A well taken set of dental radiographs can be invaluable in diagnosing or ruling out a wide range of oral pathoses but how do you know if your dentist is taking the right ones at the right time?  

Kodak Dental has come up with a list of guidelines outlining patient needs and assigning typical radiographic images to asses those needs.  This article is taken from that source and coupled with academic and clinical experience.  As always, comments and questions are welcomed.

There are two types of dental radiographs, intraoral and extraoral; the difference stated in the names.  Intraoral radiographs are taken using film that is placed inside the mouth and exposed from a source outside of the mouth.  Extraoral radiographs are taken using a film that is placed outside of the mouth and exposed there.  Examples of each kind are listed below:

Extraoral Radiographs

  • Panoramic
    • This film is helpful when evaluating impacted teeth, wisdom teeth, developing teeth, tumors, and cysts.
  • Cephalometric
    • The major use of this film is for developing a treatment plan during orthodontics.
  • Transcranial

Intraoral Radiographs

  • Bitewing (BW)
    • A series of four bitewing radiographs are used to determine interproximal caries and gum disease (the height and integrity of the alveolar bone).  These films are considered the “routine visit” radiographs.
  • Periapical (PA)
    • A periapical (PA) film differs from a bitewing in that it shows the entire tooth.  Some extraoral films also show the entire tooth, however, the detail found in a PA is far superior.  This film is used to diagnose caries and its effects on the entire tooth.  A dentist would take this film on a tooth that is in pain, suffers from moderate to severe gum disease, or on a tooth that has had extensive dental treatment.
  • Full Mouth Series (FMS or FMX)
    • A full mouth series is a combination of four bitewings and anywhere from 14 to 16 periapicals.  This film set is strictly a baseline taken every few years to confirm health among a heavily treated dentition.  (Note: Though Kodak officially states that a panoramic view is just as good as a full mouth series, in this clinicians experience, a full mouth series is more precise and produces an image with superior diagnostic qualities.)
  • Occlusal
    • Where all other intraoral radiographs view the teeth and jaw from the side, this film captures them from above.  Occlusal films give the dentist a “third” dimension and though this is helpful is many cases, it is seldom used due to the accuracy of diagnosis from PA, BW, and Panoramic radiographs.

There is a simple rule you can use to determine whether or not your teeth are being appropriately monitored:  The more dental work you have, the poorer your dental hygiene, and the higher your risk for developing tooth decay, the shorter the time interval between radiographic check-ups and the more radiographs should be taken.  In other words, people with perfectly healthy teeth do not need as many radiographs as often as people with compromised dentitions.

So, what radiographs are appropriate for you?   The Kodak guidelines define this based on specific criteria like oral hygiene, risk for caries and gumdisease, and age.  Use this along with the above article in determining what is right for you.

*These articles are informational only and are not meant to supplement actual treatment.  The linked websites are not affiliated with A Blog Apart or its authors and the ideas expressed do not necessarily represent the views of this author.  Links were provided for definition or pictoral purposes only.*