Does My Child Really Need Dental X-Rays?

A fair question, and one you are entitled to ask every time

Why baby teeth are worth imaging

The usual objection is reasonable: these teeth are going to fall out, so why look inside them?

Two reasons. Baby teeth hold space for the adult teeth coming in behind them — lose one early to decay and the neighbouring teeth drift into the gap, which is how crowding starts. And an infection in a baby tooth sits directly above the developing adult tooth, which can be damaged before it ever erupts.

X-rays also show what is not yet visible: whether the adult teeth are there at all, and whether they are pointing the right way. Some children are missing adult teeth entirely, and it is far better to know that at seven than at twelve.

Decay you cannot see

A dentist examining your child's mouth can see the chewing surfaces clearly. What they cannot see is between the teeth, where the surfaces touch. In children with tight contacts, that is exactly where decay tends to start.

This is the main reason for bitewing X-rays. A cavity found between two teeth early is a small filling. The same cavity found when it hurts is often a much larger procedure on a frightened child.

The radiation question, honestly

Digital sensors need a fraction of the exposure that old film required, and the dose from a set of digital bitewings is very small — a small share of the natural background radiation everyone receives from the environment over a year.

That is not the same as saying it is nothing. The professional standard is to take the images that are needed and no more, and to shield the child during exposure. If you want a specific dose figure for the equipment being used, ask — your dentist should be able to tell you.

How often is right?

There is no universal schedule, and be a little wary of any practice that applies one automatically. Frequency should follow your child's actual risk:

• Lower risk — no history of cavities, well-spaced teeth, good home care. Images less often.
• Higher risk — previous decay, tight contacts between teeth, or difficulty with brushing. Images more often.

Risk changes over time, in both directions. The interval should change with it.

What to ask

You are entitled to ask these every time, and the answers should be specific:

• What are you looking for with this X-ray?
• What would change about the treatment depending on what you see?
• What happens if we wait six months?

You can decline. If you do, ask what signs to watch for at home in the meantime.

If you are in Pacifica

Dr. Sepi Vafi sees our younger patients and welcomes parents into the room for the whole appointment — including the conversation about whether an X-ray is needed.

Call (650) 738-2100. More about children’s dentistry