Your oral health is important and numerous studies have linked oral health status to systemic health. To help maintain your good oral health dentists want to keep your radiographs up to date and so should you. Periodic radiographic examination of your teeth and jaws plays an important role in prevention and early detection of oral disease.

Tooth decay – Not all decay is obvious by visual or tactile examination of your teeth. Teeth are supposed to be hard tissues and in fact enamel is the hardest tissue in your body. Soft or chalky enamel (or dentin) is a visual and tactile sign of tooth decay. Unfortunately, some locations such as between teeth or below fillings and crowns cannot be directly probed. Radiographic (x-ray) examination is the standard of care for complementing the dentist’s visual and manual oral exam. What’s more, many lesions can be treated non-surgically with remineralization therapy if caught early.

Bony lesions – Probably the most common bony lesion detected by radiographic examination is the dental abscess, where bone is destroyed by infection around the roots of teeth. While most patients are aware of an infected tooth (they usually hurt), often times the tooth may not by symptomatic or only hurt for a short time. In the preceding image, the large, dark circular area at the end of the root of the far left tooth is a chronic abscess.  These types of infections may become chronic and can lead to more widespread and possibly life threatening facial infections. In addition to infection, a number of pathologies can also be detected by radiographic exam including, cysts, tumors (benign and malignant), bone loss due to periodontal disease, foreign bodies, fractured roots, and subgingival tartar/calculus to name a few.

Structural and Restorative Examination – Radiographs are important in developing dentition (as in kids) to determine if the full complement of permanent teeth are present, whether there are extra (supernumary) teeth, if there are impacted teeth, or teeth with abnormally shaped roots. Can you see that the lower permanent second bicuspids are missing in the above panoramic radiograph? When a tooth is restored with a filling or crown or if an infected tooth is treated by root canal therapy, radiographs are used to examine the fit and finish of the restoration and treatment. When teeth are missing, radiographs help determine bone support for a bridge or implant. Panoramic views can often detect non-dental pathology such as calcified carotid arteries or stylohyoid ligaments as well as temporomandibular joint (TMJ) problems.

So what or who determines how often radiographs should be taken? This depends on the type of examination. Patients with a history of decay or periodontal disease should have the appropriate annual examination, usually four “bitewing” x-rays that screen the teeth where they touch as well as the levels of bone supporting teeth. Larger survey radiographs such as panoramic views should be updated every five years to monitor bony lesions in the jaws and may be recommended more or less often depending on diagnoses and specific patients. Teeth with spontaneous pain or pain on biting can be best diagnosed with “periapical” radiographs showing the areas around the roots of the affected teeth. And the fit of new crowns and some fillings are generally checked with individual bitewing radiographs.