The Specialist

Why x-rays are necessary

Patients often think about x-rays more than the dentist does. At Center for Specialized Dentistry, patients often ask the following questions: “What did the x-rays show?” or “Is anything wrong?”

The purpose of x-rays, in general, is to visualize evidence of disease (pathology) that we cannot feel or see with the naked eye. Also, we want to confirm our suspicion or enhance our vision in a particular area.

Properly evaluating x-rays depends on three factors: the quality of the x-ray; the ability of the x-ray to actually detect the problem; and the ability of the doctor to see the disease process and to accurately read the findings on the x-ray.

Today, the quality of x-rays is very good because of digital x-rays, which allow the image to be magnified to give the dentist greater visibility; more importantly, the patient is able to visualize the image on a tablet or large screen.

How x-rays work

The x-ray beam penetrates the structures of the tooth and bone to show the image. Therefore, the harder the substance, the whiter it shows up on the x-ray. In the mouth, the enamel, which is the hardest biological substance on earth, shows up as a lighter image. On the other hand, since dentin is softer, it appears grayish on the image. However, the pulp of the tooth, which is soft, appears darker. The pulp houses the nerve and blood supply to the tooth. Also, decay or bone infection, appear dark because the diseased area is soft or is filled with pus.

Metals, however, seen in crowns (caps) or some fillings, also show a very whitish image because the x-ray beam cannot penetrate metals. This means, anything behind the metal structure cannot be seen clearly on a regular two-dimensional image, like a peri-apical or bitewing image.

A 3D Cone Beam dental scan shows multiple images in different planes. It is better for identification of disease or pathology. The 3D scan allows the specialist to see the correct volume and thickness of bone or soft tissue, which is critical for assessing the bone volume for a dental implant. Therefore, proper examination of the x-rays and CT scan come with considerable training and experience, which enables the dentist to give an accurate diagnosis and effective treatment planning.

Safety of x-rays

While dental X-rays do involve radiation, the exposed levels are so low that they’re considered safe for children and adults. If your dentist uses digital X-rays instead of developing them on a film, your risks from radiation exposure are even lower.

In modern dentistry, use of the digital x-ray is a paradigm shift. Not only does it assist with diagnosing pathology but more importantly, the patient has a visual appreciation as to what is going on in their mouth. This is important because the patient can be an active participant in their diagnosis and treatment with their dentist.

Recently, a patient came to my office with considerable discomfort because they suffered from wearing a poorly fitted lower denture. They were discouraged with dentistry because they were advised that they were not a good candidate for lower implants. The patient felt helpless and dejected.

As a part of the comprehensive examination, a CT scan was taken. After assessing the precise location of the important structures on the lower jaw, we were able to assist the patient by placing four dental implants. Today, the patient is happy with their new teeth.

X-rays are a reliable asset to the dentist, thus providing great service to patients. Advanced imaging like a CT scan, along with an experienced and conscientious dentist, are a winning combination.

Remember, your dentist cannot treat what they cannot see and do not know.

Next issue: Gum diseases: How do you get it?

• Dr. Kendal V. O. Major is founder and CEO of Center for Specialized Dentistry, a comprehensive family dental practice operating in New Providence and Grand Bahama. He is the first Bahamian specialist in gum diseases and dental implants since 1989. He is also a certified Fastbraces provider. His practice is located at 89 Collins Avenue; he can be reached at telephone (242) 325-5165 or

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