Most patients receive dental X-rays and periodontal probing at every dental visit and leave without fully understanding what was found. The clinical data from your dental appointments belongs to you and is genuinely useful to understand.
Reading bitewing X-rays
Bitewing X-rays showing the upper and lower back teeth together are primarily used for detecting interproximal cavities between teeth, assessing the height of alveolar bone relative to the teeth which changes with gum disease, and evaluating existing restorations for secondary decay or failure. On a bitewing X-ray enamel appears bright white, dentin appears lighter gray, and the pulp chamber appears dark gray or black. Cavities show as areas of decreased density typically between teeth at the contact areas or under existing restorations. Bone should be visible coming up to approximately the cemento-enamel junction. If bone appears to stop well below the cemento-enamel junction bone loss from gum disease is present.
The periodontal probing chart
During periodontal examination a probe is inserted into the space between your tooth and gum at six locations around each tooth. The probing depth is recorded. Normal probing depths are 1 to 3 millimeters. Depths of 4 to 5 millimeters indicate early periodontitis and 6 millimeters or more indicates more significant disease. Bleeding on probing is also recorded indicating active inflammation. When your hygienist calls out numbers during your cleaning those are probing depths. A sequence like 2, 3, 2 followed by 3, 4, 3 at a single tooth means three measurements on the cheek side and three on the tongue side. All within normal range in this example.
Your right to your records
Dental records including X-rays are yours. You have the right to a copy. If you are switching dental practices or want a second opinion requesting your records is straightforward and practices are legally required to provide them. Understanding what has been found at previous appointments allows more informed conversations with new providers.
Educational content. If you do not understand findings from your dental examination ask your dentist or hygienist to explain them. Informed patients make better decisions about their care.
