Many parents often ask us: "My child just took x-rays at the orthodontist office, why do they need to take more x-rays before the orthodontic treatment start?"
Orthodontist will take a Panoramic radiograph and a Lateral Ceph radiograph to aid in comprehensive treatment planning. These radiographs are taken extra-orally and allow us to see the health of the jaw bone and rule out any bone pathology, position and angulation of the roots, congenitally missing teeth, and supernumerary or extra teeth, prior to treatment. The lateral ceph also allows the orthodontist to so the angle and position of the roots from the side view and to diagnose if the malocclusion is dental derived or skeletally derived. The orthodontist have computer programs which calculate and measure different points of the skeleton and dentition to determine what treatment options are available to the patient based on how much movement can be done. Both panoramic and lateral ceph are not close or focused enough to diagnose caries (dental cavities).
Bitewings and periapical radiographs are taken with intraoral sensors that are highly defined to diagnose cavities and smaller pathologies of the teeth, bone loss, root infections. Orthodontic treatment should not be started until all teeth are treated or diagnosed to be caries (cavity) free. In fact once you are in orthodontic treatment (traditional or Invisalign) your risk for caries increases due to added surface area for food and bacteria to accumulate and more. Difficulty brushing and flossing the teeth and gums. Bitewing and periapical radiographs are recommended after ortho treatment is completed to rule out any decay that may have developed during ortho treatment.
Overall radiographs for ortho and general dentistry are different and used for different diagnosis and treatment planning, but are done in coordination for best patient care and practice.