Have you ever had x-rays at the dentist and wondered what on earth they were actually for? Well, we are going to demystify them! There are many different reasons why your dentist may suggest taking x-rays, however not all of them are clear at the time. We hope that after reading this, you’ll be x-ray experts and the decision to have x-rays will be a little less confusing.
Types of x-rays:
Each type of dental x-ray serves a slightly different purpose. The most common form of x-ray, and the one we can take in the dental chair at our clinic, is the intraoral x-ray. These are either a ‘bitewing’ or a ‘PA’ (peri-apical) x-ray. These are the ones that sit inside your mouth and are often taken as part of a check-up or to investigate new aches or pains or suspicious areas.
The other form of x-ray you may be familiar with is the orthopantomogram or OPG. These x-rays are a type of panoramic film that are taken at radiology clinics. An OPG shows not only your teeth, but the upper and lower bones of the jaw (the maxilla and mandible) and the temporomandibular joint (TMJ) – the joint between your jawbone and the rest of your head. The most common reasons for referral for an OPG are assessment of wisdom teeth, orthodontics, or to check bone health. Depending on which radiology clinic you attend, OPGs are usually bulk billed through Medicare.
Lastly, we have the lateral cephalometric x-ray, or ‘lat ceph’ for short. A Lat Ceph takes an image of the side of the face and is most often reserved for assessing and diagnosing orthodontic conditions.
Most common reasons for x-rays:
Dr David Ewen explains the most common reasons for dental x-rays:
Every two years:
Taking a set of dental x-rays every two years is a simple way to prevent serious dental problems. Sometimes tooth decay can be asymptomatic and hidden between the teeth – where the dentist cannot see. X-rays are the perfect tool to find these pesky spots. Regular x-rays can also be used to check on any existing dental work in the mouth, for example, to assess how well a filling is sealed to the tooth structure underneath or to review previous root canal treatments or crowned teeth. If x-rays have been taken on a regular basis, they often come in handy when comparing the progression of certain dental conditions.
While some causes of a toothache are obvious and can easily be seen, others are hidden inside the teeth or under the gums. X-rays can be used to assess the health of the nerve of the tooth, find dental abscesses, if decay is present, and the condition of surrounding teeth.
Chipped/cracked teeth and decay:
The main purpose of x-raying a damaged tooth or one with decay is to see how much of the tooth structure has been affected. Chipped teeth can often have underlying decay that if not removed prior to repair can cause problems down the track.
Assessment of bone levels:
An OPG x-ray is one of the best methods of assessing the periodontal status of your mouth. As periodontal disease progresses, the jawbone tends to drop away from the root of the teeth. OPGs taken at regular intervals can be used to track the progression of periodontal disease and assess the effectiveness of treatment. The bitewing and PA x-rays can also be useful in identifying and monitoring bone levels along with showing up scale (calcified plaque which is adhering to teeth). The dentist removes this scale as part of the “scale and clean” to improve periodontal health.
Different types of x-rays can be taken throughout orthodontic treatment. In the planning phase of orthodontics, OPG and Lat Ceph x-rays are useful for seeing the relationship of the teeth to the jaw, any missing teeth, extra teeth, and the condition and alignment of the jaw bones themselves. From time-to-time x-rays are taken throughout treatment to assess its progression or any complications that arise.
One of the most common reasons we refer patients for an OPG is to assess their wisdom teeth. As they like to hide in the very corners of our mouths often obscured by gum, getting a good look at wisdom teeth is often quite difficult. X-rays allow the dentist to see if the number of wisdom teeth present, their position, whether their growth is affecting surrounding teeth, and their relationship to structures like facial nerves.
Occasionally x-rays are used to assist in identifying other pathology such as cysts and cancers. OPGs are particularly useful for this. These pathologies sometimes can be found with an x-ray as an “incidental finding” to what the x-ray was originally requested for.
Like Medicine, Vet science and other health services, Dentistry is benefiting from new imaging techniques. The most common ones are CT scans and Cone beam imaging. Typically, these are ordered by dental specialists such as oral maxillofacial surgeons and endodontists. In essence these are “3D” images and are particularly useful for things such as assessing badly impacted wisdom teeth, for implant placement planning and locating dental abscesses.
Are there any risks involved in having x-rays?
At Highgate Hill Dental Centre, we like to keep on top of current technology and safety practices, that is why our x-ray machines only emit minimal amounts of radiation and are regularly serviced. All x-rays involve exposure to small amounts of radiation, that is why we only recommended them when they are clinically indicated.
How much does an x-ray cost?
The cost of intra-oral x-rays, like bitewings and PAs are not usually included as part of a standard check-up, however, are partially claimable on most private health insurance extras policies. Some health insurers offer one set of bitewing x-rays as gap free, however it is best to check with your insurer what your specific policy covers. For OPGs and Lat Ceph x-rays, we refer out to radiology clinics, therefore the prices can vary significantly. Some clinics will bulk-bill them, while others charge substantial out of pocket fees, so it is always worthwhile checking before you attend.
Can I choose not to have x-rays?
Of course! We are all about empowering patients to make decisions about their dental care. If your dentist recommends x-rays, they will give you all the information you need to decide if you would like to proceed or not.
Happy brushing and flossing and we will see you at your next check-up!