Introduction:
The dental X-rays of the mouth include the radiographic images of the jaws, teeth, and bones around the face and nose. These X-rays are classified as intraoral X-rays (inside the mouth) and extraoral X-rays (outside the mouth). These X-rays help in the diagnosis of many dental issues such as developmental or acquired deformities, dental diseases such as periapical infections, bone loss, periodontal issues, and traumas like fractures. There are different types of dental X-rays with different techniques for capturing them. It is one of the most traditional and economical ways of diagnosis compared to computed tomography.
What Are X-Rays?
X- rays are forms of energy that travel through solid objects and get absorbed by them. X- rays are absorbed by dense tissues such as bones and teeth, which then appear as white or light-colored areas in the images. Whereas the areas which do not absorb the X-rays, appear dark. It helps to diagnose the deformities which are not visible clinically. It also helps to evaluate the presence of fractures. X-rays also help in the early diagnosis of many diseases such as pulpitis or tumors, which can be treated initially to prevent more complications.
What Are The Deformities Detected By X-Rays?
X-rays help to identify the following problems in the oral cavity and the face:
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Initial decaying of the tooth, which is generally not visible clinically.
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Proximal carious cavities between two teeth can be difficult to locate clinically due to intact junctions between the teeth.
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Secondary caries is developed beneath an existing filling or restoration.
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Infection or changes in the canals of the root or the bones due to infection.
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Positions or alignment of teeth in the jaws is helpful in orthodontic and prosthetic dental procedures.
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To look for abscesses in the periapical regions of teeth.
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In cases of sinus openings in the gums, X-rays help to trace the path of the sinus.
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In cases of impacted teeth (especially third molars and canines), X-rays help to know their location and angulation. This helps in planning disimpaction surgery.
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In children, X-ray helps to trace caries formation, the status of erupting teeth, and the presence of supernumerary teeth.
What Are Different Types Of X-Rays?
Initially, there were two main types of X-rays, they are:
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Intraoral X-Rays: These cover the area inside the mouth (oral cavity), including the teeth, gums, and jaws.
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Extraoral X-Rays: These cover the area outside the mouth, including the cheekbones, chin, nose, orbital region, and frontal region of the face.
Intraoral X-rays are further divided into different types of X-rays such as:
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Periapical X-Rays: These are also known as IOPA (intraoral periapical radiograph). These X-rays cover one portion of teeth in the jaw with their images from crown to root ends (apex) and the region below the apex (periapical region).
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Occlusal X-Rays: These help to track down the occlusal placement and development of an entire arch of teeth in either the upper or lower jaw.
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Bitewing X-Rays: As the name suggests, the X-rays are taken by asking the person to bite a block between a set of teeth. This kind of X-ray helps to trace the teeth of both the jaws in occlusion relation. It helps to detect decay between the teeth and the changes caused in the bone width between the teeth due to gum disease. These X-rays also help to see the proper placement of the prosthesis crown on the tooth (especially the proximal region).
Extraoral X-rays are also divided into different types of imaging techniques depending on the positions and area captured:
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Panoramic X-Rays: This helps to show the complete mouth area, including all the teeth, both the jaws till the ramus, and the maxillary posterior region on a single X-ray image. These X-rays help to see everything, such as the position of erupted teeth, impacted teeth with their angulation, periapical abscesses in any region if present, and the presence of any cyst or tumor in the jaw. These X-rays are very significant in orthodontic treatments to study the movement and alignment of the teeth. The most commonly advised panoramic X-ray by doctors is OPG (orthopantomogram radiographs).
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Tomograms: This helps to show a specific layer or cross-section of the mouth and blur out other regions. These X-rays are a little difficult to see as the surrounding blur region blocks the view.
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Sialogram: The images inside the salivary glands are seen with the help of a dye that is visible in the X-rays. However, normally it is not possible to view the salivary glands in an X-ray. It helps diagnose the presence of any salivary stones or blockages in the glands and diseases such as Sjogren’s syndrome.
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Cephalometric Projections: It shows the lateral view of one side of the head. These X-rays help to see the relation of teeth with the jaw and the facial profile of an individual. These X-rays are used by orthodontists to develop each patient's specific teeth alignment.
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Dental Computed Tomography (CT): It is a type of imaging technique that helps to look at the interior structures in a 3-dimensional view. This imaging technique is used to investigate problems such as cysts, tumors, or fractures in the bone.
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Cone Beam Computed Tomography: It is a type of X-ray that also helps to see the three-dimensional images of teeth, jaws, soft tissues, and nerves. This imaging technique is used as a guide for implant placement and evaluation of any cyst or tumor present in the oral cavity. The techniques used in dental computed tomography and cone-beam computed tomography are different.
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Digital Imaging: It is a recently advanced technique in which the images are sent directly to a computer. This technique saves a lot of time and chemical exposure which takes place while developing and fixing an X-ray image manually.
Are X-Rays Safe?
The amount of radiation emitted from the X-rays is extremely less compared to other body parts; still, it is advised to prevent unnecessary exposure to X-rays. The health
care professionals or doctors who frequently take X-rays should wear a lead apron while exposing themselves to X-ray machines.
Conclusion:
Dental X-rays are an important part of the diagnosis of any dental issue such as caries, fractures, periapical infections or cysts, and tumors of the jaw. These X-rays also help to plan treatments such as orthodontic procedures, prosthetic placements such as implants and crowns, or surgeries such as disimpaction. It is advised to get an X-ray done only on the advice of the dentist as unnecessary exposure to X-rays can be dangerous for an individual.
