By declining x-rays for your child, you are reducing their radiation exposure, but you are also limiting our ability to diagnose and monitor oral diseases and to assess your childs dental growth and development. Some cavities can be seen during our visual exam, but cavities between the teeth are usually not visible unless they are quite large. Without x-rays we miss the opportunity of early diagnosis and treatment. Delaying cavity detection increases the risk for pain and infection and may limit treatment options to either stainless-steel crowns (silver caps) or extraction.
The initial x-rays of your childs teeth are usually taken between age 3 to 4. The first images are usually of the front upper and lower teeth (occlusal or periapical), and these are used to check for cavities, missing or additional teeth, and the development of the permanent teeth. The next images are generally of the back teeth (bitewings), and these are used to check for cavities and monitor the eruption of the permanent molars. We follow the ADA/FDA guidelines, and for most children we recommend bitewing x-rays once a year. However, in some cases bitewings are updated every 6 months.
Between the age of 7 to 9, we take a panoramic x-ray, which provides an image of all of your childs teeth and jaw bones. This x-ray is used to evaluate your childs dental and facial growth and development and to identify missing or additional teeth or incorrectly positioned teeth. The panoramic x-ray is usually repeated between the age of 12-13 and between the age of 15 to 16. These x-rays will be provided to an orthodontist or oral surgeon if your child would benefit from braces or wisdom teeth removal.
To minimize unnecessary radiation, we follow the recommendations of the American Academy of Pediatric Dentistry (AAPD). Their recommendations include: the use of digital x-rays and protective aprons and thyroid collars, and limiting the number of images to the minimum necessary.
Every day, we are all exposed to background radiation radiation from radon gas (found in groundwater, soil and rocks), from space, and from sources that are found naturally within the human body. We are exposed annually to approximately 3,000 microsievert (Sv) of background radiation, which is roughly 8.2 Sv each day. The table below compares approximate radiation from our dental x-rays and some other sources of radiation to daily background radiation. For reference, a 4 year-old child has been alive for 1460 days. If they had the four dental x-rays we recommend between age 3 to 4, this would account for an increase in their total radiation exposure of less than 3%.
National Council on Radiation Protection and Measurements. Ionizing radiation exposure of the population of the United States. National Council on Radiation Protection report no. 160. Bethesda, Md: National Council on Radiation Protection and Measurements, 2009