Is a dental X-ray necessary for a routine check up?Dental Health Screening
I recently visited a dentist for routine cleaning and check up. The dentist suggested that a dental X-ray was necessary for him to do a proper check. I had my doubts as this was never brought up before in my previous dental visits to other clinics. May I know if an X-ray is indeed necessary for a dental check-up?
X-rays are an essential part of the hard tissue (teeth, jaw bones, sinuses, jaw joints) examination.
Without x-rays, your dentist cannot assess:
1) Underneath old fillings, crowns, bridges, implants: Ill fitting crowns, decay undermining existing dental work may not be easily visible from a visual examination especially if some restorations extend under the gum line or in between the teeth.
2) Early hidden decay, especially in between the teeth.
This often presents later as a much larger painful cavity that extends very deep into the tooth, even touching the nerve. When treated at a late stage, a simple filling may no longer be sufficient and more extensive treatment such as root canal treatment or even extraction. Unfortunately, without x-rays, most patients are only aware of the decay issue at this late stage especially if routine x-rays have not been a part of your routine dental examinations.
3) Abscesses or cysts around the roots of the teeth inside the bone: Abnormal infections or swellings inside the bone may not be detected without x-rays until a late stage.
4) Buried teeth: Buried wisdom teeth, developing adult teeth (in children), extra teeth (supernumeraries) or teeth-like tumours (odontomes, odontomas) should be monitored for changes such as cyst formation.
5) Jaw bone levels around the roots of teeth: Early signs of gum disease (periodontitis) can be given away by shrinking bone levels that can only be assessed on x-rays. Periodic radiographic monitoring is important for confirming treatment success and long-term stability objectively.
6) Bony tumours: Masses can appear as incidental findings (findings not necessarily anticipated from the clinical examination). Both benign (harmless) and malignant (cancerous) tumours can appear in the jawbones.
7) The jaw joints: Abnormalities in the jaw joints can be seen in certain types of dental x-rays. This may provide useful diagnostic information for patients with complaints of clicking or stuck jaw joints.
8) The maxillary sinuses: Certain sinus conditions (acute sinusitis) may mimic dental problems such as a toothache.
9) The nasal passages: Abnormalities such as a deviated nasal septum or swollen nasal turbinates can be seen on certain dental x-rays.
If you are fine with your dentist missing out these important findings, then dental x-rays are unnecessary. Without early detection, most dental problems require more complex, more expensive and less successful treatment in the long term.