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How many dental x-rays do kids need?

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February is National Children’s Dental Health Month, the perfect time to take kids to the dentist for one of their regular visits.

But before parents do, Delta Dental encourages them to be well-informed about how often a child should have dental X-rays. Those X-rays are a valuable tool for finding problems in teeth and the bones surrounding teeth. However, all X-rays use ionizing radiation that can potentially cause damage. Though it is spread out in tiny doses, the effect of radiation from years of X-rays is cumulative. The risks associated with this radiation are greater for children than for adults.

“X-rays are an important tool for dentists to diagnose dental diseases. However, they do not need to be part of every exam,” said Dr. Bill Kohn, DDS, Delta Dental Plans Association’s vice president of dental science and policy. “They should be ordered only after the dentist has examined the mouth and has determined that X-rays are needed to make a proper diagnosis. In general, children and adults at low risk for tooth decay and gum disease need X-rays less frequently.”

The purpose of X-rays is to allow dentists to see signs of disease or potential problems that are not visible to the naked eye. They are usually ordered after the dentist has done a clinical exam and considered any signs and symptoms, oral and medical history, diet, hygiene, fluoride use and other factors that might suggest a higher risk of hidden dental disease. So be sure that your dentist checks your child’s teeth, health history and risk factors before deciding an X-ray is necessary.

Ideally, a dentist should adhere to the guidelines established by the U.S. Food and Drug Administration and the American Dental Association. The following information, adapted from those guidelines, gives a basic timeline for recommended frequency of X-rays by age group. Keep in mind that multiple factors such as the child’s current oral health, future risk for disease, and developmental stage determine need, and some children will require more X-rays, and some fewer.

Even though the individual risk from a necessary X-ray exam is quite small when compared to the benefit of aiding accurate diagnosis or guiding a treatment, dentists are encouraged to follow the ALARA principle, that is “As Low As Reasonably Achievable.” In other words, only order what is absolutely needed to make a diagnosis.

Age: Young children (ages 1 – 5), with no permanent teeth
First Dental Visit: Personalized exam which may consist of bitewing X-rays of back teeth (if no gaps exist between teeth that allow the dentist to examine the sides of teeth) and select individual (periapical) X-rays, usually of front teeth.
Routine recall visit with Active tooth decay or history of cavities (Increased Risk): Bitewing X-rays every six to 12 months
Routine recall visit with No active tooth decay or history of cavities (Low Risk): Bitewing X-rays every 12 to 24 months

Age: Older children (ages 6 – 12), with some or all permanent teeth: Personalized exam consisting of bitewing X-rays of back teeth and select periapical X-rays, usually of front teeth; or a panoramic X-ray.
Routine recall visit with Active tooth decay or history of cavities (Increased Risk): Bitewing X-rays every six to 18 months
Routine recall visit with No active tooth decay or history of cavities (Low Risk): Bitewing X-rays every 12 to 36 months

Age: Adolescent, with permanent teeth but no wisdom teeth: Personalized exam consisting of bitewing X-rays of back teeth and select periapical X-rays; or a panoramic X-ray; or a full mouth survey of X-rays (FMX) if evidence of widespread oral disease.
Routine recall visit with Active tooth decay or history of cavities (Increased Risk): Bitewing X-rays every six to 18 months
Routine recall visit with No active tooth decay or history of cavities (Low Risk): Bitewing X-rays every 12 to 36 months

Parents should follow recommendations of the child’s dentist and teach good oral health habits to children at an early age.

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