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An Introduction To Dental X-rays

Dr. Asif Nazir

3 min read

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Radiographs, or x-rays, are energy waves that are passed through a certain body part to obtain a ‘negative-like’ image of it. Like all other x-rays, dental x-rays are used to diagnose or prevent oral issues by revealing places in the mouth, such as teeth roots, that are otherwise invisible to the naked eye.

How It Works:

X-rays work by passing through soft tissues (gums) while being absorbed by dense tissues (teeth and bones). Since dense tissues appear lighter on the x-ray film, tooth decay and infection can be easily detected as they appear darker due to reduced energy absorption.

Table of Contents


X-rays are divided into the following two categories:

1- Intraoral:

These commonly employed x-rays are taken inside the mouth. Due to their ability to provide a detailed image of the teeth, bones, and supporting tissues, they are used for:

  • Cavity location and teeth root observation
  • Checking bones surrounding the teeth
  • Detecting periodontal disease
  • Observation of teeth development status

Depending upon the oral condition, intraoral radiographs are further subdivided as follows:

A- Periapical:

These x-rays are used in order to observe bone height or root tips of a particular tooth or teeth, as they highlight the entire tooth-length, from the crown (visible part of a tooth) to root, of 1-2 teeth at a time. Dentists might recommend a full mouth periapical radiography depending upon dental history and oral health.

B- Bite-wing:

Such x-rays require biting down on a wing-shaped device to secure the film in place for an accurate image of the lower and upper posterior (back) crowns, hence the name. Bite-wings are used to check tooth alignment and early signs of decay, along with the breakdown of any dental fillings or other restorations, or bone loss in case of severe gum disease. Dentists may take 2-4 of these x-rays at a time.

C- Occlusional:

Primarily employed to observe tooth development, bite, jaw fractures, a cleft in the mouth roof, or locate extra teeth and other foreign objects lodged in the teeth of children, occlusional x-rays show a near-full arch of teeth in the upper or lower jaw at one time and are larger than most x-rays.

2- Extraoral:

These radiographs are taken with films placed outside the mouth, but are less detailed than intraoral x-rays and are hence, not used for detecting flaws in individual teeth. However, they can provide information on the jaw and skull, and are used to:

  • Track teeth growth and development
  • Observe the status of impacted (pushed together) teeth
  • Examine the facial bones and teeth-jaws relationship.

Extraoral radiographs are further divided into the following sub-types:

A- Panoramic:

These comparatively low-radiation x-rays map the entire oral and nasal cavities and sinuses in one frame, which can help detect cysts, tumours, jaw and bone disorders. It is only taken when a patient requires dental implants, or orthodontic treatment (correction of teeth and jaw irregularities). The head and jaw are held in place by devices attached to a special x-ray machine for optimum results.

B- Cephalometric:

Such radiographs completely map one side of the head in order to observe the teeth in relation to the jaw and side profile and are used by dentists prior to orthodontic treatment, such as alignment correction.

C- Computed Tomography (CT):

These x-rays provide 3D images of dental structures, nerves, soft tissue and bones via a cone-shaped (aka cone-beam CT), or fan-shaped (aka standard CT) beam emitted from a machine rotating above the head, and are used prior to dental implantation.

Bite-wings, panoramic and periapical x-rays are the most common.

Digital X-Rays:

Unlike traditional radiographs, patients bite down on a small plastic apparatus containing a flat electronic pad or sensor instead of the standard x-ray film, which allows for digital images that are portable, damage-resistant, and can be enlarged to observe minute details, hence aiding in early detection.

When Is It Needed:

Adults without a high cavity-risk or tooth decay should get bite-wing exams every 2-3 years, while bite-wings are recommended every 1 ½ -3 years and 1-2 years for teens and children, respectively. However, adults and children with tooth decay and cavity risk should get bite-wings every 6 months-1 ½ years, and 6-12 months, respectively. New patients might require a full x-ray set or panoramic imaging for current oral health assessment.

Safety Concerns:

While traditional x-ray procedures use a small amount of radiation, it is further halved in digital x-rays. Yet, patients will still be given a leaded apron and even a collar as a protective aid against harmful radiations. However, pregnant and breastfeeding women should inform their dentists, as these radiations might harm the baby.

Factors Affecting The Results:

The inability to remain still or firmly clamp the plastic tray, along with the presence of braces, retainers, dentures, bridges, certain piercings (ear, lip, or nose) can negatively affect the quality of the results.

If you or someone you know requires a dental x-ray assessment, we recommend contacting a dentist to determine the exact need. At oladoc, you can search and Find a Dental Specialist in Rawalpindi, Karachi and Multan. Moreover, you can also call our helpline at 042-3890-0939 and seek the best appointment with the nearest dentist.

Disclaimer: The contents of this article are intended to raise awareness about common health issues and should not be viewed as sound medical advice for your specific condition. You should always consult with a licensed medical practitioner prior to following any suggestions outlined in this article or adopting any treatment protocol based on the contents of this article.

Dr. Asif Nazir - Author Assoc. Prof. Dr. Asif Nazir Ch. is a Dentist practicing in Multan. Assoc. Prof. Dr. Asif Nazir Ch. has the following degrees: B.D.S, F.C.P.S and has 16 years of experience. Dr. Asif's experience and qualifications make him one of the best dentists in Multan city. You can consult with him if you require any assistance regarding dental care. He also writes articles related to common dental problems and pens down the things to look out for if you suffer from any teeth-related conditions. These articles are linked below.
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