Parents ask us about dental x-rays more than almost any other topic before their child's appointment. The question usually comes up during a consultation, right before we plan dental treatment. Are dental x-rays safe? How often does my child actually need them? What happens if I say no?
These are the right questions to ask about your child's dental care. Here is what the evidence shows and how we handle pediatric dental x-rays at our Stonecrest office.
A visual exam can only show the surfaces your child's dentist can see directly. Dental x-rays reveal what is happening between teeth, below the gumline, and inside the jawbone. For children, that matters because their mouths change fast as baby teeth fall out and permanent teeth develop underneath. The benefits of dental x-rays come from catching dental problems early, before they become painful or complex.
Dental radiographs help identify:
A tooth can look perfectly healthy on the outside while hiding significant decay on the side pressed against its neighbor. Bitewing x-rays catch exactly this kind of hidden cavity, often while it is still small enough for a simple filling. Without imaging, decay between teeth can spread to the nerve and turn a small problem into a pulpotomy or extraction.
Radiation exposure is the core of most parents' concern, especially for children. The numbers are worth looking at directly.
A single digital bitewing x-ray exposes your child to about 0.001 millisieverts (mSv) of radiation. For comparison, the average American receives about 3.1 mSv of background radiation per year from natural sources like soil, air, and cosmic rays, according to the National Council on Radiation Protection and Measurements (NCRP Report No. 160). A standard set of four bitewing dental radiographs delivers roughly 0.004 mSv. That is less radiation than your child receives from a single day of normal environmental exposure.
The American Dental Association and the American Academy of Pediatric Dentistry both support dental x-rays for children when a clinical reason exists. Neither organization recommends x-rays on a fixed schedule for every child. They follow the ALARA principle: As Low As Reasonably Achievable. The goal is to use the lowest radiation dose that still produces a diagnostically useful image.
Digital x-ray technology has reduced radiation exposure compared to traditional film. Digital sensors need less radiation to produce a clear image, cutting the radiation dose by up to 80% compared to older film-based x-ray procedures, according to the ADA. Modern dental x-ray equipment produces low levels of radiation that are safe and effective for diagnostic purposes in pediatric patients.
Your child's dentist selects the type of x-ray based on what they need to see. Dental x-rays fall into two categories: intraoral (sensor inside the mouth) and extraoral (sensor outside the mouth). Understanding the different types of x-rays can help you feel informed about what dental professionals recommend for your child's oral health.
Bitewing x-rays show the upper and lower teeth in a single image, focused on the areas where teeth touch. They are the most common type for detecting cavities between teeth in children and the ones most pediatric dentists recommend at checkup visits.
Periapical x-rays capture a full tooth from crown to root, including the bone around it. Dentists use these when they suspect infection or need to evaluate damage to a specific tooth.
Occlusal x-rays show a broader view of the upper or lower jaw. They help track dental development and spot extra or impacted teeth in younger children.
Panoramic dental x-rays produce a single image of the entire mouth: all teeth, both jaws, and the sinuses. A panoramic x-ray delivers a slightly higher radiation dose than bitewings but is still well within safe limits. These extraoral x-rays are useful for evaluating overall dental development, checking for developing wisdom teeth, and planning orthodontic treatments.
Cone beam CT scans create three-dimensional x-ray imaging of teeth and jaw structures. They are reserved for specific diagnostic needs and are not part of routine dental radiography for children.
There is no single answer. The frequency of dental x-rays depends on your child's individual risk of tooth decay and their stage of dental development.
The ADA and AAPD guidelines recommend different intervals based on risk. Children with a higher risk of tooth decay (visible cavities, crowding, or poor oral health) may need bitewing x-rays every 6 months. Children with a low risk of tooth decay and no active dental problems may only need them every 12 to 24 months.
A child's first dental x-ray is typically recommended when the back baby teeth start touching each other, usually between ages 4 and 6. Your child's dentist may recommend x-ray imaging earlier if they notice signs of decay or developmental concerns during a visual exam.
Every x-ray should have a clinical reason behind it. The need for x-rays varies from child to child. If you are unsure why imaging has been recommended, ask your child's dentist to explain what they are looking for and how the results will change your child's dental treatment plan.
The primary risk of radiation from dental x-rays is cumulative exposure over time. Children's tissues are more sensitive to radiation than adult tissues, which is why pediatric dental care uses every available measure to keep doses minimal.
At the exposure levels produced by modern digital dental radiographs, the risk is extremely low. The amount of radiation from a full set of bitewing x-rays is smaller than the background radiation your child absorbs in a single day. The ADA, AAPD, and FDA all agree that dental x-rays taken for valid clinical reasons, with proper shielding, pose minimal risk to children.
The greater risk often sits on the other side: dental problems that go undetected. Untreated tooth decay can lead to infections, abscesses, damage to developing permanent teeth, and pain that interferes with eating and sleeping. In pediatric dentistry, catching decay early through x-rays typically means simpler, faster dental treatment for the child.
Dental professionals follow specific protocols to minimize radiation exposure, especially for children.
Lead aprons and thyroid collars shield the body and thyroid gland during x-ray procedures. The thyroid collar matters for pediatric patients because children's thyroid glands are more sensitive to radiation than adults', according to the AAPD guidelines on pediatric radiology.
Digital sensors reduce the amount of radiation needed per image. At our Stonecrest office, we use digital radiography for all dental x-rays of children referred to us.
Rectangular collimation narrows the x-ray beam to the size of the sensor, reducing scattered radiation that reaches your child's body. The FDA recommends rectangular collimation as a best practice for dental radiation protection.
These measures work together. A child getting four digital bitewing x-rays with a thyroid collar and rectangular collimation receives a fraction of the radiation dose that the same images would have delivered 20 years ago.
Yes. You always have the right to decline x-rays or any other dental procedure for your child. But it helps to understand what your child's dentist may miss without them.
Decay between teeth is invisible to the naked eye until the cavity is large enough to cause pain. By that point, a simple filling may no longer work. The tooth may need a crown, a pulpotomy (nerve treatment), or extraction. For younger children who cannot sit through lengthy dental work, more extensive dental treatment sometimes means dental sedation to complete everything safely in one appointment.
At Pediatric Sedation Center of Georgia, we regularly see kids whose dental problems grew more complex because early decay went undetected. An x-ray that catches a cavity at age 4 can prevent a crown or extraction at age 5. Skipping dental x-rays for kids does not eliminate the problem. It delays the diagnosis.
We will never pressure you into imaging your child does not need. But when Dr. Todd Asarch recommends x-rays, it is because the clinical situation calls for them and the results will directly shape your child's dental health going forward.
When a child comes to our office for pediatric dental sedation, x-rays are part of the planning. We need a clear picture of every tooth and every area of decay before the appointment so the entire treatment can be finished in a single visit.
Most children referred to us arrive with recent x-rays from their pediatric dentist. If those images are adequate, we use them and do not repeat the imaging. If the children's dental x-rays are outdated or incomplete, we take the specific views needed using digital x-ray technology at our Stonecrest office.
X-rays taken before sedation help us plan the number and type of procedures, estimate how long the appointment will take, and catch dental problems that a visual exam alone would miss.
Some children with dental anxiety struggle to hold still for x-rays at a regular dental office. For those kids, sedation makes it possible to get the images and complete all dental treatment in one visit without the stress of repeated attempts. If your child has avoided dental care because of fear or difficulty cooperating, read about when sedation may be the right option.
If your child's dentist recommends x-rays, consider asking:
A dentist who takes pediatric dental care seriously will welcome these questions and explain exactly why each image is needed for your child's oral health.
If you have questions about your child's dental health or want to discuss whether your child may need treatment under sedation, call us at 470-395-2524 or visit our contact page to schedule a consultation. We accept Georgia Medicaid plans and most PPO insurance plans.
