Routine dental X-rays are not backed by evidence

I'm going to also throw anecdotes into the bucket: three dentists completely missed a cavity on one of my rear molars (wisdom teeth) until I mentioned pain, and then they poked around physically and said, "oh yeah, that's a big one."

What kind of dental x-rays they took? Panoramic (shows the whole row of teeth in one image), CBCT (volumetric 3D) or intraoral (a digital sensor or film was put inside your mouth)?

Not OP, but I have only ever had the type of dental x-ray where they stick the L-shaped plastic into your mouth and make your bite down while they take photos. I had no idea there were others.

Your anecdote corroborates one of the key points in the article:

> For instance, a 2021 systemic review of 77 studies that included data on a total of 15,518 tooth sites or surfaces found that using X-rays to detect early tooth decay led to a high degree of false-negative results. In other words, it led to missed cases.

The article isn't just saying you're getting unnecessary radiation. It's also saying that relying on x-rays lets dentists be lazy about finding problems while also billing you for unnecessary work.

The original machine I used looked like a TSA body scanner but for your head. Somehow it hit plates that were developed into an image the dentist could present to me.

I had the same but with a cracked crown. The dentist did the bite wing x-rays, did whatever examination they do, and then at the end said it all looked good. They even did some fancy 3d scan trying to sell me on a mouth guard or those transparent braces.

Then I mentioned I had pain around the crown whenever I ate something sweet or sour. The dentist took another look and said "oh yeah the crown is cracked"

So now I know I either have a cracked crown or I don't. Great service.

I have had both types, within the same office, over time.

That's a bitewing, intraoral.

Does it catch cases though? If so, it doesn't mean it isn't worth it just because it misses cases.

Also, this may be a good application for AI. I would assume this is an issue with dentists being able to read X-rays carefully and not that the X-rays are unable to capture the signs.

Panoramic and intraoral.

Weird. Panoramic image should have shown the decay. I wonder if there were some image quality issues at the edges.