How often X-rays should be taken as part of routine checkups depends on your risk of having problems
and the likelihood of the dentist finding something that needs treatment.
The Australian Practical Guidelines for assessing dental caries (decay) in-between the back teeth suggest the following intervals:
- For children 12-24 months
- For adolescents 18-36 months
- For adults 24-36 months
The FDA in America has similar guidelines for the low risk group, but 'recall patients with clinical caries (that is visible decay in the mouth) or increased risk of developing caries' are as follows:
- For children 6-12 months
- For adults 6-18 months
With regards to periodontal (gum) disease, the decision is left up to the dentist to decide if and when X-rays are necessary, but radiation exposure should be kept to a minimum.
These routine X-rays are assuming that you don’t have any signs or symptoms of dental disease or anything that looks suspicious and needs further investigation. In such circumstances, or if you are undergoing treatment that requires it, X-rays will be need to be taken.
If you are high risk, then the likelihood of finding new problems is high and bitewing X-rays
may be needed as often as every 6 months. If you carry on like this, it is a slippery and expensive slope of fillings, root canals, crowns and down the track- extractions and dentures. It is important that you actively take steps to lower your risk and try to prevent this from happening; we will discuss this in the next section.
If you are low risk, and see the dentist regularly, then they may only be needed every couple of years (this is the case for most of my patients).
If you are a new patient, the dentist may recommend you have X-rays at your first visit to provide a more comprehensive initial examination and to act as a baseline for changes that may occur over time.
Generally, if I have a new patient who has had X-rays taken only 6 months ago at another practice, I will either request the X-rays be sent across to us or, assuming everything was fine, I would simply talk to them about the importance of why we need them and recommend retaking them in 12-18 months time. If I find something suspicious during the examination, they may. of course, need to be taken.
I have heard of dentists pressurising patients into having X-rays by commenting, “How am I supposed to do a proper examination if I don’t take them every time?”
In general, caries (decay) and the bony changes seen in gum disease progress slowly and so X-rays are not necessary at every 6-month check-up. They are definitely not needed twice a year- if every-time you have them- the dentist says, “Yep! They are fine!”
If you are unsure why the dentist wants to take X-rays…. Ask!