Intra oral digital x-ray

In dentistry two major types of x-rays used to film the mouth - intra oral x-rays and extra oral x-rays. Intra oral x-rays involve placing the x-ray film inside the mouth and extra oral x-rays place the x-ray film outside the mouth. The amount of radiation is reduced by around 80% using this technique. These x-rays allow the dentist to identify dental problems that cannot be identified with the naked eyes. Intra oral digital xrays help the dentist take a close looks at the tooth roots, study the condition of the developing tooth, scrutinize general tooth health, identify caries and check the strength of the bony region adjoining the tooth. Various types of intra oral x-rays are bite-wing x-rays, periapical x-rays and occlusal x-rays. X-ray films are substituted with electronic pad or sensors and the pictures are filmed. The x-rays fall on the pad in a similar fashion as they fall on the film and the pad or sensor transfers the image directly to the computer and a print out is taken unlike developing the x-ray film in a dark room. The main benefit of these x-rays is that they help comparison of current images to previous images without any difficulty and over the computer itself.

Esophagram

Esophagram is a test whereby the patient is administered a barium sulfate compound that enables the radiologist to study the function and appearance of the esophagus. A series of x rays of the esophagus is taken after the patient has swallowed the barium. The barium solution coats and outlines the walls of the esophagus. This enables the radiologist to assess the process of swallowing. Hence it is also called barium swallow. An Esophagram is done when the patient complains of pain or difficulty in swallowing. It is also done to assess the reasons for blood stained vomit and when abdominal pain and weight loss occurs or diagnosing cases of Barrett's esophagus. The Esophagram helps the radiologist to detect narrowing, stricture, obstruction or irritation of the esophagus. It helps to study complications such as ulcers, polyps and tumors. It also helps to assess hiatal hernia.

The patient is advised not to eat or drink for 8 to 10 hours prior to the examination. The patient is asked not to smoke or chew gum atleast 6 hours prior to the procedure. A patient is given a cup of barium sulfate to swallow. A radiologist watches and evaluates the swallowing process with fluoroscopy. The barium swallowed coats the lining of the esophagus, and x rays are taken to track the pathway to the stomach. The patient is placed in various positions throughout the exam so that structures are optimally demonstrated on the x rays.

The problem is that it can miss small abnormalities in the esophagus such as small erosions and ulcers. This test is not very effective for diagnosing gastroesophageal reflux associated with GERD. Pregnant mothers are advised not to undergo this procedure as the risk of radiation affects the fetus.

Panoramic X ray

The Panoramic x-ray or Panorex as it was initially called is considered the 'work horse' of dentistry. The Panorex is a large single x ray film that shows the entire bony structure of the teeth and the face. It covers a much wider area than a traditional intra oral film showing structures outside of their range including sinuses, temperomandibular joints as well as the position of the wisdom teeth. The panoramic x ray has the ability to scan the region of oral pharynx and surrounding tissues thereby increasing the dentist's diagnostic capabilities. The uninterrupted panoramic film is the most commonly used for obtaining clearly portrayed image of orofacial structures in dentistry. Other dental xrays include:

Bitewing x ray uses the least amount of radiation. It shows the upper and lower back teeth in a single view. They are used to detect decay between the teeth and to show how well the upper and lower teeth line up. Bitewing also indicates bone loss and the presence of severe gum disease or dental infection.

Periapical x rays show the entire supportive system of the tooth from the exposed crown to the end of the root and bones. They are used to detect dental problems below the gum line or the jaw. They also help to detect impacted teeth.

Panoramic x rays belong to the broad category of x rays called tomographs. The amount of radiation needed to expose a panoramic film is about the same as the radiation needed to expose two intra oral films. It is advised to use lead apron during panoramic x ray. In panoramic x ray, the x ray source passes around the patient and behind their head at a slight upward angle. Use of a lead apron helps in optimal prevention of the patient's body from scatter radiation of the panoramic x ray beam. Special panoramic lead aprons are available that cover both the back and front of the patient without interfering with the path of the X ray beam.