Do I need dental xrays?

August 13, 2015

Why take dental x-rays?

“Do I really need x-rays?” When a patient asks this question, often times what they are actually saying, not so subtly is: “I do not want x-rays.” I am reminded of the line in the famous Rolling Stones song “you can’t always get want you want, but if you try sometimes you get what you need.” So, before we get into the reasons why patients do not want x-rays I would like to explain to you why as your dentist we need x-rays. The answer is simple : So I can do a good job for you. Without x-rays I am largely blind to a lot of what is going on, like hidden decay, cysts or infections.

Small stain or decay?

I can only visually see so much. If the problem is on your lip, superficially on your gums or teeth or easily explainable without x-rays, you probably do not need them. But, if there is a problem or question that is not easy to diagnose, I can’t see bone levels. I can’t see in between the teeth, I can’t see things growing in the bone or infections at the end of the root. Here is an example of problem that I can not see.

Deep decay or just stain?

To drill or not to drill that is the question. One of the ways to determine if this is a problem that needs to be addressed or can simply be monitored, is with an x-ray. Here is a good example: the x-ray reveals deep decay (outlined in red) below what looks like a small stain in the groove of the tooth. When exposed the photo shows a huge area of decay close to the nerve. We were able to save and restore the tooth but it was close.

 

How many dental xrays and when?

We do not routinely take xrays. We try to access xrays from your previous dentist, for several reasons; one to reduce the cost and exposure to you but also so that we can make comparisons to xrays that we take to help us to determine how active any process is.

toth decay

“Why can’t we just use the old xrays?”

First, things change and sometimes rapidly. Second previous film xrays are often duplicates of originals and much detail is lost in the duplication process. Even with the transition to digital xrays some systems do not seem to be as compatible as we would like to enable us to read them well. Printed out digital xrays are often almost unreadable.

What are the routine dental xrays?

We do not routinely take the same xrays on every patient. We evaluate each patients risk for disease, previous history and the benefit and risk of taking xrays. If a person has a history of very high risk of cavities, ie. they have a lot of dental work and/or habits such as drinking soda that often lead to rapid decay between the teeth the benefit of detecting the decay before it becomes catastrophic makes xrays more beneficial. A patient who has little dental work, good oral hygiene and good habit needs xrays much less frequently.

Tooth restored with porcelain filling

“Do I have to have dental xrays?”

Some practices demand that the patient accept xrays. My job is to convince you as my patient that what I recommend is reasonable and necessary. Ultimately it is your body and your decision and we respect your right to decide. Very occasionally I will insist that an xray be taken when I feel that other visual examination signs or symptoms indicate that we my be jeopardizing the tooth, your health or a potential acute infection may be present. We are at times caught between you and your insurance company who often insist on xrays prior to treatment or they will refuse to pay benefits.

The most common reasons people refuse xrays are either the expense of xrays or the fear of radiation exposure. So lets talk about both

How much do dental xrays cost?

“Xrays are expensive. I cant afford them.”

The cost of dental xrays depends on how many we need to take to give you good advice about your dental health. The real emphasis should be how much can dental xrays save you.

First if an xray saves you from one root canal and crown, you just saved not only the tooth but one hundred times the cost of one xray. I would much rather detect a problem while it is small and relatively inexpensive and easy to fix than dealing with a disaster later that requires expensive dental heroics or the loss of a tooth. The reality is that by finding problems early when fixes are simple I make less money. Perhaps I am not a good business man and others might think me lazy but I simply do not like big problems. I treat my patients like I would treat my family.

 

If finances are tight we always are willing to work with you to set up a payment plan, pay us later we do not charge interest. We are here to help. Our financial policy/relationship with our patients is summed up as: You trust us to fix your teeth and we trust you to pay us when you can.

“I am afraid of dental radiation causing cancer.”

I completely understand peoples fears of radiation and cancer. Life is about risk and benefits. Everyday we live we risk staying alive. In fact everyday you are alive you are exposed to background radiation from natural sources. Every time you fly in a plane or go to a higher elevation you increase your radiation exposure and risk because cosmic radiation which are the same as(xrays) from space are less blocked by the thinner atmosphere. No detectable increase has been found in cancer rates or disease from living in Denver with its increased cosmic radiation. I’ve never heard someone tell me they moved to Carlsbad to reduce their cancer risk. Perhaps the the immeasurable risk is there but it may be worth the benefit of being closer to great skiing. Every time you fly in an airplane you are taking a risk equivalent of several dental xrays and I have never heard a person refuse to get on a plane to go on vacation because of the increased radiation risk.

Dental radiation compared to other sources

We of course use digital xrays and lead shields to reduce your radiation exposure even further.

To give some perspective here are some examples:

 

A set of four bite wing xrays is the same increased exposure as going on a two week ski trip to Colorado; that is if you didn’t fly. If you took a plane you received the equivalent of three sets of bite wings, check up xrays, while you were on the plane.

 

A set of four bite wings is the equivalent of one day of background radiation that you receive each day just from being on the earth.

 

A set of four bite wings is the equivalent of living in a brick house for a year vs living is a wood house because masonry gives off more background radiation.

 

Sleeping next to someone for a year is the equivalent of one dental xray as we all give off small amounts of radiation.

Make an informed decision

So the question becomes is if very small amounts of exposure matter that much are you going to stop: taking airplanes, going to the mountains, sleeping with your wife/husband/ mate, and move out of your brick house? Is a small amount of radiation worth the information the dental xray provides so that we can do a through job for you? As your dentist I think so but it is your decision.