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Tooth Squad

Extra X-Ray?

Tuesday, March 15, 2005; Page HE02

The Question On top of other routine X-rays, does every dental patient need the panoramic X-ray that many dentists recommend having taken every two to seven years? Given the added radiation exposure and the extra cost (the panoramic view runs patients about $74), Lida Radfar, assistant professor of oral diagnostic sciences at University of Buffalo School of Dental Medicine, wondered whether most patients could get by with just a full set of images of the individual teeth (known as periapical X-rays).

The Findings Radfar and colleagues searched 1,000 panoramic X-rays of 536 women and 464 men (average age 52) for abnormalities missed by periapicals and bite-wings (X-rays that focus on the biting end of a top and a bottom tooth). Radfar said only about two dozen abnormalities appeared that would not likely have shown up on periapical images. Radfar presented her findings last week at the International Association on Dental Research meeting in Baltimore.

() J. Cavallini/custom Medical Stock)

The Big Picture Radfar says panoramic X-rays are useful when looking for certain cancers or for abnormalities in bones, but "we should select X-rays based on the particular patient's condition" rather than administer them routinely. That stance is in keeping with American Dental Association (ADA) policy, which calls for adapting X-ray use to individual patients' needs and keeping radiation exposure to levels "as low as reasonably achievable," in part by X-raying only when necessary.

Chew on This But Lawrence Wolfgang, director of radiology at University of Buffalo School of Dental Medicine, said that while they're harder to interpret than other images, panoramic X-rays "show everything in front of the ear and below the eye -- a lot of structure we wouldn't see otherwise." The panoramic shot has documentary value, Wolfgang added: The U.S. military keeps panoramic X-rays on record to identify people killed in action.

-- Jennifer Huget

© 2005 The Washington Post Company


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