. Computed Tomography X-ray

A computed tomography X-ray, otherwise known as CT scanning, displays the body’s interior structure as a three-dimensional scan. It assesses issues related to the facial bones, including tumors and fractures.

6. Cone Beam Computed Tomography Imaging

Used more commonly in dentistry than CT scanning, CBCT shows a three-dimensional image of the face and jaws.  Because it requires smaller, less expensive technology than an x-ray machine, many dentists offer CBCT imaging in their private practices. CBCT images are advantageous in the planning of dental implant placement, difficult extractions, and complex root canals.

When Dental X-rays are Necessary

To minimize radiation exposure from dental X-rays, they must only be conducted when necessary. However, there’s no one-size-fits-all, and it’s left to the dentist or healthcare provider to decide when a patient requires a dental X-ray.

How often X-rays should be taken depends on various factors relating to the patient. These include:

  • Medical and dental history
  • Age
  • Stage of the dental disease or condition
  • Risk factors for various oral conditions
  • Symptoms of oral disease

Some people require dental X-rays every six months. For those that suffer from dental problems regularly, X-rays may need to be taken often. But others who do not have a history of dental or gum disease may only require a dental X-ray every few years.

In some dentist offices, new patients must take dental X-rays during their first examination to assess their teeth health. First-time X-rays also help check for problems and adjustments that take place over time. 

Children should have fewer X-rays than adults as they are more susceptible to radiation. However, decay develops faster in baby teeth than permanent teeth. Once a child shows that they have a higher risk for cavities, more X-rays may be necessary. 

Despite this, children under the age of 16 shouldn’t have a dental X-ray more than once annually.

Complications & Risks of Dental X-rays

Dental X-rays are very safe. While they work with radiation, the exposure levels are so low that they will not harm children and adults. If your dental professional works with digital X-rays, instead of developing them on film, you'll receive even less radiation exposure.

However, like with any treatment, there are some potential risks with repeated exposure. These include an increased risk of:

  • Thyroid cancer 
  • Tumors in tissues covering the brain and spinal cord
  • Radiation exposure
  • Affecting the health of developing fetus in pregnant women  

If you are concerned, there are ways that your dentist can minimize the exposure of radiation from dental X-rays. These include:

  • Taking a single X-ray image rather than multiple
  • Using the lowest radiation setting possible
  • Protecting certain areas of the body from radiation using leaded coverings

FAQs - Common Questions and Concerns

Below are some common questions and concerns that are often asked in the dental office.

Do I need to prepare for a dental X-ray?

Dental X-rays don’t require much preparation. All you need to do before meeting a dental professional is brush your teeth before the examination. This offers a cleaner and more hygienic space for the dentist examining your mouth. 

Are dental X-rays safe for children?

Many parents worry that dental X-rays may affect children negatively, as they’re more sensitive to radiation. However, the level of radiation in a dental X-ray is still safe enough for a child.

Children’s teeth and jaws are continually developing, so X-rays are essential to assess their progress.

Can I get a dental X-ray while pregnant?

Radiation poses a risk to developing fetuses. Women who are pregnant should approach dental X-rays with caution. However, most OB/GYN doctors consent to dental X-rays on pregnant patients during the second and third trimester. In many cases, the risk of dental infection is higher than the risk from the X-ray in pregnant women.

What are the different types of dental X-rays?

The different types of intraoral dental X-rays include:
-Bitewing X-rays
-Occlusal X-rays
-Periapical X-rays

The different types of extraoral dental X-rays include:
-Panoramic X-ray
-Tomogram X-ray
-Cephalometric X-ray
-Sialography X-ray
-Computed Tomography X-ray
-Cone Beam Computed Tomography Imaging

How often should you get dental X-rays?

The correct answer to this question is patient-specific and risk based. For many people with few or no dental issues, an X-ray every two or three years is sufficient to monitor your oral health. Other patients may require multiple X-rays each year to monitor treatment progress.

Are dental X-rays harmful?

Dental X-rays require very low levels of radiation exposure, so they are considered safe for both children and adults.

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Resources

Dental x-rays Mark, Anita M. The Journal of the American Dental Association, Volume 150, Issue 7, 636, https://jada.ada.org/article/S0002-8177(19)30335-6/fulltext

Dental CT imaging: a look at the jaw. Abrahams JJ.  Radiology. 2001, https://pubmed.ncbi.nlm.nih.gov/11323454/

U.S. Food and Drug Administration. Radiation-Emitting Products. The Selection of Patients for Dental Radiographic Examinations, 2019, https://www.fda.gov/radiation-emitting-products/medical-x-ray-imaging/selection-patients-dental-radiographic-examinations

New research on dental X-ray risks, British Dental Journal, 2019, https://doi.org/10.1038/s41415-019-1028-6

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Updated on: October 20, 2020
Author
Ellie Swain
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