It always amazes me when patients come in for an examination but he or she says “I don’t want any X-rays”. If we sit back and think for a minute, what would the doctor say when a patient shows up with a broken arm and said “Doc, I want you to fix my arm but I don’t want you to take an X-ray”. He would probably say “I don’t know the extent of the damage to your arm and I won’t be able to recommend the best treatment”. Essentially he doesn’t have enough information to treat the patient appropriately. He can guess but would you want your doctor to guess or do you want your doctor to know?
Time and time again we get caught for not gathering all the information before performing treatments which lead to less than ideal results at best and causing patients serious injuries at worst. Here are the 4 reasons.
1) Not doing so can put patients in serious risk of injury.
Here is a scenario. A patient goes to see a dentist with a completely broken down tooth. It was obvious to both the patient and the dentist that this tooth needed to be extracted but the dentist did not take an X-ray film of the tooth. After trying to take out the tooth for 45 minutes, the tooth didn’t seem to budge and the dentist took a radiograph. He then finds out that all the roots were curved and weren’t going to come out without removing some bone. Furthermore, the roots were wrapped around a nerve in the jaw. If the damage was done to the nerve, the patient could experience permanent numbness of the lower lip.
2) Certain conditions may not cause pain but require treatment.
Here is another scenario. A patient comes in the first time for a check-up. After looking into the mouth and taking 2 small (bitewing) radiographs to screen for decays, it appeared that everything was fine. Six months later, patient comes back with swelling on her face. After taking a large X-ray film (OPG), they found out the tooth had an infection all along. The nerve inside the tooth died from being heavily filled, not from an active decay, which is why it wasn’t picked up on the small films. Incidentally, the large X-ray film also showed a large painless tumour growing in the jaw.
3) Dentists cannot practice conservative dentistry without them.
Dentists don’t have X-ray vision like Superman and until we do, we can’t see all that well between teeth or underneath the existing fillings. After many years of research, we realised that tooth decay is a slow going process and not all decays need to be filled. Early small decay can be arrested if not reversed but it requires timely detection. Finding out decay early means patients can be informed on how to manage the problem without “drilling and filling”. If fillings are required, they are often smaller and painless to do.
4) It costs patients MORE if the X-ray films weren’t taken.
This topic deserves a whole blog entry in itself. Stay tuned for the next blog “Why it costs you more by not taking dental X-ray films”
To find out more about dental X-rays, please go to the patient information tab and type “Understanding Dental X-ray” in the search box.