Are Dental X-Rays Really Needed?

The mainstream media has recently directed more attention to the issue of dental x-rays. A recent study has come to light which shows some connection between dental x-rays and brain tumors. Although there are some challenges that this particular study faces in the gathering of its data, I believe that media attention which helps the consumer become interested and more informed about the services they receive is always a good thing. With this idea in mind, I would like to address some of the concerns I have received from patients in my dental practice.

Dental x-rays are not always needed to perform a dental exam. In fact, dental x-rays should only be taken when they are needed for establishing a benchmark for a new patient and/or when there is a necessity and need for diagnosis and treatment of dental or oral disease. Many factors are evaluated to determine the need for the type and number of radiographs. Some of these elements include: age, oral health, risk factors, current signs and symptoms. Never should a one-size-fits-all approach be used with regard to the need for dental radiographs.

There are three types of dental exams performed in a dental office. These three exams are: a comprehensive, initial, or new client exam, a limited or problem-focused exam, and a periodic or established patient exam. The comprehensive oral evaluation is performed when a new patient wishes to become an established member and there is a need to establish a benchmark or an oral health reference for the future. Since a more involved set of data is being gathered to create a basis point, it is often at these appointments that more dental x-rays are taken.

When a limited or problem-focused exam occurs, there are fewer dental x-rays needed except for the specific areas in question. During these evaluations, the x-rays are only one of many different tests or pieces of information that are reviewed to determine the mode of treatment.

A routine or periodic dental exam typically occurs during a cleaning or dental prophylaxis appointment. Various issues are being evaluated during this exam. I like to divide my periodic oral evaluations into three sections. I think of the oral exam as being a circle and the examination being split into three separate categories. This exam includes a visual evaluation of soft tissue (lips, tongue, cheeks, gum tissue or gingiva, and periodontal charting), hard tissue (teeth, jaw, occlusion or bite, and then an evaluation of any radiographs that have been taken. Each portion of the examination offers valuable data that helps to aid me, the clinician, perform a more thorough and comprehensive evaluation of the patient’s oral health. Each portion of the exam has its own merit; however, when all three components are present, the most comprehensive evaluation of the patient can be performed.

As clinicians, our objective is to provide services and information which helps each individual become an active participant in maintaining his oral health. Dental radiographs or x-rays are only one tool used to help detect disease, infection, early cavity and gum disease. When radiographs are taken, proper protective aprons with thyroid collars should always be used to help minimize exposure to sensitive and vulnerable tissues. As patients become more involved in their dental care, they ask questions to help them understand why certain recommendations are made. When patients become more informed, their quality of care improves and the partnership between patient and dentist grows stronger.