Dental Radiographs (X-rays)

Why do I need X-rays?
Radiographic or X-ray examinations provide your dentist with an important tool that shows the condition of your teeth, their roots, jaw placement, and the overall composition of your facial bones.

X-rays can help your dentist determine the presence or degree of periodontal disease, abscesses, and many abnormal growths, such as cysts and tumors. X- rays also can show the exact location of impacted and unerupted teeth. They can pinpoint the location of cavities and other signs of disease that may not be possible to detect through a visual examination.

Do all patients have radiographs taken every six months?
No. Your radiographic schedule is based on the dentist's assessment of your individual needs, including whether you're a new patient or a recall patient, adult or child, or pregnant. In most cases, new patients require a set of full mouth X-rays to evaluate oral health status, including any, underlying signs of periodontal disease and for future comparison. Recall patients may require X-rays to monitor their periodontal condition or their susceptibility to tooth decay.

My dentist has prescribed a "panoramic radiograph." What is that and how does it differ from the X-rays I usually have?

Just as a panoramic photograph allows you to see a broad vista such as the Grand Canyon, a panoramic radiograph allows your dentist to see the entire structure of your mouth in a single image. Typically, most dental patients have "periapical" or "bitewing" radiographs taken. These require patients to hold or bite down on a piece of plastic with X-ray film in the center. Bitewings typically determine the presence of decay in between teeth, while periapical X-rays show root structure, bone levels, cysts and abscesses.

Why do I need both types of X-rays?

What's apparent through one type of X- ray often is not visible on another. The panoramic X-ray will give your dentist a general and comprehensive view of your entire mouth on a single film, which a periapical X-ray cannot show. On the other hand, periapical or bitewing X-rays show a highly-detailed image of a smaller area, making it easier to see decay or cavities between your teeth. Radiographs are not prescribed indiscriminately. Your dentist has a need for the different information that each radiograph can provide to formulate a diagnosis.

Should I be concerned about exposure to radiation?

All health care providers are sensitive to patients' concerns about exposure to radiation. Your dentist has been trained to prescribe radiographs when they're appropriate and to tailor radiographic schedules to each patient's individual needs. By using state-of-the-art technology and by staying knowledgeable about recent advances, your dentist knows which techniques, procedures and X-ray films can minimize your exposure to radiation.

What if my dental insurance plan doesn't allow reimbursement for the additional X-ray?
It's wise for all patients to know the limitations or restrictions of their dental benefits plan. To control their own costs, some insurance plans limit reimbursement to a single type of radiographic survey. Occasionally they will allow coverage for additional radiographs, providing that your dentist supplies them with adequate information demonstrating why the additional radiographs are necessary. Nevertheless, X-rays should be taken based on need, regardless of whether or not they are covered by your dental benefits plan. If your dental benefits policy restricts coverage to one type of X-ray, consider writing your plan purchaser (usually someone in your Personnel or Benefits department). Your dentist can help you write this letter. Or you may want to adapt the following for your own letter.

Dear Benefits Director:

I am urgirg you to expand our dental benefits insurance policy to provide payment of benefit for periapical and panoramic radiographs. To develop an appropriate treatment plan that will meet my oral health needs, my dentist has prescribed both types of X-rays. The different information provided by each of these X-rays is medically necessary to ensure that my dentist has a complete and accurate image of my teeth and their surrounding bony structures.
Any resulting expenses would actually result in a short-term expenditure that will yield Iong term gains. Treating my condition today may actually reduce future insurance costs, since prevention is almost always less expensive than having to correct a problem that's been ignored too long.

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Send comments to:Dr. Jay Last Update February 16, 2006