Dental X-rays provide important diagnostic information to identify issues from cavities to oral cancer. However, patients rightfully want to limit radiation exposure. So what frequency of dental X-rays is considered safe and effective for oral health management?
How often X-rays get taken, as well as the types that your dentist recommends depends on his or her responsibility to perform a complete exam and ensure the early detection of problems to minimize damage to your teeth and/or gums.
Other factors that affect the frequency include:
- The condition of your mouth
- The degree of problems present
- What parts of your mouth your dentist needs to see
If you had X-rays taken recently and then change dentists, you can request a copy of your X-rays be sent to your new dentist to avoid exposing yourself to the radiation unnecessarily.
X-ray Frequency for Adult Patients
Professional dental organizations provide the following recommendations for adult patients:
1. Bitewing X-rays
These are one of the most common sets of X-rays. Bitewings show teeth above the gum line and the height of the bone between teeth, and can help diagnose gum disease and cavities between teeth.
The bitewing X-ray is placed on the tongue side of your teeth and held in place by biting down on a cardboard tab.
Normally four bitewings are taken as a set, and may be taken as often as every six months for people at high risk of tooth decay or have many cavities, or every two or three years for individuals with good oral hygiene and no cavities.
2. Full-set X-rays
A “full-set” of X-rays shows all of your teeth and all of the surrounding bone, which is helpful in diagnosing cavities, cysts or tumors, abscesses, impacted teeth, and gum disease.
A full set usually consists of 14-20 individual X-rays and is generally recommended during the first visit with a new dentist to aid in proper diagnosis and treatment planning. Additional x-rays may be needed once every 3-5 years depending on individual risk factors like susceptibility to dental disease.
3. Full Mouth Series (Panorex)
A panorex is a full-mouth X-ray that is taken without ever putting an X-ray film into your mouth. Instead, as you sit still, the X-ray head rotates around you, providing one large image of your jaws and teeth.
This type of X-ray is particularly helpful for seeing the upper and lower jaws at one time and can show impacted teeth or other hidden structures that could be hard to see on the small, individual film used for a “traditional” full-set
Panoramic X-rays may replace the full series.
4. Periapicals
A periapical (PA) X-ray refers to a single X-ray that is taken to show a specific area of concern.
For instance, if you have a tooth ache, your dentist is likely to recommend a PA film to see that whole tooth including the root.
So this type of x-ray is given only as needed for diagnosis of specific teeth with concerning symptoms. It’s not needed on a routine basis if bitewings are done.
5. CBCT scans
Cone beam computed tomography (CBCT) is a new imaging technology that uses rotating x-ray equipment, combined with a digital computer, to capture clear, 3-dimensional pictures of soft tissue, bone, muscle, and blood vessels.
Your dentist may recommend use of CBCT only on a case-specific basis for surgical planning, implants, pathology. Not for routine exams.
X-ray Frequency for Pediatric Patients
Pediatric X-rays should be administered judiciously, considering the child’s age, health, and specific dental needs. Typically, dentists follow the ALARA principle (As Low As Reasonably Achievable) to minimize radiation exposure, especially for children. (discussed in how many dental x-rays are safe in a month)
For routine dental check-ups, X-rays might be needed once a year or less frequently, depending on the child’s risk of dental problems. Dentists carefully assess the necessity of X-rays, ensuring they are only performed when essential for diagnosis or treatment planning.
Guidelines from dental academies advise:
Bitewings:
- Twice per year once molars erupt if high risk for cavities.
- Once per year for low risk patients.
Panoramic:
- Every 1-3 years to examine developing teeth.
- Before orthodontics to evaluate skeletal development.
Periapicals:
- Only as needed based on clinical signs/symptoms to diagnose primary teeth.
CBCT scans:
- Very rarely indicated for pediatric cases.
X-ray Guidelines for Special Cases
More frequent X-rays may be indicated for those with:
- High cavities risk
- History of dental disease
- Orthodontic needs
- Poor medication or diet compliance
- Frequent missed appointments
- Special healthcare needs
Recent evidence supports even less frequent X-rays for very low risk patients.
Final Note
Following professional guidelines allows optimizing dental X-ray frequency for each patient’s needs while still minimizing radiation exposure. Staying within recommended parameters keeps you safe while harnessing X-rays’ immense diagnostic power. Discuss your personal risk factors and needs with your dentist.
References
https://www.cda.org/Portals/0/pdfs/fact_sheets/xrays_english.pdf
