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Dental X-Rays Part 2
by Dr. John F. Miller DDS SMILE MONTANA
The HOW, WHY, WHAT, & WHEN This last year my wife and I both turned 40 years old. To celebrate this milestone we wanted to do something that neither of us had done previously, and that was to visit the youngest state in this great nation, the State of Hawaii. We actually went with another couple and chose Maui based on their recommendation as they had visited Maui before. Now, just like everyone else who has never visited Hawaii, I have heard about it over and over from those who have been there before. “Oh you must go, it's incredible.” they would exclaim. In my head I couldn’t help but think, “is it really all that they say it is? Is it really that great?” I was worried that Hawaii had become...overhyped. Here is my assessment. Hawaii is grossly underhyped, well at least Maui is. It washed away all my suspicions. “Is the sand really that soft and white?” It’s softer and whiter. “Is the water really that clear and warm?” It’s clearer and warmer than I could have hoped!! “Are we really going to see Sea Turtles everywhere?” Sea Turtles were everywhere!! Seriously though, it was amazing and my advice is don’t let life pass you by before you decide to do that thing you’ve been wanting to do. Find a way to make it happen...it’s worth it I promise.
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One question that I have been asked a lot is about tourism and the traffic and crowds in Hawaii. To which I respond, “I live in Whitefish, Hawaii has way less tourists and traffic...per square mile.” Things have definitely changed around here eh? I think the pandemic simply accelerated the growth in this area and now even in our shoulder season I can’t turn left onto the 93. Still love it though, in my eyes the Flathead Valley is as shiny as ever and I feel lucky to be a member of this community and to raise my family here. Let’s get to the teeth stuff shall we. In the last article from September I discussed how I had written well over 50 articles for 406 Woman and I was going to dig into the fundamentals of dentistry to give the lay person a behind-thescenes look at our methods and the How-WhatWhy-& When we use them. I started with dental radiographs (commonly referred to as X-Rays) last time and realized it was going to require more than one article to lay a solid foundation for the reader. So anyway, last time we discussed the Bitewing dental radiograph and this article will focus on the Periapical dental radiograph.
The Periapical Radiograph
In contrast to the bitewing radiograph discussed last time, the periapical radiograph ideally captures the entire tooth in the x-ray. That is to say it shows the crown of the tooth (the portion of the tooth outside of the jawbone) and the root of the tooth (the portion of the tooth within the jaw bone).
WHEN do we prescribe and capture the periapical radiograph? There are two scenarios when periapical radiographs are helpful. The first of these occurs during a new patient radiographic evaluation. A full mouth series of radiographs consists of 14 periapical radiographs and four bitewing radiographs. And while they are very valuable from a diagnostic standpoint, they also serve as a baseline for that patient that can be referred back to. If you read the last article you’ll recall that bitewing radiographs are recommended annually while periapical radiographs are recommended to be updated every 3 to 5 years. The second scenario in which a periapical radiograph will be prescribed is during a dental emergency. This could be from trauma like an athletic accident, or it could be from pathology such as cavities or gum disease that is causing swelling or discomfort. The latter is the far more common of the two. Smile Montana likely sees close to 10 patients per day suffering from acute dental pain. We refer to these appointments as LOE’s because the dental code used is a D0140 referred to as a Limited Oral Exam.