The ADA Quietly Changed X-Ray Rules—Most Patients Don’t Know

Why Dental X-Rays Guidelines Changed 0:00

Should you get dental x-rays? Well, interestingly enough, the American Dental Association just issued new guidelines for dental x-rays. They had not issued guidelines since 2012, so this has been a long time in coming and a lot of things have changed in that more than a decade. The major thing that changed is x-rays themselves. So we now have digital x-rays, digital radiography it's called. What this means is that what we use now is a sensor that goes in the mouth or a sensor that goes around the head that is exposed digitally and it requires much less radiation.

No one really thinks about the effective exposure from radiation for a dentist or their team, but every single dental x-ray that we take, we potentially have exposure from. So this has been a great advancement in dentistry for the profession, but also for all of you. Radiation is significantly less than it ever used to be. But what is the American Dental Association saying? How frequently should you get x-rays? Well, they've actually given very vague guidelines. They've said when they are clinically necessary.

What does that mean? Great question. Really, it means when you've had a history of cavities, when you've had a history of gum disease, when you have a concern, right? Sensitivity, you have a black spot on your tooth. You know, there's a reason that we find when looking in your mouth that we should take an x-ray.

When X-Rays Are Clinically Necessary 1:35

Why do we need the x-ray anyway? Well, I liken this to working with my eyes covered. I simply can't see things that are under the gums, that are inside of the root, that are inside of the tooth. I can't see them without a dental x-ray. So it really is essential to completely care for you. But we even have more available at our fingertips now with dental radiography when we are taking cone beam CT scans. What can we see there? So much more than we ever could. In fact, I think it'll be fun. Let's go look at a few in just a minute.

This is our Konbing CT machine. I really wanted you to see it because oftentimes when we say CTs, people think of a big long bed that you lay in at the hospital. That's not what we're talking about. This is the machine that we're talking about. You stand up, you put your chin here. This is set for a very tall person. You put your chin here and this arm goes around your head a couple of times actually in our machine because we need to get everything from top to bottom. It takes about a minute, if that, to take the entire scan.

You step out of the machine, it works it up on the computer, and within about five minutes time we're able to see everything that that scan is showing us.

Digital X-Rays and Lower Radiation 2:56

So very quick, very simple, very non-invasive, nothing goes in your mouth at all. You just stand here, it takes the scan, and in about five minutes, we have everything we need to know. But that's when the most crucial piece of information comes in. You need a dentist that actually knows what they're looking at when they look at the scan. So make sure you get someone who can interpret all the information that comes out on the other end after you've been in this machine. The radiation that comes from dental x-rays is very minimal, but how minimal?

Well, it really equates to a day of normal living. So the kind of extra that goes in your mouth, the little kind that goes inside of your mouth is equal to less than a day of just normal living here on the earth with sunshine exposure and in today's world, a lot of exposure with Wi-Fi and other things as well. Now, how about the big cone beam CT scan machine, you know, x-ray that goes all the way around your head? What does that equal to? About a week's worth of daily living. Do you want to do that every week, every month, every time you go to the dentist?

Absolutely not. But if there is indication if you've ever had a root canal, if you have ever had your wisdom teeth removed, If you have sinus concerns, if you have issues with breathing or sleeping, any of those things warrant having a cone beam CT scan. And you can rest assured, it's only about a week's worth of daily living on the earth. In fact, it's actually less than living in Denver or a flight from New York to LA.

Cone Beam CT Scans Explained 4:30

These things are all about equal to what a cone beam CT scan is. So there's another question people often ask. Do we have to wear those lead aprons anymore? And why is my dentist not using that anymore? The answer is because we have learned with the lower radiation amounts with digital radiography, we don't need those. But they often interfere with our x-ray taking. They get in the way. They block the x-ray. So we have to take another one, which means added exposure. They've also found that sometimes that radiation gets trapped underneath that and bounces back and forth, and you get more exposure than if you didn't have it on.

So from the American Dental Association, there is no set guideline anymore on how frequently you need to have dental x-rays. It's based on need and you do not need the lead apron when having those dental x-rays. So now I want to go show you what do we see on a cone beam CT scan? Why do we take them at total care dental so frequently? What's the clinical need? Let's go check them out. All right, let's show you what a cone beam CT scan shows and why it's different than the other x-rays you probably have had taken before.

You most likely have had something called a panorax taken, where it goes around your head. And often patients will say, no, no, I've already had one of those that go around my head. Well, this is what a panorax looks like. So this is the view that we get from a panorax or a panoramic x-ray. And it's great. We can see a lot of things. We can see your jaw joints up here. We can see your sinuses. There's your nose. We see the teak. But this is in two dimensions. I actually can't see anything forward or back in these teak.

I can't see anything forward or back in the jaw joints or actually down on the jaws. So let me show you what A cone beam CT scan shows it has all of these additional views. This is one thing that we can do is we can take each individual tooth, tooth by tooth, and I can see it in this view down here.

What Cone Beam CT Reveals 6:30

Now I can see exactly what's going on. This is underneath the nose. This is the roof of the mouth. I can see each individual tooth and what's happening with each of these teeth. So that's one thing that's different from the cone beam CT scan. The other thing we can see is this. We see the entire face and head and everything else, all of the bone structure. What's this funky thing in the back? That's actually the airway, the space that this patient is breathing through. This is another viewpoint that we can see and I love this so much.

This is My go-to view, we see the spine back here. We see the space where the patient is breathing. I see the tongue position in this patient. The tongue is too low. It should be filling the roof of the mouth here, which means most likely they're not breathing and sleeping as well as they could. I can see bone structure. I can see even sometimes glands in the brain. Then we can scroll sideways and I can find the jaw joint in detail. There's the jaw joint. There's the ear. We can see if there's correlation between in the ear challenges and the joint itself.

There's the other jaw joint on the other side. You can see the value of all of this information on these scans. And then this one, we see everything all put together. It's so much better for you as a patient to be able to really understand what are we talking about when we show you things on an x-ray when you can see it actually in real life three dimensions. So now you can understand a little bit better why this has been such an amazing and improvement for dentistry, but also so crucial when we're looking for hidden infections around the bottoms of root canals, when we're looking for hidden infections in jawbones, when we're looking and saying, why are you struggling to sleep?

Why are you waking up so tired? Oh, wow, look, all of the tissue that should be in the mouth is actually back in the place where the air flows. No wonder you can't breathe very well. We can look at jaw joint issues and say, is this a joint problem?

Why Dental X-Rays Still Matter 8:37

Do you have joint degeneration? Or is this a muscle issue? We can actually see what's happening. Now you see the value of this Colbeam CT scan, and here's the kicker. With this scan, it eliminates the need for so many other x-rays because I see everything at the same time. I cannot see cavities very well. If they're giant, I can see them on this. Small little tiny cavities, I have to have the kind that go in your mouth, those kind of x-rays still. But this really takes the place of a lot of dental radiography and answers so many questions.

So hopefully this cleared up a lot of things for you when it comes to x-rays. How frequently? Based on need. Lead apron? You don't need it anymore. What kind of exposure, what does it equate to? A day to maybe a week's worth of daily living. Is it okay to have dental x-rays? Yes. And frequently, there is no way we can really determine the root cause of some of the symptoms and other issues you're experiencing without them. So they are something that is really, that are really crucial to have and important.

as part of your health journey. Hopefully this has been helpful for you. Make sure to click below, subscribe, check out all the information we're sharing. We share up to date new information that you want to know about your overall health and about your oral health. If you are here in Utah, we'd love to see you at Total Care Dental. If not, go check out the directory on the website at livingwellwithdrmichelle.com and find a dentist like us that can provide this kind of care for you wherever you are because our mission is to help more people live well.