X-rays provide your dentist with an important tool that shows the condition of your teeth, its roots, jaw placement and the overall composition of your facial bones. X-rays can help your dentist determine the presence or degree of periodontal (gum) disease, abscesses and many abnormal growths, such as cysts and tumors. X-rays also can show the exact location of impacted teeth. These can pinpoint the location of cavities and other signs of disease that may not be possible to detect through a visual examination. Without X-rays, your dentist is practically blind to perform an exam.
Your radiographic schedule is based on your dentist’s assessment of your individual needs, including whether you’re a new patient or a follow-up patient, adult or child. In most cases, new patients require a full set of mouth X-rays also known as FMX. It consists of 18 individual X-rays. This is the standard of care used to evaluate oral health status, including any underlying signs of gum disease, and for future comparison. These types of X-rays are taken every 3 to 5 years. If you have very good oral hygiene with few small restorations, once every 5 years would be sufficient. If you have many restorations and are prone to gum disease then every 3 years would be more appropriate.
Follow-up patients require X-rays known as bitewings. These consists of 2 to 4 X-rays which are taken every 6 to 18 months depending on the caries index rate of each patient.
More and more dentists are acquiring digital X-rays. It carries a high initial investment which could be prohibitive for largely established offices to make the switch. Digital X-rays require less radiation (not always significantly). You can see the captured image within seconds. Also, the image can be digitally tweaked for better viewing. However, the sensors are rather thick and could be quite uncomfortable for some patients. Also, the quality is good but it is still not as effective as some of the traditional X-ray films.
FMX, also known as Full Mouth X-rays, typically consists of 18 individual X-rays. These have the highest resolution and are great for looking at details. Most patients assume that it is the number of individual X-rays that determine the overall radiation dosage, but that is not an accurate assumption. For example, a chest X-ray is a single exposure, yet it exposes you to more radiation than a FMX. A FMX of 18 X-rays has 27 times less radiation than a lower gastrointestinal (GI) series and 20 times less radiation than one year of normal background radiation from the environment. The 4 bitewing X-rays taken during dental checkups have 79 times less radiation than a year of normal background radiation. The bottom line is that X-rays are the standard of care and an important tool for the dentist to examine you.
A panoramic radiograph allows your dentist to see the entire structure of your mouth in a single image. Within one large film, panoramic X-rays reveal all of your upper and lower teeth and parts of your jaw.
What is apparent through one type of X-ray often is not visible on another. The panoramic X-ray will give your dentist a general and comprehensive view of your entire mouth on a single film, which other X-rays cannot show. On the other hand, you might need close-up X-rays to show a highly detailed image of a smaller area, making it easier for your dentist to see decay between your teeth. Panoramic images do not have the detailed resolution of a FMX. Your dentist has a need for the different information that each X-ray can provide to formulate a diagnosis.
These type of X-rays provide a 3D image of your jaw. It does expose you to a higher radiation dosage but the information that is obtained is priceless, especially when you have to perform dental work close to critical structures. These X-rays are great for placing implants, removing teeth that are very close to the main nerve of your jaw, evaluating lesions to determine the extent of coverage, etc.
This is a relatively common issue for dental offices when patients refuse X-rays and still expect to be treated! Unfortunately not having proper X-rays is a liability for the dentist and should there ever be a dispute, the dentist is held liable even if the patient did consent to not having X-rays taken. If you are determined to refuse X-rays, do not be surprised if the dentist also refuses to examine and refuses to treat you. Taking X-rays for proper diagnosis is the standard of care. The dentist needs to see the extent and exact location of your specific problem, otherwise, he/she would be guessing and cutting your tooth blindly.