Show
Dental x-rays enable us to see inside a tooth. This quick guide shows you some of what we see and what we are looking for. This is an x-ray of the back teeth on the upper arch. With x-rays, you can only see the hard tissues, such as the teeth and bone but you cannot see the soft tissues, such as the gums, lips, or nerves. This enables us to differentiate between what is normal tooth and bone and what is diseased tooth and bone. The green arrows are pointing to the bone. The blue arrows are pointing to the healthy enamel. The red arrows are pointing to the pulp, where the nerve and blood vessels are located for a tooth. The dentin layer is between the enamel and the pulp. The purple arrows are pointing to areas of decay, which show up as a dark spot on x-rays. Bacteria have attacked the tooth and have dissolved the enamel and entered the dentin. The decay must be removed before it dissolves the dentin and enters the pulp. If the decay enters the pulp, the tooth will require either a root canal or an extraction. This x-ray shows cavities between the front teeth. This is the same x-ray but the arrows have been added. Our LocationFind us on the mapHours of OperationOur Regular SchedulePhoenix Dental Office Wednesday: 7:00 am-4:00 pm Thursday: 7:00 am-4:00 pm – How dentists read bitewing radiographs. Signs they look for. | Decay stages- How advancing cavities look on x-rays. | How dentists determine when a cavity has advanced enough that a filling is needed. | How often should bitewing x-rays be taken? The scenario.Possibly you’ve been at your dentist’s office for a checkup. Radiographs (a dentist’s term for x-ray pictures) have been taken and you’ve just been told that you have a cavity. Your dentist shows you the pictures of your teeth, so you’ll be fully informed. But the problem is, you don’t really know what you’re looking at or what to look for. Interpreting dental x-rays takes a little skill.We can’t make you an expert but this page outlines how dentists read x-rays. It describes:
This page also discusses current guidelines about how often bitewing x-rays should be taken. Dentin and Enamel: The calcified tissues of a tooth. How to identify tooth decay on dental x-rays.The basic premise involved is this …When searching for a cavity on a tooth, a dentist looks for any sign on the radiograph that indicates or suggests that the density of any portion of the tooth’s hard calcified tissues (enamel and/or dentin) is different than normal or expected. How dental x-rays work.When a dentist takes a radiograph, a tooth’s hard mineralized tissues will block some of the radiation (x-rays) that have been aimed through them. Due to this effect, those portions of the x-ray film (or digital image receptor, the more modern way to take an x-ray), that lie behind these heavily calcified tissues will be less exposed (have fewer x-rays hit them). As a result, these protected portions of the picture will look lighter in color. (These areas of the film don’t turn as dark because fewer x-rays were able to penetrate through the tooth to strike them.) On x-rays, more calcified tooth structures appear lighter in color. Animation of the progression of tooth decay (see below). On an x-ray (see illustration):
Why cavities show up on x-rays.Since decay is an area of tooth demineralization (an area of reduced mineral content), or even possibly an outright hole (a space that would have no mineral content at all), those locations where it has formed will show as a darkened area on an x-ray. That’s because the decayed portion of the tooth is less “hard” (less dense or intact) and therefore the x-rays penetrate that portion of the tooth more easily and ultimately expose the film more so (making the corresponding area on the film look darker). Preventing When evaluating a radiograph:
Stages of cavity formation that show up on x-rays.Our mockup of a dental x-ray illustrates some of the stages that the decay process goes through. The characteristic look of advancing tooth decay on dental x-rays.
Real-life examples of the carious lesions illustrated in Frames A, B and C.
▲ Section references – White What type of treatment does this x-ray show is needed?A bitewing dental x-ray. This film shows two fully formed cavities and one that’s just starting. When reading this image, a dentist would diagnose a need for the following work.
▲ Section references – Hilton “Bitewing” x-rays.The film shown here is the same radiograph as above. In dental terminology, it’s referred to as a “bitewing” x-ray. This is the standard type of image that’s used to look for cavities. A bitewing dental x-ray showing 3 areas of decay.
▲ Section references – White, Foster-Page How often do you need to have bitewing x-rays taken?Taking x-rays shouldn’t just be a perpetual, automatic profit center for your dentist. They should instead be taken for specific reasons. The authority.Fortunately, via a collaboration of representatives from the American Dental Association (ADA) and the US Food and Drug Administration (FDA), a set of guidelines exist for dentists to follow. They’re titled: “Dental Radiographic Examinations: Recommendations for Patient Selection and Limiting Radiation Exposure.” What are the guidelines for taking bitewing x-rays as a tool for detecting tooth decay?The need for a dentist to take bitewings during a dental examination should be based on …
How often should you have bitewings taken? – Case examples.1) Adult recall patients.The term “recall” as used in this context refers to a dental appointment where the patient has returned for periodic examination. (An interval of every 6 to 12 months is common.) Bitewings every 24 to 36 months. – If no decay is identified during the patient’s clinical examination, and they’re not considered to have any associated factors that place them at increased risk for developing cavities. Bitewings every 6 to 18 months. – If clinical examination identifies decay, or the patient is considered to have associated factors that place them at increased risk for developing cavities. 2) Adult new patients.“New” patients are those persons new to a dental practice and therefore the dentist has limited knowledge about the person’s decay history and has no historic x-rays as background information. Taking bitewings is generally indicated. – Especially in the case where decay has been identified during the patient’s clinical examination. 3) Adolescent recall patients – Permanent dentition only.This category is composed of adolescents that have lost all of their primary (baby) teeth. Bitewings every 18 to 36 months. – If no decay is identified during the patient’s clinical examination, and they’re not considered to have any associated factors that place them at increased risk for developing cavities. Bitewings every 6 to 12 months. – If clinical examination identifies decay, or the patient is considered to have associated factors that place them at increased risk for developing cavities. 4) Adolescent new patients – Permanent teeth only.Taking bitewings is generally indicated. – Especially in the case where decay has been identified during the patient’s clinical examination. 5) Adolescent recall patients – Transitional dentition.The term “transitional dentition” indicates that the person has some permanent teeth but still retains some primary teeth too. Bitewings every 12 to 24 months. – If no decay is identified during the patient’s clinical examination, and they’re not considered to have any associated factors that place them at increased risk for developing cavities. Bitewings every 6 to 12 months. – If clinical examination identifies decay, or the patient is considered to have associated factors that place them at increased risk for developing cavities. 6) Adolescent new patients – Transitional dentition.Taking bitewings is generally indicated. – Especially in the case where decay has been identified during the patient’s clinical examination. 7) Child recall patients – Primary teeth only.This group of children is characterized by the fact that they only have primary (baby) teeth. Note: Some children have spaces between all of their baby teeth. If so, x-rays are not needed to evaluate for decay. Bitewings every 12 to 24 months. – If no decay is identified during the patient’s clinical examination, and they’re not considered to have any associated factors that place them at increased risk for developing cavities. Bitewings every 6 to 12 months. – If clinical examination identifies decay, or the patient is considered to have associated factors that place them at increased risk for developing cavities. 8) Child recall patients – Primary teeth only.Taking bitewings is generally indicated. – Especially in the case where decay has been identified during the patient’s clinical examination.
Page references sources: Am. Dental Assoc. and US FDA. Dental Radiographic Examinations: Recommendations for Patient Selection and Limiting Radiation Exposure. Foster-Page LA, et al. The effect of bitewing radiography on estimates of dental caries experience among children differs according to their disease experience. Hilton TJ, et al. Summitt’s Fundamentals of Operative Dentistry: A contemporary approach. White SC, et al. Oral Radiology: Principles and Interpretation. All reference sources for topic Tooth Decay. What are the white spots on dental xThese white spots are a sign of where minerals have been lost from the surface of your teeth. Luckily, when these white spots appear, it's not too late. At this point, the development of a cavity can be stopped or reversed.
What does decay look like on xray?In an X-ray, cavities are seen as dark areas in a tooth. Cavities start at the outside layer covering the tooth, called the Enamel, which has the lightest color in an X-ray. Cavities will then advance to the layer under enamel, called the Dentin, which is softer and has a darker color than enamel in an X-ray.
How do you read dental teeth?The first thing to realize is dentists use a two-digit numbering system. So the upper right teeth begin with the number “1” (i.e. 11), the upper left teeth begin with the number “2” (i.e. 21), the lower left teeth begin with the number “3” (i.e. 31), and the lower right teeth begin with the number “4” (i.e. 41).
|