The purpose of X-rays is to allow dentists to see signs of disease or potential problems that are not visible to the naked eye. They are should be suggested after the dentist has done a clinical exam and considered any signs and symptoms, oral and medical history, diet, hygiene, fluoride use and other factors that might suggest a higher risk of hidden dental disease.
However, all X-rays use ionizing radiation that can potentially cause damage. Though it is spread out in tiny doses, the effect of radiation from years of X-rays is cumulative. The risks associated with this radiation are greater for children than for adults. So be sure that your dentist checks your child’s teeth, health history and risk factors before deciding an X-ray is necessary.
“X-rays are an important tool for dentists to diagnose dental diseases. However, they do not need to be part of every exam,” said Dr. Bill Kohn, DDS, Delta Dental Plans Association’s vice president of dental science and policy. “They should be ordered only after the dentist has examined the mouth and has determined that X-rays are needed to make a proper diagnosis. In general, children and adults at low risk for tooth decay and gum disease need X-rays less frequently.”
Ideally, your dentist should adhere to the guidelines established by the U.S. Food and Drug Administration and the American Dental Association. The following chart, adapted from those guidelines, gives a basic timeline for recommended frequency of X-rays by age group. Keep in mind that multiple factors such as the child’s current oral health, future risk for disease, and developmental stage determine need, and some children will require more X-rays, and some fewer.
Routine recall visit
Routine recall visit
Active tooth decay or history of cavities (Increased Risk)
No active tooth decay or history of cavities (Low Risk)
Young children(ages 1 – 5), with no permanent teeth Personalized exam which may consist of bitewing X-rays of back teeth (if no gaps exist between teeth that allow the dentist to examine the sides of teeth) and select individual X-rays, usually of front teeth. Bitewing X-rays every six to 12 months Bitewing X-rays every 12 to 24 months
Older children (ages 6 – 12), with some or all permanent teeth Personalized exam consisting of bitewing X-rays of back teeth and select individual X-rays, usually of front teeth; or a panoramic X-ray. Bitewing X-rays every six to 18 months Bitewing X-rays every 12 to 36 months
Adolescent, with permanent teeth but no wisdom teeth Personalized exam consisting of bitewing X-rays of back teeth and select individual X-rays; or a panoramic X-ray; or a full mouth survey of X-rays if evidence of widespread oral disease. Bitewing X-rays every six to 18 months Bitewing X-rays every 12 to 36 months
Many people believe that if their dental plan pays for a certain number of X-rays, they should take advantage of that benefit. For most patients, however, this yearly X-ray exposure is excessive and unnecessary. Don’t let your insurance coverage dictate your decision. If you have questions or concerns related to dental X-rays, discuss them with your dentist.