Why do dentists take x-rays even prior to performing simple procedures?

Many patients are reticent about taking "needless" X-rays. This is understandable because research has show that the effects of radiation can be cumulative. That being the case, dentists often feel the need to take a radiograph or two in order to fully diagnose a problem, even if they strongly suspect the know what the problem is, but need to rule out other possibilities.

It is not that unusual for me to develop an opinion of what a patients problem may be prior to taking a radiograph. I may visualize a obvious cavity, a crack line, a superficial swelling in the gum or a fistula ( usually a sign of a draining infection), but I still feel the need to take a radiograph because experience has taught me that sometimes the nature of the problem is not entirely how it may appear from my initial hunch. Taking an x-ray tends to confirm or change my diagnosis. If the x-ray shows no pathology, that give information as well since it may rule out a bunch of possible problems and help narrow my choices since many types of problems are not evident during the viewing of x-rays ( many cracks, sensitivity from bruxing, some pulpal pathology....).

Sometimes during my initial clinical exam I see a problem like a cavity in a tooth prior to taking the radiograph and when I look at the x-ray I notice that an adjacent tooth has an even larger carious lesion and most likely is causing the patients discomfort.

A patient may come in and want some elective cosmetic bonding or bleaching done on their teeth and really doesn't feel that radiograph(s) are needed, Still I take any radiographs to document the prior condition and eliminate the possibility of an quiet pre-existing condition, since it is not uncommon for patients who experience discomfort after treatment to ascribe their symptoms to how the dentist performed the procedure. In fact when a patient comes in with pain in a quadrant I have worked on previously within the year they almost always assume their problem comes from the tooth that was treated. Sometimes it is and sometimes not. Having an x-ray from before treatment allows me to see problems on adjacent teeth and the x-ray can be compared with an X-ray taken when they come in with a problem. I an adjacent tooth has a visible problem but not before it will often show on the radiogaphs as well. So radiographs are important from a medical-legal aspect.

If a patient comes in but doesn't have any recent  x-rays that I may view,  I rarely deliver treatment , other than performing a cleaning and an exam. In fact performing any actual other treatments might be viewed as negligent if a patient develops a problem .





from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2019/09/why-do-dentists-take-x-ray-even-when.html - http://lspindelnycdds.blogspot.com/