Why are dental x-rays important?

X-rays of your child’s teeth are used to diagnose and monitor oral diseases (usually cavities), evaluate injuries, and assess your child’s dental growth and development.

What are the risks of NOT taking x-rays?

By declining x-rays for your child, you are reducing their radiation exposure, but you are also limiting our ability to diagnose and monitor oral diseases and to assess your child’s dental growth and development. Some cavities can be seen during our visual exam, but cavities between the teeth are usually not visible unless they are quite large. Without x-rays we miss the opportunity of early diagnosis and treatment. Delaying cavity detection increases the risk for pain and infection and may limit treatment options to either stainless-steel crowns (“silver caps”) or extraction.

What type of x-rays do we take and how often do we take them?

The initial x-rays of your child’s teeth are usually taken between age 3 to 4. The first images are usually of the front upper and lower teeth (occlusal or periapical), and these are used to check for cavities, missing or additional teeth, and the development of the permanent teeth. The next images are generally of the back teeth (bitewings), and these are used to check for cavities and monitor the eruption of the permanent molars. We follow the ADA/FDA guidelines, and for most children we recommend bitewing x-rays once a year. However, in some cases bitewings are updated every 6 months. 

Between the age of 7 to 9, we take a panoramic x-ray, which provides an image of all of your child’s teeth and jaw bones. This x-ray is used to evaluate your child’s dental and facial growth and development and to identify missing or additional teeth or incorrectly positioned teeth. The panoramic x-ray is usually repeated between the age of 12-13 and between the age of 15 to 16. These x-rays will be provided to an orthodontist or oral surgeon if your child would benefit from braces or wisdom teeth removal.

What steps do you take to keep my child safe?

To minimize unnecessary radiation, we follow the recommendations of the American Academy of Pediatric Dentistry (AAPD). Their recommendations include: the use of digital x-rays and protective aprons and thyroid collars, and limiting the number of images to the minimum necessary.

I’m concerned about the amount of radiation my child receives from the x-rays.

Every day, we are all exposed to background radiation – radiation from radon gas (found in groundwater, soil and rocks), from space, and from sources that are found naturally within the human body. We are exposed annually to approximately 3,000 microsievert (µSv) of background radiation, which is roughly 8.2 µSv each day. The table below compares approximate radiation from our dental x-rays and some other sources of radiation to daily background radiation. For reference, a 4 year-old child has been alive for 1460 days. If they had the four dental x-rays we recommend between age 3 to 4, this would account for an increase in their total radiation exposure of less than 3%.

 


X-ray type

Effective dose in µSv 

Equivalent amount of background radiation

Single periapical or bitewing

9.5

28 hours

Two bitewings

19

2 days

Panoramic

14.2 – 24.3

2 – 3 days

Flight from Seattle to NYC

35

4 days

Chest x-ray

100

12 days

 

References:

American Academy of Pediatric Dentistry Oral Health Policies & Recommendations: Prescribing Dental Radiographs for Infants, Children, Adolescents, and Individuals with Special Health Care Needs

National Council on Radiation Protection and Measurements. Ionizing radiation exposure of the population of the United States. National Council on Radiation Protection report no. 160. Bethesda, Md: National Council on Radiation Protection and Measurements, 2009

Ludlow John B, Davies-Ludlow Laura E, White, Stuart C. Patient risk related to common dental radiographic examinations. J Am Dent Assoc 139 1237-1243; 2008.

CDC – Radiation from Air Travel (https://www.cdc.gov/nceh/radiation/air_travel.html)

FDA -Reducing Radiation from Medical X-rays (https://www.fda.gov/consumers/consumer-updates/reducing-radiation-medical-x-rays#HowMuch)