The Two Extremely Important Reasons Why You Need Another X-Ray for Dental Implants

The Two Extremely Important Reasons Why You Need Another X-Ray for Dental Implants

A common question asked by many patients when they go to another practitioner’s office for a consult is “why do I need another x-ray?” It may not be just for an implant consult either. It could be for an extraction consult, a wisdom tooth consult, or a reconstructive consult.


There are two primary reasons:


1) A surgeon has to be able to fully visualize an area before operating upon it. 

There is one truism: “You can’t do well what you can’t see well.” If a surgeon is being asked to consult on an issue, that surgeon cannot give the patient an informative consultation if they cannot see the whole area of concern. If part of a tooth is not able to be seen on an x-ray, and that tooth is to be removed, is there anything “lurking off-screen” which might be a problem during the surgery? Who knows if no one can see the whole tooth, roots and all.

This is particularly true for dental implants. If you can’t see an area, you can’t comment on what might be found in that area during a surgery. For example, in the lower jaw there is a main feeling nerve on each side. It enters a boney tunnel within the jaw, at about ear-lobe level. It travels within the tunnel and exits to give feeling in the lower lip and chin, approximately half way between the molars and the lower front teeth.

Normally, when the jaw is healthy, all the bone and teeth are present, that exit of the feeling nerve is two-thirds to three-quarters of the way down towards the bottom, from the top of the jaw where the teeth are. However, when teeth are lost, the bone that used to hold those teeth shrinks and melts away. This is an inevitable response to tooth loss. No amount of calcium supplements can prevent it.

2) Every x-ray machine magnifies at different amounts

X-rays are important prior to considering dental implant placement. If you can’t see important structures on the x-rays, how can you measure how much room you have to place an implant before reaching an important structure?  You measure, of course. But that’s where an unforeseen problem results. What many people don’t know is that all x-rays magnify what is shown. That means if you get out a ruler to measure something, you’ll be tricked into thinking there is more room, or things are larger than they really are.

What complicates matters even more is that each x-ray machine, other than state of the art ConeBeam CT scans (a subject for another blog), magnify at different rates. Many panoramic x-ray machines magnify from 25-35%. That means if you measure how far down from the top of the jaw it is till you might reach the main feeling nerve to see how much room you might have to place a dental implant, and you measure it at one inch, guess what? You don’t have an inch to go before running into that all-important main feeling nerve and causing possible permanent damage to feeling in your jaw, lip and chin. How come? Even though you’ve measured an inch distance, the magnification tricked you in to thinking you have an inch of distance but in reality you have (depending upon what x-ray machine was used) at least 25-35 % LESS room than you measured.

These important reasons are why additional x-rays are actually in your best interest before having oral surgery, especially for dental implants.

One Response to The Two Extremely Important Reasons Why You Need Another X-Ray for Dental Implants

  1. John Spahn

    My implant dentist takes two or three x-rays Everytime I come to the office for one implant. So far over the past year they have done 15 x-rays. Is this too much?

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