What could happen if I choose not to have dental x-rays?

Many diseases of the oral cavity (which includes the teeth and surrounding tissues and bone) cannot be seen when the dentist examines your mouth. An x-ray exam can help your dentist see the small areas of decay between the teeth and fillings; bone damage from a tooth infection or cyst; boneloss due to periodontal (gum) disease; developmental defects; some types of tumors; the effects of trauma; and the position on unerupted teeth in children and adults. If you choose not to have x-rays, you could prevent your dentist from finding and treating dental problems at an early stage. Ultimately, this can save time, money and unneeded discomfort and help prevent more serious health problems.

Dental x-rays are the road map that the dentist uses to diagnose a variety of oral diseases. Without x-rays conditions such as cavities, gum disease, fractured teeth, root canal infections and even cancer may go undetected. Early detection of oral health problems usually means less invasive and less costly treatment.

Many patients refuse dental X-rays for many reasons. They were recently exposed for a mammography, chest film or other diagnostic test - some just out of fear of being exposed to radiation. A dental X-ray is like electricity. It's either on or off. Dental X-rays are not radioactive; they do not build up over time in the walls or linger in the room. We can accept the fact that radioactive fallout from a nuclear blast or accident has definite health risks and consequences. Dental and Medical X-rays do have a risk but we cannot study or analyze the risk because it's unethical to expose human subjects to X-rays to determine how many dental X-rays will cause cancer.

A dental X-ray doesn't travel through the entire body. With lead shields and focused films the only area exposed is a couple of teeth or the jaw bones. Evidence Based Medicine has proven that animal studies are a start but a poor predictor of what actually occurs to humans. A laboratory rat can tolerate a much higher exposure to X-rays before exhibiting signs and symptoms to that exposure than we can.

The bottom line is we really don't know how much x-ray exposure is harmful but the risk is extremely low. It's good practice to determine if you are a high risk, medium risk or low risk patient for dental disease. In every case the lowest exposure time and only necessary images should be taken to do a proper exam. How much exposure to the sun is too much? Talk to your dentist and let them explain why dental X-rays are needed. The risk is much smaller than the risk of what a dental infection can do to your body.
Rita Medwid

You won't know the whole story. Your dentist can only give you part of the information that he sees from looking at your teeth and gums. But under the surface, there may be more problems and they will only worsen if neglected. Two thirds of your tooth is under the gum tissue and can't be seen clinically. With x-rays, the dentist can take care of the disease process earlier, so it will be less costly than if you had waited. Dental disease can harm your health, cause strokes and heart attacks, if left undiagnosed and untreated.

I think my Association and the previous 5 doctors answered this question well. What I would add is that patients have an absolute right to refuse x-rays. At the same time, dentists have the right to refuse treatment to a patient who does not allow x-rays that are thought to be necessary for treatment.

Furthermore, you cannot absolve the doctor of liability for not taking x-rays. In other words, you cannot promise to hold harmless any dentist for any damage done to you due to the refusal to allow x-rays requested by the dentist. If a dentist feels x-rays are necessary, it is ethically as well as medicolegally wrong for a dentist to perform treatment without those x-rays.

Having said that, some dentists take far more x-rays than do others. A dentist should be able to justify every radiograph that is taken. The anticipated benefit of the radiograph should outweigh the estimated risk. So if you have doubts, ask your dentist why an x-ray or series of x-rays is recommended. I don't think any dentist should have a problem answering that question.
If you choose not to have dental x-rays, you may not learn about a health problem until it has done severe damage or become increasingly difficult to treat.

Areas of decay show up as dark spots in x-ray images. A dentist may be able to see decay on an x-ray image that is not visible to the naked eye because it is hidden by a filling or is located beneath the gum line. An x-ray may reveal cracks in a tooth or show that teeth are not growing properly beneath the gum.

X-rays can be used to plan tooth implants, reveal signs of cysts and cancers, and check for bone loss.
Dental radiographs are an essential diagnostic tool for evaluation of your oral health. Even with a thorough visual clinical examination there may be conditions that can only be detected with radiographs. Radiographs are important for diagnosis of decay, periodontal disease, impacted teeth, missing teeth, endodontic problems, cysts, growths and many other abnormalities.

Although dentists, just as patients, want to minimize patient radiation exposure, the frequency with which radiographs are advised may vary depending on the condition of the patient's teeth including decay, frequency of decay detected and periodontal disease.

If you refuse dental radiographs, you may be asked to sign a form that states that you refuse radiographs and understand that diagnosis of your oral health is therefore limited. The dentist may also suggest that your treatment be provided elsewhere, because a complete examination and evaluation is not possible.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.