5 reasons why dental radiographs are needed in dentistry

Full-mouth dental radiographs are still the golden standard of imaging in veterinary dentistry, especially if the animal is presented for the first time, or if the clinical condition has changed significantly since the previous visit.

To obtain dental radiographs, veterinary patients should be under general anaesthesia to avoid any trauma to the patient and damage to the equipment. Also, obtaining dental radiographs is usually just a part of the procedure and is followed by other diagnostic and therapeutic procedures.

Dental radiography requires a dental x-ray unit, a detection system and some skills. Obtained radiographs are evaluated for their technical quality (Is the area of interest on the image? Is there any elongation/foreshortening of teeth? What is the quality of exposure? Are there any processing errors?) and properly oriented, before being systematically examined. Interpretation of dental radiographs requires the knowledge of normal dental radiographic anatomy in order to be able to diagnose any anatomical/developmental abnormalities, periodontal and endodontal pathologies, and other abnormalities.

Why full-mouth dental radiographs?

1. We will see more pathology than with clinical examination alone

In cats, detailed clinical examination without supporting dental radiographs could miss clinically important findings in 41.7% of the animals without clinical signs of dental disease. In dogs, this value is 27.8%. Without dental radiographs we are missing disease and undertreating our patients!

2. We will choose the right treatment for the patient

Just as an example – a cat with a tooth resorption lesion exposed to the oral cavity. It needs treatment. Shall we extract the tooth or perform crown amputation with intentional root retention, which is faster and less traumatic procedure? While clinical examination is important to diagnose oral exposure of the lesion, radiographs are a must to determine the type of the lesion – only those teeth affected by type 2 tooth resorption can in selected cases be safely treated by crown amputation with intentional root retention. All teeth affected by type 1 tooth resorption must be extracted! The same applies to tooth resorption in dogs.

3. We will be able to evaluate the treatment outcome

How shall we be sure, that we removed the root tip that fractured during a dental extraction? Or evaluate what we are doing within the root canal during an endodontic treatment? Or evaluate the success of endodontic treatment or crown amputation with intentional root retention procedure at the re-check appointment? Or evaluate the healing after an odontogenic cyst enucleation procedure? And much more…

4. We will better explain the diseases and procedures to our clients and colleagues

»A picture is worth a thousand words«. And it applies to veterinary dentistry as well. Not just clinical photos, but also dental radiographs greatly enhance our communication and hence improve our services and relationships further.

5. We will have our (legal) patient’s medical record complete

However, the limitations of intraoral radiography must be considered, especially when dealing with e.g., palatal defects, maxillofacial trauma, temporomandibular joint (TMJ) disease or oral neoplasia, when advanced 3-dimensional imaging techniques (usually computed tomography (CT) or cone-beam computed tomography (CBCT) or, rarely, magnetic resonance imaging (MRI)) are recommended.

If you have noted any problems with your animal, please consult your veterinarian.

Selected references
1. Bar-Am Y, Pollard RE, Kass PH, Verstraete FJ (2008).The diagnostic yield of conventional radiographs and computed tomography in dogs and cats with maxillofacial trauma. Vet Surg 37(3):294-299.
2. Campbell RD, Peralta S, Fiani N, Scrivani PV (2016). Comparing intraoral radiography and computed tomography for detecting radiographic signs of periodontitis and endodontic disease in dogs: an agreement study. Front Vet Sci 3:68.
3. Coffman CR, Brigden GM (2013). Oral and dental imaging equipment and techniques for small animals. Vet Clin North Am Small Anim Pract 43(3):489-506.
4. DuPont G, DeBowes LJ (2009). Atlas of dental radiography in dogs and cats. St. Louis: Saunders Elsevier.
5. DuPont GA (2002). Crown amputation with intentional root retention for dental resorptive lesions in cats. J Vet Dent 19(2):107-110.
6. Fiani N, Arzi B (2010). Diagnostic imaging in veterinary dental practice. Endodontic disease. J Am Vet Med Assoc 236(1):41-43.
7. Heaton M, Wilkinson J, Gorrel C, Butterwick R (2004). A rapid screening technique for feline odontoclastic resorptive lesions. J Small Anim Pract 45(12):598-601.
8. Moore JI, Niemiec B (2014). Evaluation of extraction sites for evidence of retained tooth roots and periapical pathology. J Am Anim Hosp Assoc 50(2):77-82.
9. Niemiec BA (2010). Veterinary dental radiology. In: Niemiec BA (ed.). A color handbook of small animal dental, oral and maxillofacial disease. Boca Raton: CRC Press, Taylor & Francis Group; p. 63-87.
10. Niemiec BA (2014). Feline dental radiography and radiology: A primer. J Feline Med Surg 16(11):887-899.
11. Verstraete FJ, Kass PH, Terpak CH (1998). Diagnostic value of full-mouth radiography in cats. Am J Vet Res 59(6):692-695.
12. Verstraete FJ, Kass PH, Terpak CH (1998). Diagnostic value of full-mouth radiography in dogs. Am J Vet Res 59(6):686-691.