What You See

Author: Kimberly N. Powell, DDS, MS

During your hygiene appointments, a clinical and radiographical evaluation is performed by your dentist. Radiographs will show gray scales from white to black depending on the object density. The more dense an object is, the less the x-ray beam hits the film/sensor and is absorbed by the object making it appear bright/white. Objects that are less dense will not significantly obstruct the beam from hitting the film/sensor and will appear dark/black. When looking at the oral cavity radiographically, all shades aren’t equal. The enamel and dentin of a tooth appear gray with the dentin being slightly darker. The pulp chamber and root canal show a distinctively darker gray compared to the enamel and dentin due to the lack of density. An amalgam/silver filling will appear a bright white, and composite/tooth-colored filling appear a softer white. When evaluating healthy tooth structure, the only really dark area on a tooth is where the nerve resides. Decay destroys tooth structure making it less dense and appears dark gray to black on the radiograph. Although the size may vary, what is now seen on the tooth is pathological not physiological and needs to be treated before further damage is done. While things look just gray on the radiograph, a colorful picture is being reflected for the clinician.