Your dentist will first review
your history, examine your mouth, and then decide whether you need
X-rays examination as well. X-rays often provide information essential
for detection, diagnosis, and treatment of conditions that can threaten
your oral and general health. If you are a new patient, the dentist
may ask you to have complete X-rays to determine the present health
of your mouth. Afterwards, you may need X-rays only when information
is needed about a particular problem like impacted
teeth. Children may need X-rays taken more often (every
6 months) than adults because their teeth and jaws are still developing.
There are many diseases of the teeth and surrounding tissues that
cannot be seen when your dentist examines your mouth. If X-rays are
not used, small cavities between teeth, abscesses,
cysts, tumors, and other diseases may be impossible to detect until
obvious signs and symptoms have developed and serious damage has been
done to your health.
Women must tell their dentist if they are pregnant. When a pregnant
woman wears a leaded apron during dental X-rays it is unlikely that
the developing baby receives any detectable radiation from outside
the body. Today the lead aprons offer more peace of mind than actual
protection because stray radiation from modern dental X-ray machines
is almost nonexistent.
For adults, radiographs can:
Show areas of decay that your dentist may not be able to see
with just a visual examination, such as tiny pits of decay that
might occur between teeth
Find decay that is developing underneath an existing fillings
Find cracks or other damage in an existing filling
Reveal problems in the root canal, such as infection or death
of the nerve
Help your dentist plan, prepare and place tooth implants,
orthodontic treatments, dentures
or other dental work
Reveal other abnormalities such as cysts, cancer and changes
associated with metabolic and systemic diseases
The different types of X-rays: These are divided
into two main categories: intraoral, which means that the X-ray
film is inside the mouth; and extraoral, which means that the film
is outside the mouth.
Intraoral radiographs:
The various types of intraoral X-rays show different aspects of
the teeth: Bite-wing X-rays highlight the crowns of the teeth. On each
radiograph, the upper and lower teeth in one portion of the mouth
are shown, from the crown to about the level of the jaw.
Periapical X-rays highlight the entire tooth. On each radiograph,
the teeth from either the upper or lower jaw in one portion of the
mouth are shown. The difference from bitewings is that in a periapical
X-ray, the whole tooth is shown, from the crown down past the end
of the root to the part of the jaw where the tooth is anchored.
Periodically, a dentist may recommend a "full-mouth radiographic
survey," or FMX. This means that every tooth, from crown to
root to supporting structures, will be X-rayed using both bitewing
and periapical radiographs
Occlusal X-rays are larger and highlight tooth development
and placement. On each radiograph, nearly the full arch of teeth
in either the upper or lower jaw is shown. These X-rays are taken
with the X-ray machine either pointing straight down from near the
nose (to take pictures of the upper jaw and teeth), or straight
up from under the chin (to take pictures of the lower jaw and teeth).
Digital
radiographs are one of the newest X-ray techniques around. With
digital radiographs, film is replaced with a flat electronic pad
or sensor. The X-rays hit the pad the same way they hit the film.
But instead of developing the film in a dark room, the image is
electronically sent directly to a computer where the image appears
on the screen. One of the great advantages of this process is that
radiographs can be digitally compared to previous radiographs in
a process called subtraction radiography. The computer can digitally
compare the two images, subtract out everything that is the same
and give a clear image of anything that is different. This means
that tiny changes that may not be noticeable with the naked eye
can be caught earlier and more clearly with digital-subtraction
radiography.
Extraoral radiographs:
Extraoral X-rays are made with the film outside the mouth. Extraoral
X-rays are less detailed than intraoral X-rays, so they are not
used for detecting caries or flaws in individual teeth. They show
teeth, but their main focus is on the jaw or skull. Extraoral radiographs
are used for monitoring growth and development, looking at the status
of impacted teeth, examining the relationships between teeth and
jaws and examining the temporomandibular joint or other bones of
the face.
Panoramic radiographs show the entire mouth area - all teeth
on both upper and lower jaws - on a single X-ray. This type of X-ray
requires a special panoramic X-ray machine. The tube head that emits
the X-rays circles behind the patient's head, while the film simultaneously
circles across the front. That way, the full, broad view of the
jaws is captured on one film. The machines may have chin rests,
forehead rests, and side head positioners, plus bite-blocks that
patients will be asked to close their teeth around. But the process
is very safe and often uses less radiation than intraoral radiographs
Tomograms are a special type of radiograph in which the
dentist can focus in on one particular layer, or slice, of anatomy
while blurring out all other layers. This allows dentists to see
structures that may be difficult to see with standard X-rays, for
example, the temporomandibular joint. The condyle that makes up
part of the joint is in the middle of a dense cranial base, so it
is extremely difficult to X-ray. Using a tomography technique called
a temporomandibular joint projection, a straight " slice"
that's lined up with the condyle shows that area more clearly.
Cephalometric projections are X-rays taken of the entire side
of the head. They are used to look at the teeth in relation to the
jaw and the profile of the individual. Orthodontists use cephalometric
projections to plan their treatments. They will look at the entire
face to determine the best way to get the teeth aligned in the right
way for that particular person, according to the size of their teeth
and jaws.
Sialography is a way of visualizing the salivary glands on
a radiograph. Soft tissues, like gums and salivary glands, can't usually
be seen on an X-ray because they are not dense enough to absorb enough
X-rays to appear clearly on film. With sialography, the dentist injects
a radiopaque contrast material directly into the salivary glands.
This material shows up easily on film, allowing dentists to diagnose
salivary gland problems, such as blockages or Sjögren's disease.
Computed tomography, or CT scanning, usually is performed in
a hospital, not the dentist's office, although a dentist may refer
a patient for this test. With this process, the patient lies still
in the CT machine while the X-ray beam rotates around. From the X-ray
information, a computer creates a three-dimensional image of the interior
structures. It is used to identify problems in the bones of the face,
such as tumors or fractures.
There is allot of confusion and concern about the radiation from dental
radiographs. The diagnostic X-rays affect only a small part of the
body for a very short time. Exposure to large amounts of X-radiation
is harmful. But with modern techniques and equipment, the amount of
radiation received in a dental examination is extremely small. The
new digital radiograph systems produce less than 1/5 the radiation
that the older film systems use.
The other factor is the type of tissue exposed to radiation. Radiation
damage is mostly only a consideration with rapidly dividing tissues
such as reproductive organs, bone marrow, etc. The tissues exposed
to dental x-rays (teeth, jaw, cheeks) are not as susceptible to radiation
damage. Therefore, the risk of harmful effects from dental X-rays
is negligible.
It is difficult to determine whether small doses of X-rays increase
the individual patient's risk of cancer. However, the chances are
extremely small that dental X-rays contribute to cancer, because the
exposure of the tissues of the head and neck is so small. Even so,
X-ray examinations should be made only when necessary. Many times
a radiograph is necessary to diagnose certain conditions; and therefore,
the benefit outweighs the risk.
An important advantage to this new digital X-rays technology is
that it reduces the amount of radiation by 90% and is much faster.
The digital image only takes about 20 seconds to appear in the monitor.
In addition, this new technology is friendly to the environment since
no chemicals are needed for developing the image.
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Statutory Warning: The information is intended
to help you better understand dental conditions and procedures and should
not be construed as specific medical advice or recommendation. The general
information provided here is not a substitute for a consultation with the
dentists. Only personal discussion of your individual needs with a professionally
qualified doctor / dentist will determine the best method of treatment suitable
for you.
ABOUT US 
Digital
radiographs are one of the newest X-ray techniques around. With
digital radiographs, film is replaced with a flat electronic pad
or sensor. The X-rays hit the pad the same way they hit the film.
But instead of developing the film in a dark room, the image is
electronically sent directly to a computer where the image appears
on the screen. One of the great advantages of this process is that
radiographs can be digitally compared to previous radiographs in
a process called subtraction radiography. The computer can digitally
compare the two images, subtract out everything that is the same
and give a clear image of anything that is different. This means
that tiny changes that may not be noticeable with the naked eye
can be caught earlier and more clearly with digital-subtraction
radiography. 
