How typical are preventative dental xrays for kids?

December 15, 2012 12:27 PM

Our kids' toothologist dentist would like to take x-rays to look for cavities. Is this typical?

Our three year old toddlers had their first dentist visit recently. The dentist comes highly recommended and we liked her; the visit went well. I was taken aback, however, when the assistant mentioned they would like to take xrays at the next visit "to look for cavities." It was explained to us that there was not enough space between some of our kids molars to allow a visual inspection for cavities. There have been no toothaches or other symptoms and the kids' dental health was judged overall to be excellent.

So...I guess I'm just leery of head x-rays and want to be sure this is standard practice. I know from other AskMes that dentists vary in how aggressively they pursue cavities. Is our dentists recommendation typical?

posted by werkzeuger to health & fitness (23 answers total)

X-rays for cavities has been my experience as a young adult. Can't vouch for the 3-year-old part of it, though.
posted by too bad you're not me at 12:28 PM on December 15, 2012 [1 favorite]

I've had X-rays for cavities once a year for as long as I can remember, so at least since I was 5 or 6 (my memory doesn't extend to when I was 3, however).
posted by smangosbubbles at 12:31 PM on December 15, 2012 [3 favorites]

Sounds unusual, although the occasional x-ray won't do any harm.

You like the dentist. She's been recommended. I'd say go along with it for now, and see what your gut says after a few visits.
posted by pipeski at 12:32 PM on December 15, 2012

From my own parenting experience: starting at age 3 all of my children have gotten dental x-rays yearly. Sometimes the dentist will come across a small cavity that they want to "keep an eye on." And then there are some cavities that do need to be taken care of soon.

You do not want any dental problems to get to the toothache stage before addressing them, hence the x-rays.
posted by Sassyfras at 12:33 PM on December 15, 2012 [2 favorites]

I've consistently had X-rays both for cavities and to check that my teeth are coming in correctly (I'm in my 20s and my wisdom teeth still haven't reared their ugly heads yet) since childhood. I had to have cavities filled because of what was apparently a genetic mutation affecting the formation of my teeth (not an issue with hygiene, no pain/other symptoms); this was not detectable without an X-ray.
posted by capricorn at 12:34 PM on December 15, 2012

This article gave me a lot of information when I was worried about the same thing. After reading, I did ask our pedi dentist (and then the orthodontist) about the type of x-ray equipment he uses.

My kids have had a very small handful of x-rays over the years (like once every 2 years). They not only check for cavities, but also for tooth development, which actually became a small flag to follow for my younger kid.

As an aside, it was a huge thrill (for a sentimental fool such as myself) to see those x-rays and the adult teeth forming.
posted by mamabear at 12:35 PM on December 15, 2012 [2 favorites]

Oh, and we did find an orthodontist who doesn't use the cone-beam CT machine. Our dentist actually doesn't like them either.
posted by mamabear at 12:37 PM on December 15, 2012

I've had annual x-rays at the dentist for all of my toothed years.
posted by something something at 12:45 PM on December 15, 2012 [1 favorite]

Totally normal. Cavities are holes in the enamel only; they don't hurt. I have lots (just luck of the draw... I brush/floss/flouride mouth wash daily and it keeps them away 99% of the time... so my overall dental health is good too).

They DO however continue to deepen and get worse - by the time it hurts, the interior of your tooth (the tissue/nerve ending part) is infected, and you're looking at a root canal or pulling the tooth (pain + expense). So yeah - x-rays are normal, and filling small cavities is good. I think now they use some sort of white plaster stuff for filling, rather than silver (traces of mercury?). Also, FWIW, having fillings done, while kinda uncomfortable, doesn't really hurt (or rather, doesn't have to if they're gentle). My dentist when I was a kid gave us a little laughing gas =).

Honestly, the most painful part is when they're careless and pinch your non-anesthetized lip between their hand and your teeth. I hate that.

Good luck! (Always glad to see parents taking their kids to the dentist!!)
posted by jrobin276 at 12:48 PM on December 15, 2012

Ask them about their machines. The newest ones for dental work are so sophisticated they could only be technically called X rays. I just had an x ray a couple of days ago and the image was up on the screen within minutes with the fancy new machine they had which moved around my head. I didn't even need to take off eyeglasses, necklace etc that they used to make me do whereever the older "X Ray" machines are still being used.
posted by infini at 12:50 PM on December 15, 2012

Thanks for all the input so far. I'm getting the impression that annual x-rays are pretty common.

infini, you might want to check out that NYT piece mambear linked to...
posted by werkzeuger at 12:52 PM on December 15, 2012

The age at which we begin to take xrays to see what we want to see varies. Cooperation from the pt is a large factor, as is the spacing between teeth. the risk from the very small xray exposure is considered much much smaller than the risk from untreated caries.
posted by OHenryPacey at 12:53 PM on December 15, 2012 [1 favorite]

Are you a dentist OhenryPacey? If so, (and I know you are not my dentist, etc.) do you have an opinion about the imaging technology article that mamabear linked to?
posted by werkzeuger at 12:57 PM on December 15, 2012

I don't know what age X-rays start, but otherwise totally normal. The kids will have some of those molars for quite a while, so addressing cavities with prophylaxis (improved flossing, brushing) or treatment (fluoride, fillings) is important. The dentist cannot see developing cavities visually between teeth, hence X-rays.
posted by zippy at 12:59 PM on December 15, 2012

I took my 3 and 5 year old to a pediatric dentist earlier this year, and she wanted to x-ray the 5 year old but not the 3 year old. 5 year old wasn't ready, so we decided to do it next visit (which is due now), so we could talk to him about it first. I'm not sure if she waits til age 5 for co-operation reasons, or if the teeth spacing on my 5 year old made it harder for her to get a good look.
posted by Joh at 1:02 PM on December 15, 2012

First xrays at 3 are entirely typical, and since s/he's already done a visual inspection and told you that there's places that can't be seen.... In addition, the xrays will also allow the dentist to see how the permanent teeth are forming. (both of my kids got baselines at 3, then at 18month intervals until they were 10, and now they get them annually.)

Cavities *don't* hurt until they get too deep for filling. Even toddlers can have cracks or cavities that need to be filled.
posted by jlkr at 1:08 PM on December 15, 2012

Annual ones definitely seem to be normal practice. I think I've had at least one every year since I was 6 or 7. (Probably more in the time just after I smashed my face into the ground and busted out a couple of front teeth.)
posted by brennen at 1:34 PM on December 15, 2012

At this point I'm pretty comfortable marking this resolved; the consensus seems to be this is well within the realm of typical. Thanks everybody! If you have something to add I'd be happy to hear it, of course.
posted by werkzeuger at 1:53 PM on December 15, 2012

I just had a chat w/ my dentist about the x-rays she uses this week. I've worked with X-ray machines professionally in the past, and it inspired me to learn more about what sources of exposure I have. It was really great, because she (and the hygienist, who I talked to first) were really clear about their commitment to reducing radiation exposure and using the safest technology possible. There are some advances in the last few years that made a massive reduction in the amount of x-ray exposure... but your dentist needs to have made the investment to get the new system, and needs to show that they're taking all the necessary precautions to protect their patients as much as possible.

Anyone who just says, "Don't be ridiculous, of course it's safe!" and tries to brush off your concerns about radiation - rather than explaining what they're doing and the ways they try to protect patients - would send up red flags for me, that at least you should do some research into different types, find out exactly what kind your dentist is using, etc. However, dental x-rays of SOME sort are routine and recommended, and I think folks above make some great points about the benefits.
posted by Lady Li at 2:13 PM on December 15, 2012 [1 favorite]

Yes. I pm'd you.
posted by OHenryPacey at 3:12 PM on December 15, 2012

There are some advances in the last few years that made a massive reduction in the amount of x-ray exposure... but your dentist needs to have made the investment to get the new system, and needs to show that they're taking all the necessary precautions to protect their patients as much as possible.

These are digital xray sensors instead of the little pieces of film jammed in your mouth. They are able to provide better resolution, quicker, and at vastly reduced levels of exposure. There is no longer any need to put on the lead apron, or even for the operator to go hide in the other room. It is amazing.

And just chiming in to say that a cavity won't hurt until it is infected. That sucks for anyone, but I suspect could be quite damaging for youthful jaws that still have to grow adult teeth.
posted by gjc at 3:54 PM on December 15, 2012 [1 favorite]

I started taking my 5 year old to the dentist when she was 3. Only at her most recent visit, when she had just turned 5 did they want to take x-rays of her teeth. In fact, one of the ladies said, "Since she is 5 now, we would like to take some x-rays, is that ok?" which made it seem like they just don't do it for kids younger than that. At least at that particular office.
posted by fancyoats at 5:53 PM on December 15, 2012

I have an X-ray everytime I go to the dentist. Ttotally normal to me and I wouldn't think twice if any dental professional asked to X-ray a 3yo.
posted by Under the Sea at 12:47 AM on December 16, 2012