Xrays? Do We Seriously Need Them? How Often?
The SODA that we are about to spill for you here is the x-ray routine that we have observed to work best for the majority of our patients.
It’s what we have found to be a perfect balance. It reduces radiation exposure (very minimal for dental x-rays to begin with), saves patients’ money, and still effectively maintains the health of everyones’ mouths.
To us, we have found the perfect balance.
The general rule:
First and foremost, let us say that dental x-rays ARE essential in maintaining the health of your mouth.
They help us out immensely by showing us what we dental professionals cannot see or feel while cleaning and doing our exams. They especially help us see between your teeth and under your crowns and fillings.
For example, we can’t FEEL cavities growing in between your back teeth until they are quite large.
Some patients won’t let us take x-rays. We promise that we will still try our best to find every bit of decay for them, but we cannot promise that they’ll be getting a small filling instead of a crown once a problem is found.
The larger the decay, the larger and more involved it is to fix it. It’s much better to catch it early.
As a general rule, dental bitewing x-rays, aka "checkup x-rays," are recommended ONCE a year. They consist of 4 “bitewing” x-rays, two on each side of your mouth. This is the norm that most offices go by. This is the norm that most insurance companies cover.
Our rule:
Our office sees an average of 4160 patients per year for routine cleanings.
After seeing this number of patients, we have witnessed that most of them do just fine having bitewing x-rays taken every year and a HALF, every 18 months. So, we tend to let people slide a little longer than the "norm."
Our rule, for people who DO get cavities often, though:
Some patients ARE prone to decay.
Either their diet and hygiene habits lead them there, or it’s simply the gene that their parents gave them. Their dental history has proven it.
***(be sure that an honest dentist has confirmed that your cavity risk is high. If you’ve been going to a dishonest office, it’ll sure seem like you’re prone to decay…but maybe you’re really not)
If you ARE more prone to developing cavities quickly, it would not be wise to wait on x-rays.
These patients should definitely have x-rays taken once a year. Every 12 months.
Your honest dentist and dental hygienist should be able to explain to you if this is necessary. They should be able to show you on your x-rays that your cavities are growing too large, too quickly, etc.
You should be able to feel their explorer instrument “stick” into the cavities that they can reach. Shadowing and dark spots on your teeth do not always mean that you have a cavity.
Be sure to read the SODA that we have spilled for you about cavities, as well as our post called “How to read your own x-rays.” Knowledge is gold, and it will help you better understand what your honest dentist is trying to explain to you.
But remember, they are still the dentist in the end. They still know more than you do. Please go easy on them. The honest ones are telling you the truth.
Our rule, for people who don’t get cavities often:
Some patients prove over the years, to be RESISTANT to cavities…having one, two, or even ZERO in their lifetimes. It's unlikely that they're going to pop up with a bunch of cavities all of a sudden, so with these patients, we let them slide even longer.
These patients get x-rays every two years. Yes, sometimes they “schmooze” their way out of them a little longer even, but it’s important to remember that dental x-rays are STILL very important. We really don’t want to miss anything.
The “NEVER get x-rays” request is not recommended. You shouldn’t go for longer than 2.5-3 years. It’s also important to look at your bone level. When you’re NOT prone to decay, YOU are more prone to periodontal disease.
Periodontal disease happens when the bacteria eats at your BONE instead of your teeth.
Just because you don’t get cavities doesn’t mean that you are immune to dental problems. You, my friends, are more prone to getting gum and bone disease. You still need to brush and floss well and see your dentist REGULARLY. Don’t get too cocky now!
Though we’d like to say that all hygienists and honest dentists are absolutely perfect at finding every cavity with our physical dental exam, we are not. Like we said above, X-rays show what we CAN’T always see or feel ourselves.
Usually, by the time we can see it or feel it in the hard to examine areas, the decay is large and should have been discovered sooner.
Diet changes and dry mouth can cause a non-cavity person, to become a cavity person. Please keep that in mind as well, and watch your mouth closely.
If we see a problem that we'd like to take a closer look at, we usually choose to go ahead and take an x-ray. You should understand the need is still there and let your honest dentist or hygienist make that call. They should be able to explain why it’s needed and make you feel comfortable about it.
Be sure you have found an honest dentist and dental hygienist who you feel care about the morality and honesty of their jobs and about your dental health.
You should feel that they are taking the diligent time and measures necessary to give you the best, most thorough dental care they can.
Your cleaning appointments should take 45min-1hr, not 15-20 min.
Don’t De Fooled:
Recently, some dental insurance companies have started to pay for x-rays to be taken every 6 months. Some dental offices have capitalized on that.
We believe that this is overboard for the AVERAGE patient.
Patients who are EXTREMELY prone to decay may benefit from this. We are talking, though, about patients who have severe dry mouth or those who LIVE on sugar with have poor oral hygiene. We are referring to those who partake in recreational drugs or patients who have had to undergo radiation treatment to their head and neck region. THESE types of patients may benefit from the closer watch, but it should NOT be a general rule across the board.
We believe a more practical approach would be for insurance companies to pay for additional teeth cleanings. Just one or two extra per year. Better yet, if they would pay for adult fluoride treatments or adult sealants to help prevent decay. Each is much less expensive and much more effective. It doesn’t make much sense.
In the end, your best dental insurance will always be FLOSSING and brushing well…taking care of your teeth.
Feel free to read the SODA we have learned and spilled about dental insurance over the years and whether it’s worth purchasing on your own.
There are other types of x-rays that your dentist may recommend too:
The 4 bitewing x-rays we were talking about show only the crowns of your teeth and a small portion of your root beyond. These checkup x-rays are designed to give your dentist a generalized picture of your mouth for your checkup, but they do not show the whole picture of each tooth. They don’t show all the way to the root tips.
Now and then, you may have a tooth bothering you. Your honest dentist may see something on those bitewings or within your mouth that they are concerned about. They may want to take a closer, more detailed look at a tooth.
At this point, an additional "PA" might be taken of that tooth. "PA" stands for “peri-apical,” and it will show the BIG picture of that specific tooth, all the way to the root tips (apex) and all the bone around it.
So go ahead and let your honest dentist take that x-ray. It's an important step needed for them to see the whole picture.
Full mouth set of X-rays:
When you go to a dentist for the first time, it's a good idea to take a full mouth set of x-rays. With these, the dentist is able to do a good, thorough check of your entire mouth.
This full mouth set will get pictures of the crowns of the teeth, their root tips, as well as the bone health around each tooth.
Once this big picture is established, your honest dentist can keep a close watch on your mouth with just the checkup bitewing x-rays for quite some time.
Another full mouth set of x-rays shouldn’t be needed on the average patient for another 3-5 years unless something detrimental is happening in their mouth. Some patients go even longer.
In the end, the best idea is to find an honest dentist who cares about morals, honesty, and YOUR best interest. Once you find them, you should feel comfortable with what they recommend for your specific situation.
They are still the dentist, remember. They are telling you the truth if you have taken the SODA time to find an honest one.
This is what your dental appointments should look like:
-At your very first dental visit, a FULL mouth set of x-rays is usually taken to get a generalized picture of your mouth. An honest office will give you the option of obtaining your x-rays from your previous dentist if they were taken within the 3-5 year time frame. (1 year for bitewing x-rays) There is no need to take them again if you don’t have to.
-In the years following your initial visit, “checkup” bitewing x-rays are taken according to the “every year” or “every year and a half” recommendation.
-It’s also a good idea to take pictures of the front teeth periodically because we can miss cavities in between there too, especially under white fillings and veneers. We take these about every 2-3 years, sometimes instead of another full mouth set, if a patient’s need doesn’t seem to be there.
-Then comes your dental cleaning. A good dental hygienist should be doing a THOROUGH cleaning on you every 6 months and removing all the plaque and tartar that they find. Some patients have a cleaning more often, every 3-4 months if they develop periodontal disease, rapidly build tartar, or get cavities very quickly.
During your cleaning, they should also be assisting the dentist in checking for decay as he/she DILIGENTLY cleans around every aspect of every tooth in your mouth.
The dental hygienist is the one who is in your mouth for 45 min. The doctor does the exam in nearly 5 min. Who do you think is most likely to find your hidden decay? Your cleaning should therefore be diligent and thorough.
If your hygienist is choosing to clean your teeth with the ultrasonic scaler every time, they cannot feel the cavities. They just can’t. The tactile sensitivity is not there. Hygienists are best able to feel the cavities with their hand scalers.
-Finally, you meet the doctor and it’s determined if you have cavities, gum and bone issues, or any other work to be completed. If they seem a bit aggressive in their treatment plan, seek out another opinion.
So, there you have it! We hope this answered your x-ray questions and gave you a bit of extra knowledge too!
Though it would be best if we did, we’ll never claim to know it all, all of the time. Nobody knows it all! We do claim honesty, though, and we sincerely want to help as many people as we can! Our patients have maintained beautifully, following our conservative recommendations :)
So, thanks so much for reading and letting us spill our SODA! Remember to take the time to find your HONEST DENTIST, and be sure to browse around our links and follow us on social media for answers to more of your exciting dental questions, like:
