Are Some Problems Not Detectable by Dental X-Rays?

Dental X-Rays are an important part of a dental health program, allowing dentists to detect tooth decay, abscesses, cysts, gum disease, bone loss, and root canal problems. There are several types of dental x-rays in use in North America. Most dental health problems can be detected by an x-ray; however, there are a few conditions that cannot be detected by an x-ray.

The bite-wing and periapical x-ray has been in use by dentists for decades. They give a close view of the teeth and the underlying root and bone supporting the teeth. They are most helpful in detecting decay on and between teeth. Newer are the panoramic x-rays, which give a whole-mouth view.

Panoramic x-rays will detect problems with the upper or lower jaw, the jaw joints, nasal sinuses and surrounding tissue, or the mandibular nerve. Oral cancer will not be detected with a bite-wing or periapical x-ray. The dentist is able to do a screening for oral cancer during a regular check-up, examining the cheeks, floor and roof of the mouth, and the surface and base of the tongue. Oral cancer will most often look like small lesions on any of those soft tissues.

Temporomandibular disorder (TMD or TMJ) is another condition that can be detected on a panoramic x-ray, but not the bite-wing or periapical. TMD is a condition related to the jaw. Often people suffering TMD hear a clicking or popping accompanied by pain when they open their mouths. It has many causes; arthritis, injury or stress. The muscles of the face often tense when we are under stress, and this pulls the muscles of the jaw taut, causing pain when using those muscles. TMD can also be a cause of headache or toothache. Sometimes it manifests as pain around the ear when chewing, neck, shoulder or back pain, or difficulty opening the mouth wide, or even dizziness.

Sinus problems can cause toothache, and will be visible on a panoramic x-ray. Your dentist will ask questions to help narrow down the cause of the pain, and avoid unnecessary dental treatment. Other oral conditions that will not be detected by x-ray are burning mouth or burning tongue, often caused by nutritional deficiencies, and facial neuralgia caused by damaged nerves to the face.

Bulimia experienced over a period of time can cause damage to the enamel of teeth because of the acids produced when purging. Oral infections such as mouth thrush will not show on an x-ray. Many of these conditions will be visible to the dentist while doing a routine exam, and a complete health history will be an important tool for the dentist when diagnosing problems in the mouth. Sometime tooth decay will not be seen on an x-ray, if it is on a surface at the back, tongue side of a tooth. Sometimes during scaling or root planing, a treatment for periodontal disease will reveal decay not visible on a routine x-ray.

Dental X-Rays are an important part of making sure that you do not have any serious or developing problems. It is important that everyone has dental X-rays as part of their dental care visit.