You can absolutely get X-rays while wearing braces; it is a routine procedure in dental and orthodontic offices. While the metal components, such as the brackets and wires, interfere with the X-ray beam, modern technology and specialized techniques ensure that diagnostically useful images can still be captured. Regular X-rays are necessary to monitor tooth movement, root health, and jawbone structure during treatment. The slight image distortion caused by the metal is a recognized challenge that dental professionals are trained to manage.
How Braces Affect X-ray Image Quality
The interference caused by braces is known as “metal artifact,” which occurs because the metal components are highly radiopaque. Materials like stainless steel and titanium absorb X-ray photons much more effectively than soft tissue or bone. This high absorption leads to beam hardening, where lower-energy X-ray photons are filtered out, creating distortions.
This process manifests on the resulting image as bright areas, dark streaks, or shadows radiating from the metal. The bright areas represent the metal, while the dark streaks, sometimes called “photon starvation” artifacts, obscure surrounding dental structures. In severe cases, these artifacts can mask underlying issues like root resorption or bone loss, degrading the diagnostic quality of the image.
Techniques Used to Ensure Clear Diagnostic Images
Dental professionals employ several strategies and technologies to mitigate the effects of metal artifacts in routine two-dimensional (2D) X-rays. For periapical X-rays, which focus on a few teeth and their roots, the clinician may adjust the angulation of the X-ray tube. By slightly altering the horizontal or vertical angle, they can gain a clearer view of the root and surrounding bone by avoiding the densest metallic parts.
Digital imaging systems also enhance image clarity after capture. Specialized software applies digital filters, contrast equalization, and brightness adjustments to minimize the visual impact of streaks and shadows. Another element is that certain diagnostic X-rays, like the lateral cephalometric view, naturally minimize artifact interference. This view captures a side profile of the skull and jaw, allowing the X-ray beam to pass through the teeth from the side, reducing the overlap of brackets onto the roots.
Specific Scenarios Requiring Specialized Imaging
While routine 2D X-rays are manageable, braces pose a greater challenge for three-dimensional (3D) imaging, such as Cone Beam Computed Tomography (CBCT). CBCT scans provide a comprehensive, rotational view of the skull and jaw, and metal artifacts can be severe, creating pronounced streaks that obscure bone detail. This is problematic in complex treatment planning, such as preparing for orthognathic surgery or placing dental implants.
To address this, advanced imaging centers utilize sophisticated Metal Artifact Reduction (MAR) algorithms embedded in their CBCT software. These algorithms mathematically predict and correct the distortions in the raw data before the final image is generated. In rare instances, when the highest possible resolution is needed for critical pre-surgical measurements, the orthodontist may request the temporary removal of the archwire or specific brackets. This measure ensures an artifact-free scan and is reserved for highly specific diagnostic needs.