Minimizing Radiation, Maximizing Prevention: A Guide to Dental X-rays for Kids

One question that comes up regularly—and sometimes causes concern—is whether children need dental x-rays. I understand where this concern comes from. There’s a lot of fear, confusion, and even misinformation about dental x-rays. Some people worry they’re just a way to generate more income, or that they expose children to harmful radiation for little benefit.

So I’d like to take a moment to explain our philosophy on x-rays, how they help protect your child’s oral health, and why we only recommend them when truly necessary.

Our Philosophy: Minimize Harm, Maximize Prevention

As a biologic dental office, our mission includes using minimally invasive techniques and the least harmful materials possible. Core values like honesty, integrity, and excellence guide everything we do—including how we use x-rays.

In 2023, we invested in one of the lowest-radiation dental x-ray machines on the market. We also customize x-ray timing for each patient based on their age, cavity risk, and medical and dental history. Every recommendation is made with thought, intention, and your child’s safety in mind.

Pros and Cons of Dental X-rays for Children

The Cons

• Radiation Exposure: While extremely low, there is a small amount of radiation involved.

• Discomfort: Some children may feel uncomfortable during x-rays, especially if they have smaller mouths or a strong gag reflex.

The Pros

• Early Detection = Prevention: X-rays can catch small changes in the enamel before they become cavities. At this early stage, we can often reverse the damage without the need for fillings.

• Monitor Tooth Development: X-rays help us see if permanent teeth are developing properly. We can identify missing teeth, extra teeth, or unusual angles that may require orthodontic intervention.

• Avoid Painful Problems: Without x-rays, cavities between teeth can go unnoticed—eventually leading to pain, infections, abscesses, rounds of antibiotics, hospital visits, and even IV sedation for extensive dental treatments.

• Protect Permanent Teeth: X-rays allow us to monitor how teeth are erupting, helping us prevent damage to nearby permanent teeth through timely orthodontic referrals.

What About Radiation?

We hear this concern often, and we agree—radiation should always be minimized, especially in children.

But dental x-rays today are very different from the traditional film x-rays used decades ago. Here’s a comparison to help put things into perspective:

Imaging Type	Approximate Radiation Dose
4 Intraoral Bitewings (digital)	5–15 µSv
Extraoral Bitewings (Planmeca)	8–16 µSv
Panoramic X-ray (entire jaw)	9–24 µSv
Daily background radiation (U.S.)	8–10 µSv
Chest X-ray	~100 µSv
Mammogram	~400 µSv
CT Scan	2,000–10,000 µSv

In other words, a set of dental bitewings exposes your child to about the same amount of radiation as a single day of just living on Earth or taking a short domestic flight.

Other qualities of x-rays to consider are collimation and scatter.

• Collimation refers to how the x-ray beam is narrowed and precisely directed to the area we need to image, which limits exposure to surrounding tissues.

• Scatter radiation is stray radiation that can travel beyond the intended target. Today’s x-ray machines use focused beams that greatly reduce scatter and improve safety.

While we still use lead shields and thyroid collars to protect the body, the improvements in collimation and scatter control reduce the need for such measures because exposure is concentrated exactly where we want it.

When Should Kids Get X-rays?

We tailor x-ray timing to each child’s unique situation. However, some general guidelines include:

• By age 6: X-rays should be taken to evaluate the development and position of permanent teeth, even earlier if there are signs of disease, trauma, or delayed eruption.

• If there are concerns: X-rays may be recommended earlier or more frequently if there are symptoms like pain or visible issues.

• Routine monitoring:

  • Every 6 months for children with higher risk or active dental concerns

  • Every 12–18 months for children with low risk and no current issues

Final Thoughts

We want the best for every patient—especially children. They are the future, and prevention is the foundation of lifelong oral health.

If we can catch problems early or prevent them entirely, we can help children grow up with healthy smiles, fewer fillings, and less dental anxiety. That’s always our goal.