How often are xrays taken and why? – OPG

OPG or panoramic X-rays are great for an overall assessment of the entire mouth, bones, sinuses and jaw joints of new patients. In other words it can be used as a screening tool for a person’s first visit. A lot of information can be obtained including which teeth have been nerve treated or have infections, missing teeth, bone levels around teeth and implants, shape of teeth and roots, position of wisdom teeth.

For children an OPG is important to determine the presence and position of erupting teeth. This is usually indicated if there is delays in teeth coming through, there is crowding, or jaw shape issues. This may need orthodontic treatment. This OPG is usually taken at about 8 years old at the mixed dentition stage. This is where the baby back teeth and canines and new front teeth plus 6 year old molars are present.

For young adults, ideally an OPG is taken at around 18 years. This is to determine the presence and position of third molars. This is important for lower molars in relation to the nerve trunk lying within the jaw bone and how much bone surrounds the tooth. This helps determines the risk in wisdom teeth removal. In the upper molars where they in relation to the sinus is helpful to know.

Gum treatment which needs regular monitoring of bone levels OPG x-ray can be taken yearly in some cases.

Jaw joint shape and position in opening and closing can be shown in particular views of an OPG.

Some Sinus views may prompt a referral to an Ear Nose and Throat specialist. The position of the sinus is important to the planning of implant placement in the upper jaw.

People who have a strong gag reflex may have trouble with an x-ray sensor in the mouth. So an OPG allows some information and is kinder to the patient.

Any changes to the shape of the jaw bone or history of trauma to the jaws, an OPG is ideal to aiding diagnosis. However, the image is 2D and in the middle, where there can be an overlap of structures such as the spine, blurring may occur.

Generally if there is a history of problems then a shorter frequency is needed. However, if there are no symptoms or history then every five years an OPG can be taken for screening purposes. The great advantage of the digital world is the image can be magnified, measured and manipulated. If needed, it can be e-mailed to a specialist. Of course there is the opportunity to show patients the glory of their “inner face” on the monitor.

Next week: The things that dentists wear – not just a smile.