Dentists push x-rays because they want to provide comprehensive care, protect themselves from liability, and also for forensic odontology purposes. The first two reasons you may have guessed but forensic dentistry probably escaped you.
You may think that your dentist is pushing radiographs on you but they're really trying their best to do good for you and to protect themself.
Of course, you can always decline to have your xrays taken. Although at the end of the day the radiation isn't harmful by any appreciable means.
Why dentists take xrays
The reasons that dentists recommend taking x-rays is to provide you with comprehensive care, protect themselves from liability, and also for forensic odontology.
Comprehensive care
If your dentist is to provide you with a comprehensive check up, they will need to take x-rays. There is only so much that you can see with your naked eye. A lot of oral conditions occur from within the tooth, on the tooth root, or even inside your jaw bone.
Examples of disease and conditions that require x-rays for diagnosis:
Cavities in between the teeth.
Periapical abscess.
Impacted wisdom teeth.
The three images above are x-rays which show these three conditions. They can only be visualized on the radiograph because if you look in the mouth, the teeth will look perfectly normal as if it had no pathology.
In summary, if something is ailing you your dentist will need a supplementary x-ray in order to give you a proper diagnosis. Without a radiograph, they would simply be guessing as to what is wrong with your tooth.
Liability protection
It pains us to say this but in this day and age, society is very litigious. In order for dentists to protect themselves from such claims, they must provide thorough evaluations of your mouth.
Unfortunately this equates to taking all of the x-rays possibile in order to rule out any bad outcomes. This issue isn't specific to dentistry because if you went to the hospital, you'll have x-rays, tests, and exams ordered to cover all of their bases.
Forensic odontology
There is a sub-specialty of dentistry called forensic odontology which the masses are unaware of. Yes, they are called forensic dentists and they do exist. If you're getting an image of CSI in your head, you are right on the mark!
"It plays a pivotal role in identifying the human remains of victims, not only those of mutilated, burnt and decomposed but also victims of bioterrorism and mass disasters. Catastrophic events have also underlined the importance of forensic odontologists in the identification of victims from industrial blows, airline accidents, natural disasters, and terrorist attacks including that of explosive, chemical, radiological or nuclear, and may occur as a solitary catastrophe or sweeping event."
To sum it up, if an unfortunate or catastrophic event occurs where the result is a bunch of dead bodies that have been mutilated or burned beyond recognition, a forensic dentist can help.
They can help identify these bodies using dental x-ray records.
Human skin and fingerprints can burn off or melt off chemically but typically the teeth will survive. Dentists can compare x-ray records to figure out who the deceased individual is.
What happens
Have you ever wondered why insurance companies will usually cover dental x-rays once a year? It's so that we have a means of identifying you in case you get burned to death.
The more recent your x-rays are the more accurate it'll be in identifying you.
Your dentist's office will get a subpoena if there is suspicion that you may have been involved in one of these catastrophic accidents. The federal government or whoever is involved with the case will ask for the most recent set of x-rays.
The federal law mandates that these x-ray records need to be kept for a minimum of 6 years.
Adverse effects of x-rays
Dentists do abide by x-ray radiation regulations and recommendations such as ALARA (as low as reasonably achievable). That means your dentist will attempt to take the minimum amount of necessary radiographs.
Of course, when x-rays are taken in excess or unnecessarily, there can be adverse effects.
Side effects of excessive radiation:
Cancer later in life
Cataracts
Skin reddening
Hair loss
Amount of radiation in dental x-rays
You may be surprised but dental x-rays produce very low levels of radiation when compared to other types of medical xrays. As a reference point, the average American will receive a dose of about 0.62 mrem per year from just being alive.
To put it into perspective, here are some sample radiation doses for reference.
Type of X-ray | Radiation Dose (mrem) |
Pelvis | 70 |
Abdomen | 60 |
Chest | 10 |
Mammogram | 72 |
Dental | 1.5 |
Full body CT | 1000 |
If we do say so ourselves, getting x-rays of your teeth gives you the least amount of radiation. If you get a single full body CT, you've essentially received as much radiation as 666 years of annual dental check up x-rays!
Note: Just for the record, it is safe for nursing mothers to take x-rays. The radiation doses are very low and it also doesn't stay in the breastmilk.
Can I refuse x-rays?
You can always refuse to have your x-rays taken because your dentist can't force you to do anything that you don't want to do. However, you'll most likely need to sign a waiver which documents consenting to refusing radiographs.
You should know that by rejecting the x-rays, your dentist will not be able to provide a complete examination. What they can tell you will only be based on what they can visually see with their naked eye.
Risk for refusing x-rays:
Missing in between cavities.
Missing tooth abscesses.
Missing periodontal disease.
Without radiographs, you'll be undiagnosed or incompletely diagnosed by missing the above conditions.
The Verdict
Dentists aren't pushing x-rays on you for no reason. They do it to provide you with the best care possible. They also do it to protect themselves from liability issues. Last but not least, x-rays are a part of your dental records which are used for forensic dentistry
If you succumb to any sort of catastrophic event where your skin is burnt beyond recognition, you will need your x-rays to identify your body! As morbid as that sounds, it is a fact of life.
