DISCLOSURE: This blog may be lengthy, but it is very important.

A visual dental examination, that is, an exam WITHOUT radiographs, allows us to see only 3 of 5 exposed surfaces on each tooth (that’s only 60% of each tooth).
– Keep in mind that 2/3 of each tooth lies below the gumline and into the bone.
– A visual exam allows us to see only what is happening above the gumline.
– So if only 1/3 of the tooth is above the gumline, and we are only able to see 60% of that 1/3, doing a dental exam without radiographs is essentially allowing us to inspect only 18% of each tooth.

That is not a very thorough exam!

So, what are we looking for?         
Radiographs are necessary to evaluate and definitively diagnose most oral diseases and conditions. Most commonly what we find is dental decay and periodontal disease, but in many cases, we find much more than that. Because of the use of radiographs, we have detected countless diseases and conditions in our years of treating patients. 
– We have detected numerous tumors and cysts. 
– We have discovered calcification of glands and arteries, which are life-threatening conditions.
– We have found congenitally missing teeth. 
– We have found foreign bodies.
– We have revealed developmental anomalies which, if not discovered early, could end up costing the patient a lot of time, discomfort, money, and even loss of teeth.

Very few of our patients have only permanent teeth. Most have a combination of baby and adult teeth, and their smiles are still developing. Radiographs help us confirm that their smiles are developing normally and make it possible to detect problems early (saving our parents and patients TIME and MONEY).

We can determine when permanent teeth are erupting ectopically and may need assistance in finding a path into the mouth. We can find out early if crowding and misalignment is going to be an issue, and often take steps to eliminate the need for orthodontics or minimize the amount of time spent in braces.

Although the presence of these diseases and conditions is the not usual case, in the years that we have been in practice, we have encountered every condition mentioned above in our office, some of which were missed by the patients’ previous dentist. 
          
What about radiation?
If radiation exposure is your main concern, we completely understand! The American Academy of Pediatric Dentistry (AAPD) recommends to minimize the patient’s exposure in regards to frequency and type of xrays recommended. We take the MINIMUM number of radiographs necessary to perform our exams. We use lead aprons, thyroid collars, beam collimation and we have the most advanced sensors on the market, which require the least amount of exposure to obtain a diagnostic image. Our office takes every step possible to minimize exposure, but in reality, the amount of radiation we use is so low that it can be considered close to negligible.

On average, Americans receive a radiation dose of about 620 millirem each year.  The average dental radiograph exposes the patient to 1.5 mrem. We take 2-4 images every 12-24 months. So even on our highest risk patients that get radiographs taken every year, we are only exposing them to about 6 mrem per year. We get way more radiation from the food we eat (about 30-40 mrem/year) or from a round trip flight to Frankfurt (10 mrem) than we do from dental x-rays (please reference to our shared photo).

For those of us who work with and around radioactive material, the U.S. Nuclear Regulatory Commission (NRC) has established standards that allow exposures of up to 5,000 mrem per year. Almost every day, we remain in the room with patients to help them get their “pictures” taken.  We basically expose ourselves to the equivalent amount of radiation that my patients do on an annual basis, on a daily basis.

The last reason, and a very important one from a professional perspective, is that we have a legal duty to provide competent care, and radiographs are vital to proper diagnoses. Without the necessary films, we compromise our ability to provide competent care.