Many of our clients sustain serious injuries in Atlanta automobile accidents. Insurance companies often dispute the severity of the injuries. Because x-rays can penetrate human tissue, they provide an excellent picture of the body’s anatomy and injuries thereto. X-rays are films of the body structures and look like negatives of photographs. When bones are fractured, the break is visible as a black line. This is why X-ray can provide an objective form of proof of a fractured bone or herniated disc spinal injury from an automobile accident.
In other types of cases, such as dental malpractice, for instance, radiographic evidence in the form of an x-ray, Cone Beam CT Scan (“CBCT”) or other type of film studies, can provide objective evidence of an injury caused by the malpractice. Sometimes these objective tests are performed before, during and after the treatment in question by the at-fault defendant. Other times, it is captured by care and treatment given by a subsequent treating doctor or dentist. But, in any case, the old adage: a picture is worth a thousand words, is equally applicable to x-rays and the like when it comes to proving dental malpractice or medical malpractice.
Of all the cases that we handle, x-rays are the most important in dental malpractice cases. The following are used in dental cases and become important in the evaluation and pursuit of dental malpractice cases:
Bite-wing X-rays (right)
highlight the crowns of the back teeth. Dentists take one or two bite-wing X-rays on each side of the mouth. Each X-ray shows the upper and lower molars (back teeth) and bicuspids (teeth in front of the molars). These X-rays are called “bite-wings” because you bite down on a wing-shaped device that holds the film in place while the X-ray is taken. These X-rays help dentists find decay between back teeth.
Periapical X-rays (left)
highlight only one or two teeth at a time. A periapical X-ray looks similar to a bite-wing X-ray. However, it shows the entire length of each tooth, from crown to root.
Occlusal X-rays (right)
are larger than most X-rays. They highlight tooth development and placement in children. Each X-ray shows nearly the full arch of teeth in either the upper or lower jaw.
Extraoral X-rays are made with the film outside the mouth. These can be considered the “big picture” X-rays. They show teeth, but they also provide information on the jaw and skull. Extraoral radiographs are used to:
- Keep track of growth and development
- Look at the status of impacted teeth
- Examine the relationships between teeth and jaws
- Examine the bones of the face
Extraoral X-rays are less detailed than intraoral X-rays. For this reason, they are usually not used for detecting cavities or flaws in individual teeth.
Panoramic X-rays show the entire mouth on a single X-ray. They include all teeth on both upper and lower jaws. This type of X-ray requires a special machine. The tube head that emits the X-rays circles behind your head while the film circles across the front. That way, the full, broad view of the jaws is captured on one film. Because the machine moves in a set path, you have to be positioned carefully. Devices attached to the X-ray machine hold your head and jaw in place. All this may look and feel intimidating, but the process is very safe. It often uses less radiation than intraoral X-rays.
Cephalometric projections are X-rays taken of the entire side of the head. They are used to look at the teeth in relation to the jaw and the person’s profile. Orthodontists use cephalometric projections to determine the best type of orthodontic treatment.
Cone-beam computed tomography (CT) provides three-dimensional images. You stand or sit while the machine rotates around your head. The beam is cone-shaped, instead of fan-shaped as in a standard medical CT. A cone-beam scan uses less radiation than a medical CT scan but far more than any standard dental X-ray. The cone-beam CT is particularly useful for dental implant selection and placement.
Standard computed tomography (CT) usually must be done in a radiologist’s office or a hospital. Typically, you will lie down while the image is taken. The radiation exposure is higher for this type of CT than for a cone-beam CT. A standard CT scan may be done to determine size and placement location for implants.
Digital radiographs are one of the newest X-ray techniques. Standard X-ray film is replaced with a flat electronic pad or sensor. The image goes into a computer, where it can be viewed on a screen, stored or printed out. Digital X-rays taken at different times can be compared using a process that highlights differences between the images. Tiny changes therefore can be caught earlier. Used properly, digital X-rays use about half the radiation of conventional film.