To x-ray your child’s teeth or not to x-ray your child’s teeth. That is the question! How often should a child’s teeth be x-rayed?
This issue has been long debated by parents and dental professionals alike.
Indeed, the validity of regular dental x-rays was the question posed by the New York Times “Ask Well” feature in August of this year.
The featured answer came from the Dr. Paul S. Casamassimo, an Ohio State University Professor of Pediatric Dentistry. He was adamant about the topic. He stated, “X-rays should not be done unless there’s a reason.” He added, “The concept of a routine X-ray is gone.” Dentistry for Children agrees.
Of course, many parents already know why he stated this. It has almost become common knowledge that our exposure to radiation must be minimal, since it could possibly increase the lifetime build-up of the risk of cancer and other problems.
X-Ray: A Lifetime of Radiation?
Here at Dentistry for Children, in Orlando, we realize that every child is different. And each child’s dental needs are unique. We have three important rules about this matter of X-ray usage:
1. We always check a child’s medical and dental records before taking X-rays.
2. We only order X-rays after extensive visual examination.
3. We only order X-rays when there is no other way to see the child’s dental problem.
The American Dental Association as well as the Food and Drug Administration have been blamed for setting up a law about X-rays being considered every 6 to twelve months. What many people did not realize was that the “rule” was simply a guideline. Nowhere is it written in stone that it is required to give your child x-rays every 6-12 months.
To X-Ray or Not To X-Ray: A Case-By-Case Decision
By judging each case on its own merit, a child whose baby teeth are full of cavities might require frequent X-rays. Such a child would be a high-risk patient for caries and a lifetime of dentistry. .
However, in cases of very young children, who have never had cavities and show no symptoms, the time without X-rays could easily be extended to 12 months or even longer.
X-Ray: Look before You Leap!
In all three of our above rules, we ascribe to the guidelines of the American Dental Society. In their words, “A thorough clinical examination, consideration of the patient history, review of any prior radiographs, caries risk assessment and consideration of both the dental and the general health needs of the patient should precede radiographic examination.”
An exam is a detailed inspection of your child’s teeth. And dentists like Dr. Troy King, here in Orlando, are trained to see decay. He knows a gentle touch or tap can elicit a reaction from a child that can only mean pain, a big indicator of decay.
As your child ages and his or her mouth fills up with permanent teeth, x-rays might need to be more frequent simply because it is very difficult to see between two teeth. We agree with Dr. Casamassimo’s New York Times comment about a cavity in the microscopic space between teeth, “If you wait until you can see it without an X-ray, that tooth is in big trouble!”
X-ray Justifications: Modern Uses for a Classic Tool
Most people think X-ray is just a weapon for hunting cavities, but modern X-ray has many important applications in the pediatric dentist’s office. Below, you can see a list of some of the conditions that demand the use of X-ray for proper examination and treatment:
pain in the teeth,
Evidence of dental/facial trauma,
Mobility of teeth,
Fistula in the Sinus Tract,
Oral involvement in known or suspected systemic disease,
Evidence of foreign objects,
Pain and/or dysfunction of the temporomandibular joint,
unexplained bleeding and migrating teeth….
Serious dental problems and mouth injuries might require the order of a special type of X-ray called a cone beam CT scan. These 3-D X-ray pictures show teeth, roots, jaws and skull.
In summary, yes, the ADA has created special charts concerning justified X-rays. They match your child’s age and dental condition. However, the ADA has also recommended every case be judged on its own merit. They state that pediatric dentists must apply professional judgement to each patient’s situation.
X-ray: We Believe in Safety First!
Rest assured, with our first class digital equipment and careful shielding, Dentistry for Children maintains the highest level of safety for your children. So when an X-ray is needed, it is administered with the utmost care.
At Dentistry for Children, we always maintain the use of the ALARA principle and we believe it should be mandatory in every dental office. We quote from the ADA guideline: “Even though radiation exposure from dental radiographs is low, once a decision to obtain radiographs is made, it is the dentist’s responsibility to follow the ALARA Principle (As Low as Reasonably Achievable) to minimize the patient’s exposure.”