Dental X-rays for kids

[kmpls]

I took my kids to a recommended pediatric dentist this morning.

they wanted to do X-rays on the 5 yr old and then stated depending on the results (this being his 1st set) they would repeat every 6 months at worst or 1.5 years at best. Stating they usually do first set at age 3.

i understand doing a baseline or if there was a problem but I am not on board with routine radiation. The dentist gave me a hard time for refusing and stated if we didn't do them next time then basically we aren't welcome back. 

This just really sems over the top for small children with baby teeth. Today's visit before insurance was $500 for 2 kids to count teeth, fluoride, and dentist check. Our insurance is not good so, we will pay a lot of this out of pocket. 2 times per yr? Ouch, $1000 a yr seems steep.

do you get annual X-rays for your kids? Any mn peeps feel free to pm any dentist recs!

[speckledfrog]

Baby teeth get cavities, too. At the very least I would do them once a year.

[vlagrl]

no way to X-rays start at age 5?! Dang I was hoping it would be longer. We have delayed buying dental insurance for DD because it's too expensive and said we would start buying it when they X-ray her.

[Deleted]

sent, teeah22 any insight?

[alexis]

My FIL is a dentist and says the x rays they do now have very little radiation exposure. Did you bring up your concerns about radiation with the dentist. What did he say?

Unfortunately cavities are very common in young children. Perhaps you should discuss your concerns with your pedi as well.

[sent]

So I wasn't at your kid's appointment and I'm not their dentist, but my hunch based on interacting with pediatric dentists is the following. The dentist is doing bitewing x-rays at age 5 to look for cavities in between the back teeth, the baby molars. These are areas that can not be seen with the naked eye when the dentist does his/her examination. These baby molars will also be present in your child's mouth and be primary chewing surfaces for your child until around age 10 and even later. With at least 5 years to go, they can develop cavities and worse problems if they are not routinedly examined with xrays. Also, around age 6, your child's first permanent molars will start to grow in behind the last baby molar. So at age 7, the x-rays are not only to look for cavities between baby teeth, but also to make sure there are no cavities developing on the in-between surface where the new permanent molar touches the baby molar. As your child gets older in the 8, 9, 10 year old range, these bitewing x-rays also start to show what is going on underneath the baby tooth - does it look like the permanent tooth is growing in normally, is the permanent tooth not there when we expected it to be there, etc. These are the most common things dentists look for on x-rays in kids. There are less common pathologies that can show up on x-rays as well, but those rare pathologies are not the reason they are recommending them as often as they do.

They gave you a range of x-rays every 6 months to every 1.5 months depending on what they see on the first set of baseline x-rays. Perfect x-rays with 0 cavities, you probably go 1.5 years between sets. Lots of cavities or areas that look suspicious, you will be in the 6 month range.

Digital x-rays do have less radiation than film x-rays. We get more radiation on a daily basis from just waking up and living our daily lives than we do from a set of dental x-rays every 6 months.

I'm not surprised that they implied they do not want you to return if you don't agree to x-ray. It's a liability issue for them.

[thejackpot]

Glad they chimed in- is there a way that you can improve your dental insurance? My 6 yr old has had x-rays and I always view preventative measures as much less expensive then when there are issues.

[karinothing]

DS had his first dental x-ray at 3. I think they only do them once a year at this point, but I am not 100% sure. I am okay with this. They have less radiation and they REALLY cover the kids up with protective stuff. Anyway, I get being scared because my mom died of thyroid cancer after working in an xray office for 15 years. But from what I heard, dental xrays expose you to a very limited amount of radiation.

[wawa]

Sooooo...when did all these xrays become the standard of care? I'm just asking because I don't remember getting a set until I was more like...8? Old enough that I remember it clearly at least. If kids can have all these cavities hiding in their baby teeth - were we all just super lucky as kids that our teeth didn't rot out of our heads?

I know the "well back in my day" argument is a bunch of crap when medical science has improved since 30 years ago, but...no really...did they do this back in my day and I'm just not remembering?

[jeaniebueller]

WE have been doing yearly biting x rays since DS started going to the dentist a few years ago. I am not concerned about it.

[tres3]

Jun 30, 2015 7:16:34 GMT -5 wawa said:

Sooooo...when did all these xrays become the standard of care? I'm just asking because I don't remember getting a set until I was more like...8? Old enough that I remember it clearly at least. If kids can have all these cavities hiding in their baby teeth - were we all just super lucky as kids that our teeth didn't rot out of our heads?

I know the "well back in my day" argument is a bunch of crap when medical science has improved since 30 years ago, but...no really...did they do this back in my day and I'm just not remembering?

I always had xrays at least annually growing up. 

[ECB]

Jun 29, 2015 22:05:02 GMT -5 kmpls said:

Today's visit before insurance was $500 for 2 kids to count teeth, fluoride, and dentist check.

I thought MY dentist was expensive!  Hell.  $250 per kid for a basic checkup? 

 

[hopecounts]

Jun 30, 2015 7:16:34 GMT -5 wawa said:

Sooooo...when did all these xrays become the standard of care? I'm just asking because I don't remember getting a set until I was more like...8? Old enough that I remember it clearly at least. If kids can have all these cavities hiding in their baby teeth - were we all just super lucky as kids that our teeth didn't rot out of our heads?

I know the "well back in my day" argument is a bunch of crap when medical science has improved since 30 years ago, but...no really...did they do this back in my day and I'm just not remembering?

I remember getting them yearly from the time I was in kindy so turning 6 but I hated them so it may have stuck out more to me

[kmpls]

www.deltadental.com/Public/NewsMedia/NewsReleaseHowManyDentalKidsNeed201402.jsp

I dont have have a problem with a baseline or if there are issues but every year? We have delta dental and looking at the site above, it doesn't appear yearly X-rays are the mandatory standard of care.

this article states yearly X-rays are excessive and unnecessary 

[auntie]

DS got them from about 3. Usually about once a year for DS, but he didn't have cavity issues aside from one tooth that had fractured enamel when he was about 2. He started with his pediatric dentist at 6 months because of some concern around staining.

They're also looking at the developing permanent teeth. They picked up DS's crossbite pretty early on which gave me time to sort of orthodontists at my leisure.

[auntie]

www.imagegently.org/Portals/6/Dental/IG14_DentalBrochure.pdf

2 bitewings are about equal in radiation from exposure to a single day's naturally occurring environmental raditation or a 4 hour flight.

[erbear]

Mine don't get annual x-rays. They did a baseline one at 3 or 4 (can't remember, but it wasn't the first time they went) but haven't mentioned repeating them the last 2 or 3 times we've been.

[CrazyLucky]

Jun 30, 2015 8:04:20 GMT -5 kmpls said:

www.deltadental.com/Public/NewsMedia/NewsReleaseHowManyDentalKidsNeed201402.jsp

I dont have have a problem with a baseline or if there are issues but every year? We have delta dental and looking at the site above, it doesn't appear yearly X-rays are the mandatory standard of care.

this article states yearly X-rays are excessive and unnecessary 

My son is five and gets dental e-rays once a year.  My daughter just went for the first time at almost 3.  She did not get x-rays, but will next time.  I'm not concerned about the radiation.  According to what sent said, the only way to tell if they have cavities is by looking at x-rays, so annual doesn't seem excessive to me.  However, if it was going to cost me as much as it costs you, I would probably try to space it out as much as possible.

You can't quote an article that an insurance company touts as proof that you don't need certain procedures.  There is a giant conflict of interest there.

[Deleted]

Jun 30, 2015 8:04:20 GMT -5 kmpls said:

www.deltadental.com/Public/NewsMedia/NewsReleaseHowManyDentalKidsNeed201402.jsp

I dont have have a problem with a baseline or if there are issues but every year? We have delta dental and looking at the site above, it doesn't appear yearly X-rays are the mandatory standard of care.

this article states yearly X-rays are excessive and unnecessary 

The chart says for ages 1-5 that are low risk they recommend bite wing X-rays every 12 to 24 months. 

For ages 6-12 that are low risk recommends every 12 to 36 months. 

Obviously you are the parent to make the final decision, but overall I would trust professional guidelines, especially since the radiation exposure is very minimal. Every 24 or 36 months doesn't seem excessive to me. 

[ttt]

Jun 30, 2015 7:29:51 GMT -5 ECB said:

Jun 29, 2015 22:05:02 GMT -5 kmpls said:

Today's visit before insurance was $500 for 2 kids to count teeth, fluoride, and dentist check.

I thought MY dentist was expensive!  Hell.  $250 per kid for a basic checkup? 

 

Mine is $235 per kid per visit, just for the basic cleaning/checkup. I think that's pretty standard for pricing. 

[ijack]

Jun 30, 2015 8:04:20 GMT -5 kmpls said:

www.deltadental.com/Public/NewsMedia/NewsReleaseHowManyDentalKidsNeed201402.jsp

I dont have have a problem with a baseline or if there are issues but every year? We have delta dental and looking at the site above, it doesn't appear yearly X-rays are the mandatory standard of care.

this article states yearly X-rays are excessive and unnecessary 

But how do you know if there are issues if you aren't getting x-rays? We also have delta dental and they cover bitewing xrays 2x a year. I'm pretty sure my kids get them at every visit.

[ECB]

Jun 30, 2015 10:02:05 GMT -5 ttt said:

Jun 30, 2015 7:29:51 GMT -5 ECB said:

I thought MY dentist was expensive!  Hell.  $250 per kid for a basic checkup? 

 

Mine is $235 per kid per visit, just for the basic cleaning/checkup. I think that's pretty standard for pricing. 

Ours is about $160 and our dentist is pricey for this area. And this is a M to HCOL area.

[2curlydogs]

Is being anti dental x-rays the new anti-vax woo thing? I've seen a lot of parents become skeptical of these in recent years.

[asdfjkl]

www.aapd.org/media/Policies_Guidelines/E_radiographs.pdf

[eclaires]

We have delta dental and my kids get x-Rays once a year like I do. Basically every other visit. Neither have ever had any cavity issues as of yet. We don't go to a specific pediatric dentist though. And our insurance covers all preventative type stuff - we don't pay anything for regular visits and i thought our dental insurance sucked. Well all dental insurance sucks in my opinion as I stare down the reality of braces.

[mich1]

Not only this, many young children do not sit still long enough for the dentist to be able to get a really close look at their teeth. Also, those xrays not only look for caries, but also let the dentist know if the next set of teeth are developing normally.

I really don't blame your dentist for refusing to see you if you do not comply. You are not allowing him to do his job to the best of his ability and him missing something would likely come back and bite HIM in the butt.

FWIW....I had great dental insurance that covered preventative care 100%. When I went out on disability and lost it, I had to pay for it myself. For an adult, as a new patient, my first bill ran just under $300. Since then, it's ranged around $170. I imagine if you are going to a pediatric dentist, it's likely going to be more.

[mich1]

This just really sems over the top for small children with baby teeth.

Really sad story.  I spent an internship working in a dental van that went to schools to treat kids whose parents had no insurance.  We treated one little boy about 6 who lost 4 teeth on the bottom and 4 teeth on the top to caries.  I felt really bad, as this kid had absolutely NO ability to bite into anything and chew with any sort of competence.  Once the cavity gets to the nerve, chances are that it is large enough that there is not enough tooth to support a filling and your choices are a root canal/crown or pulling it.

According to the dental xrays, this kid had quite a while longer before his permanent teeth would erupt.

[Deleted]

Jun 30, 2015 10:07:28 GMT -5 ECB said:

Jun 30, 2015 10:02:05 GMT -5 ttt said:

Mine is $235 per kid per visit, just for the basic cleaning/checkup. I think that's pretty standard for pricing. 

Ours is about $160 and our dentist is pricey for this area. And this is a M to HCOL area.

Yeah, I'm in a HCOL area and ours costs about $130 for just a cleaning and exam. He starts x-Rays around age 5 so I don't know what the cost will be with those added in.

[af1212]

Jun 30, 2015 0:47:19 GMT -5 sent said:

So I wasn't at your kid's appointment and I'm not their dentist, but my hunch based on interacting with pediatric dentists is the following. The dentist is doing bitewing x-rays at age 5 to look for cavities in between the back teeth, the baby molars. These are areas that can not be seen with the naked eye when the dentist does his/her examination. These baby molars will also be present in your child's mouth and be primary chewing surfaces for your child until around age 10 and even later. With at least 5 years to go, they can develop cavities and worse problems if they are not routinedly examined with xrays. Also, around age 6, your child's first permanent molars will start to grow in behind the last baby molar. So at age 7, the x-rays are not only to look for cavities between baby teeth, but also to make sure there are no cavities developing on the in-between surface where the new permanent molar touches the baby molar. As your child gets older in the 8, 9, 10 year old range, these bitewing x-rays also start to show what is going on underneath the baby tooth - does it look like the permanent tooth is growing in normally, is the permanent tooth not there when we expected it to be there, etc. These are the most common things dentists look for on x-rays in kids. There are less common pathologies that can show up on x-rays as well, but those rare pathologies are not the reason they are recommending them as often as they do.

They gave you a range of x-rays every 6 months to every 1.5 months depending on what they see on the first set of baseline x-rays. Perfect x-rays with 0 cavities, you probably go 1.5 years between sets. Lots of cavities or areas that look suspicious, you will be in the 6 month range.

Digital x-rays do have less radiation than film x-rays. We get more radiation on a daily basis from just waking up and living our daily lives than we do from a set of dental x-rays every 6 months.

I'm not surprised that they implied they do not want you to return if you don't agree to x-ray. It's a liability issue for them.

My 5 1/2 year old just had her first X-rays about a month ago and all of the above is exactly how the dentist explained it to me.

[caramia17]

Jun 29, 2015 22:05:02 GMT -5 kmpls said:

I took my kids to a recommended pediatric dentist this morning.

they wanted to do X-rays on the 5 yr old and then stated depending on the results (this being his 1st set) they would repeat every 6 months at worst or 1.5 years at best. Stating they usually do first set at age 3.

i understand doing a baseline or if there was a problem but I am not on board with routine radiation. The dentist gave me a hard time for refusing and stated if we didn't do them next time then basically we aren't welcome back. 

This just really sems over the top for small children with baby teeth. Today's visit before insurance was $500 for 2 kids to count teeth, fluoride, and dentist check. Our insurance is not good so, we will pay a lot of this out of pocket. 2 times per yr? Ouch, $1000 a yr seems steep.

do you get annual X-rays for your kids? Any mn peeps feel free to pm any dentist recs!

This is a really good sign that your dentist is using the baseline radiographs to stratify your child based upon risk.

Also, as radiation decreased for radiographs that were taken the risk-benefit analysis changes, which is why recommendations/standard of care change.

Finally, our fluoridation system in the US is worse than it was in the 1970s and 1980s due (mostly) to crumbling infrastructure and no willingness to spend $$ to get it up to speed. 

If cost is a concern, perhaps seek out a different provider, try a University setting, change your insurance, etc. but I think your dentist's recommendations fit the AAPD's guidelines and I agree with teeah22 and sent