Written by: Mark Friend, SCD Clinical Advisor

Why are pre-alignment radiographs so important?

I had a case in recently which underlined for me the importance of taking good pre-alignment radiographs. Adult patient attended looking for correction of a small relapse in alignment of the upper central incisors.  The case looked very straightforward and during the clinical examination I was beginning to formulate ideas around retention, how long the case might take and so on.

I am attaching a radiograph I recorded of the upper incisor teeth. Very significant root resorption issues and clearly not suitable for consideration of alignment. Significantly there were no clinical signs such as mobility to suspect this root issue and if the case had proceeded then the consequences would have been profound and impossible to defend.

What did I learn?

Even if you think you understand a situation, try to understand more about it.  This phrase is true in every walk of like but none more so than clear alignment.  Good pre-operative radiographs are primarily about finding out the status of the tooth.  Is it safe to move this tooth?  Will I do harm if I move it? Finally, in this case the consult took a very different turn to the one expected and I had to delivered bad news to the patient regarding the prognosis of their front teeth. So be prepared for this eventuality, have the form of words ready to communicate this with tact, empathy and support.