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Hi Dr. Hall,
I am wondering if you can help me with a few dental exam questions? When I go to the dentist it seems they insist that I receive x-rays every six months. Is this necessary—what is the recommendation? Also, as an adult, do I need fluoride and if it is not needed will it have a negative effect if I get it?
– Kay from Arizona
The general guidelines for routine checkups are to have bitewing x-rays (two or four x-rays taken while you bite on a tab that holds the film) once a year and a panographic x-ray or full series of x-rays (showing the roots of the teeth) once every five years or more.
There are variations from this that can depend on the individual. Some people with aggressive decay problems may need x-rays very 6 months, but that would be rare. In my practice of over a thousand patients, I maybe had a handful of patients for whom I would want x-rays that frequently. I did have some for whom I recommended x-rays less frequently.
As far as fluoride treatment, that is generally given to children and youths up to age 14—in some cases up to age 18. Once the permanent teeth are fully formed and the enamel has matured, the benefits of fluoride treatment are less. Adult fluoride treatment would similarly be justified in the case of some patients with aggressive decay problems.
There are no deleterious effects of fluoride treatment on natural teeth. But if you have any porcelain work, the most common type of fluoride can etch the porcelain, destroying the glaze and possibly removing some of the color. Most fluoride administered in dental offices is acidulated fluoride. The acid in the fluoride assists in its absorption by the teeth, but that same acid will etch porcelain, making the surface more rough which makes it attract stain. Also, the dental laboratory technician who fabricates the porcelain restoration will sometimes place tints in the surface in order to match the coloration of adjacent teeth, and those tints could be dissolved away by acidulated fluoride.
– Dr. Hall
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
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