Dental X-rays: Are they bad for you?

Dental x-rays are an important tool to assess the health of your teeth, gums and bones. They aid in diagnosing diseases such as decay, infection/abscess, advanced gum disease (periodontitis), tumors, extra teeth, missing teeth, impacted teeth (teeth not growing in the right direction), jaw joint issues and failing fillings among many other reasons.

Dental x-rays diagnose what the naked eye cannot see; there is more happening inside a tooth than what is sometimes visible superficially. Early decay, especially at the contact points of teeth, can mostly only be diagnosed with x-rays. A hole in your tooth is usually only seen once the decay has progressed quite far into the tooth structure.

There are various types of dental x-rays. The most common ones are:

- Bitewings (BW) : used to capture back teeth and bone

- Orthopantomogram (OPG) : Captures all the teeth in the upper and lower jaw including the bone and the jaw joints (temporomandibular joint)

- Periapical (PA) : isolated radiograph used to assess a tooth from its crown to root

Many patients are concerned with radiation exposure from dental x-rays. The radiation from dental x-rays are in very small doses, in fact you are exposed to more radiation from your environment on a daily basis than your routine radiographs! For a pair of bitewing images, the lifetime risk of harm (of fatal and non-fatal cancer and severe hereditary effects) is less than one in a million. This is about the same as smoking 1.4 cigarettes or flying about 1,000 km in a commercial airliner (Ministry of Health, 2021).

X-rays are tailored to you, and this is based on factors such as lifestyle (including smoking habits), diet (sugar consumption), oral hygiene (frequency of brushing and flossing), fluoride exposure (if water and toothpaste contain fluoride) and age among the most important factors. Dental x-rays are also safe to be taken in the second trimester of pregnancy. If you are worried about radiation to the rest of your body, you may request for a lead apron to be worn when the x-ray is being taken as an extra layer of protection.

Despite dental x-rays being safe, you will always see the clinician leaving the room when taking your x-rays to avoid being exposed to high frequencies of radiation throughout the day from the many x-rays they take.

Prevention is always better than cure hence, we are strong believers of preventive dentistry. X-rays are taken at different intervals for every individual; it is tailored to you. Your dentist or oral health therapist will inform you of your risk status after every checkup. For example, if you have had multiple fillings in your recent checkup, you will be advised to come back for a checkup with x-rays in 6 months time. If you are a low risk patient by definition of having no cavities, you will be advised to come back in 18 months. Hence, regular dental checkups are paramount.

This chart depicts radiation exposures of different
types (Ministry of Health, 2021).

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