What Your Dentist Looks For in an X-Ray

By Premier Dental of Ohio

Dental X-rays

When you see your dentist on a consistent basis, you understand that dental x-rays are a vital part of your “check-ups”.  Because many dental problems do not cause symptoms in their earliest stages, the only way to detect them is through the use of radiographic images.  In fact, in most states, it is illegal for your dentist to diagnose dental problems without dental x-rays.

Why Are Dental X-rays So Important?

Without dental x-rays, your dentist would rely on a visual examination of the teeth and your description of symptoms to diagnose a problem.  That means he or she would miss every underlying problem that is asymptomatic.  In the case of cavities, waiting until a cavity is either visible or causing pain equals waiting until it is quite large.  This matters to the patient because a large cavity requires more extensive and more expensive treatment.

Through the information provided by dental x-rays, your dentist is able to give you the best and most conservative dental care.  X-rays allow for early detection of cavities, gum disease, and even dental infections.  X-rays will show signs of change before you feel any symptoms at all.

The frequency of dental x-rays depends on the risk for disease.  Someone with a very low risk for dental diseases may go up to two years between x-rays.  However, those with worsening problems or a high risk for cavities and/or gum disease may require x-rays as often as every 6 months.

What X-rays Do I Need to Maintain Great Dental Health?

Your dentist will typically recommend both close-up and large-scale images of your teeth and jaws to provide a comprehensive picture of your oral health.  The close-up images comprise two different types of dental x-rays, known as bitewings and periapicals.

A bitewing x-ray shows a high definition view of the upper and lower back teeth.  It also shows the surrounding jawbone in a healthy mouth. On average, dentists request bitewing x-rays of patients about once each year.  A periapical x-rays shows a high definition picture of the entire length of a tooth, including the root and the bone surrounding it.  Periapicals are only necessary in areas of high risk for disease around the root, including root canal treatments and dental implants.  With those risk factors, the dentist will order periapicals yearly.  Without that type of risk factor, patients only need periapical x-rays every five or more years.

The most common large scale x-ray of the teeth and jaws is a panoramic x-ray, also called a panorex.  This image shows the upper and lower jaws in their entirety.  You can see the TMJs, all of the teeth, and any underlying structures.

What Does the Dentist Look for in a Bitewing X-ray?

A bitewing x-ray is the perfect tool for early detection of cavities between the teeth.  These common cavities, often caused by a lack of flossing, are not visible to the naked eye until they are quite large. When the dentist catches them in their earliest stages, called an incipient lesion, he or she can “intercept” and stop them from growing.

Your dentist also uses bitewing x-rays to evaluate the health of the jawbone surrounding the teeth.  Gum disease can destroy this bone, and any changes in the bone are visible on this close-up image.

Bitewing x-rays show abnormalities in the tooth’s nerve chamber, such as resorption, or in the ligament connecting the tooth to the jawbone.  When you see the see dentist for an extended length of time, he or she can compare to previous x-rays to note any changes.  Bitewing x-rays can show changes in the position of teeth and the way they bite together.

What Does the Dentist Look for in a Periapical X-ray?

In a periapical x-ray, the dentist is evaluating the entire tooth and its surrounding structures.  These x-rays are essential for confirming the health and stability of both root canal treatments and dental implants.  In both cases, you can have significant problems or infections with little to no symptoms at all.  The x-ray, taken on a yearly basis, helps your dentist ensure that there are no issues developing.

In cases of dental implants, the periapical x-ray shows the degree of integration between the implant body and the surrounding jawbone.  When an implant fails to integrate, the failure is visible on the x-ray.

A periapical x-ray is typically the first image the doctor orders when someone presents with a severe toothache.  The most dangerous dental situation is an abscess, which can spread to other areas of the body.  This is the type of x-ray needed to view abscesses.

We also take periapical x-rays when someone suffers an injury to the mouth.  They show whether an injured tooth has a root fracture, jawbone fracture, widened socket, etc . . .

What Does the Dentist Look for in a Panoramic X-ray?

A panoramic x-ray is an important diagnostic tool in the growth and development of a child’s teeth and jaws.  It allows dentists to evaluate the jaw joints (TMJs), the teeth before they erupt into the mouth, and the upper and lower jaw bones.  We use panoramic x-rays to evaluate the wisdom teeth before the come into the mouth.  This aids in the decision of whether to extract them.

Any masses in the jaws, like tumors or cysts, are visible on a panoramic x-ray, so we use this image as an additional screening tool for any abnormal pathology.  Dental infections, gum disease, and cavities, when large, will also show up on a panoramic x-ray.

Are All of These X-rays Safe?


The amount of radiation exposure from dental x-rays is much lower than any other type of x-ray.  We use strict radiation protocols to ensure the safety of both our patients and our team members who take the x-rays.  The risk of any tissue damage from dental x-rays is so low that the American Congress of Obstetricians and Gynecologists says dental x-rays are safe for pregnant patients at any stage in their pregnancy.

More Questions about Dental X-rays?

Call your nearest Premier Dental of Ohio location today.  We can answer any questions you have about dental x-rays and schedule you for a consultation with one of our knowledgeable and compassionate doctors.


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