You wonder why your dentist sends you to do dental radiographs and you are concerned about their effect on your body?
We want to answer you to these questions and ensure you of the minimum effects of dental radiographs on your health.
The dentist needs the dental radiographs because they provide details that cannot be obtained otherwise , details which are essential for a co,plete and correct diagnosis for performing the right medical maneuvers for your problem.
Many diseases of the teeth and surrounding tissues can be seen only on x-ray , such as interdental caries , infection of the root( granulomas , cysts) tooth fractures , maxillary bone resorption due to periodontal damage.
If we expect for the damage to become clinically visible , the treatment would be more complicated , more expensive and with less chances of success. Thus, dental radiographs helps us in having a correct and complete diagnosis of the clinical case and in establishing a treatment plan.
The most recommended dental radiographs are: retroalveolar radiography ( periapical) , panoramic radiography ( orthopantomogram). We can also recommend: Bite-wing x-rays , occlusal radiographs , teleradiographs , radiographs of the temporomandibular joints , radiographs of the maxillary sinuses.
Periapical retroalveolar radiography
Retroalveolar radiography ( periapical) is the simplest most recommended and cheapest radiological investigation. This type of x-ray reveals the entire tooth , including the crown , root and bone to which it is anchored.It is performed by positioning the dental x-ray sensor in the patient’s mouth using a plastic sterile support , fixing it and then performing radiography. The dental radiology nurse asks the patient to sit still for a few seconds, as long as it is necessary for the sensor to record the radiological image. The sensor is then scanned into a computer and the image appears immediately on the screen. The radiographic image obtained highlights 2-3 teeth on a dental arch ( maxilla or mandible). This type of radiography is indicated in the following situations: initial evaluation for development of treatment plan ( dental status) , detection of caries , detection of periapical infection / inflammation , assessment of periodontal condition , detection of already made treatments and assessment of their correctness , visualizing root morphology before canal treatment or extraction after dental trauma to view the teeth which are not broken or which are about to come out.
Initial evaluation for treatment plan development ( dental status ) caries detection.
Control during the development of treatment radiographs with needles on the dental canal to verify roots permeability , roots to the tip, checking complete desobturation of canals , check of prosthetic works adaptation on limit , control and post-treatment assessment , evaluation of accuracy of endodontic treatments immediately after their performance , at 3 months and 6 months in teeth with apical periodontal damage , and then annually to all endodontically treated teeth , periodontal treatment effectiveness evaluation at 3 months , 6 months , and then annually after apical resection , evaluating implants after surgery and after osseointegration , as well as annually.
This type of radiography is used for detecting caries between teeth , gingival caries or under filings for evaluation of periodontal condition and bone loss.
Panoramic radiographs (orthopantomogram)
Any dentist should recommend a panoramic radiography to the patient at the first visit , before making any treatment. Based on panoramic radiography , the doctor and the patient discuss about the treatment plan which represents the steps to follow to solve any existing dental problems.
Panoramic radiography provides the doctor and overview of the patient’s clinical situation without providing detailed information. It includes both dental arches and shows quite accurately the relationship between the teeth and neighboring anatomical formations: maxillary sinuses , mandibular canals. To achieve such a radiography the patient is equipped with lead protective equipment and is positioned towards the dental nurse with his/her head at the level of a machine that will rotate around him/ her at the time of exposure. The patient is asked to sit still for 20 seconds. At the end of those 20 seconds , the radiological image has already appeared on the computer screen. This is usually performed at the beginning of treatment , being very important for an overall correct diagnosis. Often , retroalveolar radiographs are needed ; they are smaller in size but show more information in detail. Indications are multiple: initial evaluation within the treatment plan, emphasizing bone lesions or the teeth which didn’t come out , assessment of periodontal status and support bone structure , visualization of wisdom tooth in case of maxillary or mandibular fractures to assess the position and orientation of critical structures such as the inferior alveolar nerve , maxillary sinus position in relation to dental roots , emphasizing cancer lesions.
Why is our fear unjustified? Many daily activities even the most common ones expose ourselves to radiation. The amount of radiation absorbed by a person is measured by Sievert ( Sv). The Sievert is the irradiation dose measured by quantitatively evaluating the biological effects of radiation.
In case of a retroalveolar radiography the effective radiation dose is approximately 5 micro Sv.
In case of a panoramic radiography the effective radiation dose is approximately 30 micro Sv.
In case of a chest radiography the effective radiation dose is approximately 100 micro Sv.
Daily average background dose is 10 micro Sv ( radiation received from the sun and the earth’s crust).
Smoking a pack and a half of cigarettes every day for a year causes absorption of 3600 microSv and at 100.000 microSv ( equivalent to 20.000 retroalveolar radiography) and the risk of developing cancer appears.
There is an unjustified fear that dental x-rays produce irradiation. The patient must understand the limitation imposed by the lack of x-rays and the fact that the benefits of information obtained through radiographs , far outweigh the risk given by exposure to a minimum dose of ionizing radiation.
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