Definition

Dental x-rays are a type of picture of the teeth and mouth. X-rays are a form of electromagnetic radiation, just like visible light. They are of higher energy, however, and can penetrate the body to form an image on film.

Structures that are dense (such as silver fillings or metal restoration) will block most of the photons and will appear white on developed film. Structures containing air will be black on film, and teeth, tissue, and fluid will appear as shades of gray.

Alternative Names

X-ray - teeth; Radiograph - dental; Bitewings; Periapical film; Panoramic film

How the test is performed

The test is performed in the dentist's office. There are four types of x-rays:

Bitewing
Periapical
Palatal (also called occlusal)
Panoramic

The bitewing is when the patient bites on a paper tab and shows the crown portions of the top and bottom teeth together.

The periapical shows one or two complete teeth from crown to root.

A palatal or occlusal x-ray captures all the upper and lower teeth in one shot while the film rests on the biting surface of the teeth.

A panoramic x-ray requires a special machine that rotates around the head. The x-ray captures the entire jaws and teeth in one shot. It is used to plan treatment for dental implants, check for impacted wisdom teeth, and detect jaw problems. A panoramic x-ray is not good for detecting cavities, unless the decay is very advanced and deep.

In addition, many dentists are taking x-rays using digital technology. The image runs through a computer. The amount of radiation transmitted during the procedure is less than traditional methods.

How to prepare for the test

There is no special preparation. Notify the dentist if you are pregnant.

How the test will feel

The x-ray itself causes no discomfort. Some people find that biting on the piece of film makes them gag. Slow, deep breathing through the nose usually relieves this feeling.

Why the test is performed

Dental x-rays help diagnose disease and injury of the teeth and gums.

Normal Values

The x-rays show a normal number, structure, and position of the teeth and jaw bones. There are no cavities or other problems.

What abnormal results mean

Dental x-rays may be used to identify the following:

The number, size, and position of teeth
Unemerged or impacted teeth
The presence and extent of dental caries (cavities)
Bone damage (such as from periodontitis)
Abscessed teeth
Fractured jaw
Malocclusion of teeth
Other abnormalities of the teeth and jaw bones

What the risks are

There is very low radiation exposure. However, no one should receive more radiation than necessary. A lead apron can be used to cover the body and reduce radiation exposure. Pregnant women should not have x-rays taken unless absolutely necessary.

Special considerations

Dental x-rays can reveal dental cavities (tooth decay) before they are visible even to the dentist. Many dentists will take yearly bitewings to catch the early development of cavities.

Another imaging test, called cone beam computerized tomography (CBCT), may be used prior to dental surgery, especially when multiple implants are being placed. This test is usually done in a hospital or imaging center.

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