Lacy Walker, RDH, BS, CDA, MAADH, FAAOSH
Radiation is an aspect of everyone’s daily lives, regardless if you are a healthcare professional or a patient. In modern dentistry, cutting-edge technologies have revolutionized how oral health is assessed and treated. One of the most indispensable tools in a dentist's and dental hygienist's arsenal is dental radiography, also known as dental X-rays. These diagnostic images have been instrumental in diagnosing and treating various dental conditions for over a century. It is essential to understand the importance of dental radiographs, the different types, safety, and how they aid dental professionals in providing optimal patient care.
Radiation can be absorbed through many sources, such as from natural sources, flying from the East Coast to West Coast, airport security scans, eating a banana, and smoking. Eating a banana and airport scanning results in minimal radiation exposure; however, people are exposed to more radiation through natural sources than from annual dental radiographs. The benefits of radiographs outweigh the financial healthcare costs associated with exposure to a dental radiograph due to their ability to detect disease and other dental issues.
Dental Radiographs Have Been Used for Over a Century: Dental radiographs were first discovered by Wilhelm Conrad Roentgen in 1895. Since then, they have been an essential tool in dentistry for diagnosing dental issues that are not visible to the naked eye. Another important person in the discovery of radiographs is Marie Curie, who conducted pioneering work in radiology, developing and deploying mobile X-ray machines for the battlefields of World War I. (1)
Electromagnetic Waves: According to the Centers for Disease Control and Prevention (CDC), radiation is a form of “electromagnetic waves”; it is energy with an electric and magnetic field that comes from a source and travels through space at the speed of light. (2)
Different Types of Dental Radiographs: There are several types of dental radiographs, each serving a specific purpose. These include periapical X-rays, bitewing X-rays, panoramic X-rays, occlusal X-rays, and cephalometric X-rays. Each type captures different views of the teeth, jaws, and surrounding structures. Periapical radiographs are the main intraoral radiographs used in root canal therapy (endodontics), and these particular films have been utilized in root canal treatment for more than ten years. (3)
Panoramic radiographs allow a broader view of the head, neck, and jaw in addition to evaluating the carotid artery. Dr. Yrjo Veli Paatero, “The Father of Panoramic Radiography,” experimented with the slit beam method of panoramic radiography for dental arches. (4)
Low Radiation Exposure: Dental radiographs are considered safe and expose patients to very low radiation levels. Modern digital X-rays significantly reduce the radiation dose compared to traditional film X-rays. Dental professionals are taught ALARA (As Low As Reasonably Possible); ALARA is a governmental approach to ensure safety when dealing with radiation while producing diagnostic radiographs. (2,5)
Essential for Diagnosis: Dental radiographs are crucial for diagnosing to confirm or classify suspected issues or diseases such as cavities, impacted teeth, bone loss, and infections and to evaluate growth and development changes. Some conditions cannot be adequately identified without the use of X-rays.
Detection of Hidden Dental Problems: Many dental problems, such as decay between teeth or beneath fillings, can be hidden from the dentist's view. Dental radiographs allow dentists to detect these issues early, preventing further complications.
Aid in Treatment Planning: Dentists use dental radiographs to plan treatments like root canal therapy, extractions, dental implants, orthodontic procedures, and periodontal therapy. These images provide valuable information about the underlying structures, helping dental professionals formulate the best treatment approach to the patient’s needs.
Digital X-rays vs. Film X-rays: Traditional film X-rays were widely used in the past, but digital X-rays have become more prevalent in recent years. Digital X-rays offer several advantages, including faster processing, easier storage, and the ability to enhance and manipulate images for better diagnosis.
Intraoral vs. Extraoral X-rays: Intraoral X-rays, the most common type of dental radiograph, are taken inside the mouth. On the other hand, extraoral X-rays are taken outside the mouth and capture a broader view of the facial bones and jaws.
Precautions for Pregnant Patients: While dental X-rays are generally safe, precautions are taken for pregnant patients. Lead aprons and thyroid collars shield the abdomen and thyroid gland from radiation during X-ray procedures.
Regular X-rays for Prevention: Dental X-rays are not only used when problems arise. Routine dental X-rays and dental exams are crucial for preventive dental care. They help dentists monitor changes in oral health over time and detect potential issues early, leading to more effective and less invasive treatments.
Dental radiographs have become an indispensable tool in modern dentistry, revolutionizing how dental professionals diagnose, treat, and manage oral health issues. With their ability to reveal hidden problems and guide treatment planning, dental radiographs have undoubtedly improved patient care and outcomes.
As technology advances, dental radiography will likely become even more efficient and safer, further elevating the standard of oral healthcare. So, the next time you visit your dentist and are asked to have dental X-rays taken, rest assured that these seemingly invisible images are vital to maintaining your bright smile and overall oral health.
If interested in learning more or receiving CE credit, please visit https://dentalacademyofce.com/courses/are-you-curie-ous-about-radiation/
References
1. Jorgensen, Timothy J., How Marie Curie Brought X-Ray Machines To the Battlefield, (2017) https://www.smithsonianmag.com/history/how-marie-curie-brought-x-ray-machines-to-battlefield-180965240/
2. Radiation basics. Centers for Disease Control and Prevention. https://www.cdc.gov/nceh/radiation/basics.html.
3. Almanei, K., Alsulaimani, R., Alfadda, S., Albabtain, S., & Alsulaimani, R. (2017). Digitally Scanned Radiographs versus Conventional Films for Determining Clarity of Periapical Lesions and Quality of Root Canal Treatment. The Scientific World Journal, 2017. https://doi.org/10.1155/2017/2427060
4. DentalReach - Leading Dental Magazine - Dentistry Journal, News & Events (Dec 14, 2022) The Journey of Panoramic Radiography – A Review (Part I). Retrieved from https://dentalreach.today/the-journey-of-panoramic-radiography-a-review-part-i/
5. Environmental Health & Safety. Glossary, University of Illinois Chicago. https://ehso.uic.edu/research-safety/radiation-safety/glossary/