Due to a move, I needed to find a new dentist for my 90 year old mother. Her prior dentist seems to have disappeared with no trace, so I cannot access her prior records, and her memory is not reliable.

The new dentist wants to do a panorama x-ray for $128 that my mother's Medicare doesn't cover. She says she has no problems with her teeth.

The question is, all things considered, how necessary is a panorama x-ray in a 90 year old who will pay for it out of pocket? Should we at least wait to see what the initial exam shows?

Martin, thank you very much for this good question.

Hello Martin,

The panoramic film to which you refer is a very good adjunct to a successful examination. It is not all about teeth and it also has to do with bone structure and hidden tumors or cysts or growths. Many things are hidden from the naked eye so we look for how the bone appears and many things of which I won't go into all of them. Martin, your question is very valid and it's something that needs to be addressed.  In her case, at her age, since there are  no previous records (which is very sad to hear) I think it's best to get an exam that is as thorough as possible.  I don't know her dental condition, if she  has teeth or not, bridgework or not, dentures or not so it's hard to be more specific.  I believe her that she feels there is no problem with her teeth and she's probably right. Given the lack of previous information I'd suggest making this exam as complete as you possibly can.  This way her new dentist has a perfect baseline from which to work in the future.

I hope this is helpful and if you have more questions or need me to clarify anything then please contact me again.

Dr. Karmen


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Thomas Karmen


All general dentistry questions, especially those related to fixed prosthetics. Endodontics, Periodontics, and implants, minor oral surgery I can't answer much about othodontics nor advanced treatment of carcinoma nor deep tissue surgery nor osseous surgery such as jaw reduction or advancement.


DDS In general practice and consulting with having done some lecturing for local dental societies.

ADA and Florida Dental Association and Iowa Dental association

DDS degree

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