“Can a CT scan show a dental abscess where a bitewing X-ray would not?”
During a routine dental visit, multiple bitewing X-rays were performed near tooth #15, and everything appeared fine. The dentist said it looked great. A root canal had been previously done on the tooth.
However, during a visit to my ENT a week later, a CT scan was taken of my sinuses. After the scan, the ENT said that she spotted a fairly large abscess on tooth #15 and said that it appeared to have been there for some time. I asked if she was sure it was a dental abscess; she said that she was positive and said that it can easily be seen from multiple angles.
I am not symptomatic, to my knowledge, other than sinus issues and sinus headaches.
Is it possible for multiple bitewing X-rays not to show a dental abscess, whereas a CT scan clearly shows it?
However, during a visit to my ENT a week later, a CT scan was taken of my sinuses. After the scan, the ENT said that she spotted a fairly large abscess on tooth #15 and said that it appeared to have been there for some time. I asked if she was sure it was a dental abscess; she said that she was positive and said that it can easily be seen from multiple angles.
I am not symptomatic, to my knowledge, other than sinus issues and sinus headaches.
Is it possible for multiple bitewing X-rays not to show a dental abscess, whereas a CT scan clearly shows it?
Male | 36 years old
11 Answers
DentistDentist
A periapical film would show a longstanding abscess. Bitewings would show nothing.
yes
I believe it can show.
yes
No. Run, don't walk to another ENT. They are famous for buying cheap CT scanners that give low quality images, yet they can bill the same as a way more expensive and high tech low dose CT. They give substandard images and should be outlawed. The ENT then reads the images themselves. They have no training in reading CT scans and do it for the money. If you had an abscess, you would have a fever and severe pain.
Yes common for an abscess to escape detection using a bitewing xray. You would need a periapical x-ray to see most abscesses
A dental CT scan called a CBCT scan is much more accurate than conventional X-rays for revealing abscesses.
Typical dental X-RAYS of the teeth usually identify dental problems. Most dentists have a panoramic X-ray or as some patients call it--"X-ray in the round: the dentist can view the entire right side and left side of the face from the lower jaw to above the eyes and right and left TMJ JOINTS. TOOTH #15, CAN HAVE ROOTS HIGHER IN THE SINUS. IF YOU HAVE NOT MENTIONED ANY TOOTH OR SINUS PROBLEMS, YOUR DENTIST MAY HAVE DECIDED TO TAKE THE INDIVIDUAL X-RAYS. HAVING A ROOT CANAL ON A TOOTH DOES NOT MEAN THAT THE TOOTH WILL HAVE ANY FUTURE PROBLEMS.
A bite wing X-ray does not show the tip of the tooth root where the abscess was spotted from the CT scan.
Hello,
Hope your sinus are doing better! There are a couple of interesting areas about your question that are worth mentioning. First off, no bitewing X-rays do not show the root tips of teeth which is where an abscess is most likely to show up. So it would be very rare to see an abscess on a bitewing X-ray. A peri-apical (peri meaning around, and apical meaning apex or root tip) is the type of x-ray that is generally used to see if there is an abscess.
Secondly, if tooth #15 had a previous root canal then it is highly likely to have what we refer to as apical scaring (just like in any other area of the body, when there is a large cut, a scar can form). There was a reason that the root canal was done the first time. That reason could have easily because #15 had an abscess. When there is a an abscess associated with a tooth, a lot of the times the bone around the abscess does not heal all the way. There is nothing wrong here, it can stay like that for the rest of time but it will continue to look like there is an abscess there. As a matter of fact, is a peri-apical x-ray (PA) is taken of tooth #15 it would probably show that there is a dark spot there as if the abscess did not heal all the way. When a CT scan is done it shows areas that are voids and the maxillary sinuses sit very close to #15. Scar tissue is not as dense as jaw bone so the scar will look like an abscess on #15.
Finally, there are two things to consider whether there is a re-infection of #15 or if it is just scar tissue. The first is to look at any previous peri-apical x-rays and compare them to a recent one. If the dark area has not changed or gotten bigger it is most likely scar tissue and not an active abscess. The second consideration is where there are symptoms associated with #15. If there are no symptoms associated with #15 then it is most likely scar tissue that was seen in the CT scan. Hope this help.
My best to you!
William F. Scott IV, DMD
Hope your sinus are doing better! There are a couple of interesting areas about your question that are worth mentioning. First off, no bitewing X-rays do not show the root tips of teeth which is where an abscess is most likely to show up. So it would be very rare to see an abscess on a bitewing X-ray. A peri-apical (peri meaning around, and apical meaning apex or root tip) is the type of x-ray that is generally used to see if there is an abscess.
Secondly, if tooth #15 had a previous root canal then it is highly likely to have what we refer to as apical scaring (just like in any other area of the body, when there is a large cut, a scar can form). There was a reason that the root canal was done the first time. That reason could have easily because #15 had an abscess. When there is a an abscess associated with a tooth, a lot of the times the bone around the abscess does not heal all the way. There is nothing wrong here, it can stay like that for the rest of time but it will continue to look like there is an abscess there. As a matter of fact, is a peri-apical x-ray (PA) is taken of tooth #15 it would probably show that there is a dark spot there as if the abscess did not heal all the way. When a CT scan is done it shows areas that are voids and the maxillary sinuses sit very close to #15. Scar tissue is not as dense as jaw bone so the scar will look like an abscess on #15.
Finally, there are two things to consider whether there is a re-infection of #15 or if it is just scar tissue. The first is to look at any previous peri-apical x-rays and compare them to a recent one. If the dark area has not changed or gotten bigger it is most likely scar tissue and not an active abscess. The second consideration is where there are symptoms associated with #15. If there are no symptoms associated with #15 then it is most likely scar tissue that was seen in the CT scan. Hope this help.
My best to you!
William F. Scott IV, DMD
Yes, a bitewing does not show the bottom of the tooth.
Rev. Dr. Laurentis Barnett
Rev. Dr. Laurentis Barnett
