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Dental X-ray
Wilhelm
Conrad Roentgen was experimenting with vacuum tubes. In 1895, he produced, with one of these tubes, an invisible ray that
was capable of penetrating substances opaque to life. When certain objects were place between the tube and the screen, there
shadows were cast upon the screen. Unable to define the exact nature of this radiation, he named it the “x-ray”.
Dental
x-rays went through major improvements.
It is now possible to take dental x-rays exposing the patient to as little
as one-tenth the amount of radiation of older, conventional x-rays. This is
done with the use of digital x-rays that do not use film and do not need chemicals for development. Sensors instead of film
are placed in the patient's mouth. These sensors are slightly thicker than
the conventional x-ray film, but absolute majority of the patients will tolerate it as well as conventional film. After exposure,
the image appears on a computer screen in just seconds. The
resultant digital pictures are as clear as conventional film x-rays. They also provide a lot of information that was not available
before. Instead of holding up small films that are hard to see, the dentist and the patient can look at the images on a computer screen together. The taken images can be enhanced and enlarged many times its actual size.
| Bite wing X-ray |
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| Arrows point to decay, not visible at the exam |
Extraoral X-rays
There
are two principal kinds of dental x-rays.
Extraoral X-rays mean that the film or digital sensor remains outside of the mouth
while the machine shoots the beam through other structures from the outside. The most used dental extraoral x-ray is the panoramic
x-ray (Panorex). The Panorex is a large, single x-ray film that shows the entire bony structure of the teeth and face.
It takes a much wider area than any intra oral film showing structures outside of their range including the sinuses, and the
Temperomandibular Joints. It shows many pathological structures such as bony tumors and cysts, as well as the position
of the wisdom teeth. They are quick and easy to take. It gives full picture of the dentition, but it lacks some details that
intraoral x-ray have.
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| Digitally enhances same picture |
Why the x-rays are are necessary?
More
than 50 per cent of the decayed areas in teeth are discovered only through x-rays findings. Doctor or hygienist cannot see
those cavities that form between the teeth and under the gum during examination. Secondary decay under old fillings also very
easily missed without x-rays. Periapical infections may slowly develop not causing any symptoms and the only way to spot them
through x- ray examinations.
Many
times patient would refuse x-rays at the examination in order to save a few dollars. But if the cavity is small, it can be
filled with filling material, as it becomes bigger and bigger RCT, post and core and the crown could be the only solutions.
And these procedures do not come cheap.
Intraoral X-ray
The intraoral
x-ray is done to get the detailed image of a tooth and surrounding tissue. X-ray film or small sensor (digital X-ray) is placed
inside patient mouth, behind the teeth, catching the light bin passing through the tooth. There are two kinds of intraoral
x-rays:
Bitewings –they show the image of the
crown part of the teeth and used to diagnose caries lesions, not visible during regular exam.
Periapical X-ray catches the full image of
the tooth and used for viewing areas of the teeth below the gum line.
The full
mouth series is the combination of periapical and bitewings x-rays, allowing the doctor to oversee the whole dentition
for diagnoses and treatment planning.
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*The information contained on this site
is intended for educational purposes only. It is not intended and should not be construed as the delivery of dental/medical advice
and it does not substitute for diagnosis, treatment, or treatment planning. Persons requiring diagnosis, treatment, or with
specific questions are urged to contact your family dental/health care provider for appropriate care.
Copyright 2005-2008 by Dr. Vadim Khrakovsky
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