The Truth About Dental X-Rays (Dentist Perspective)

Dr. Matthew Hannan | My Dental Advocate
Young woman patient in dental x-rays machine | My Dental Advocate

The few seconds you have to hold still give dentists an important picture of your dental health.

Dental X-rays allow the clinician to detect and diagnose dental diseases that would otherwise be difficult to see intraorally.

What’s the truth about digital x-rays? Are they harmful? Learn all about dental x-rays below.

Recommended Reading: Overcoming Obstacles at the Dentist

Understanding Digital X-rays

The two most common X-ray systems are either conventional or digital.

However, traditional X-rays are becoming obsolete because they’re time-intensive, challenging to analyze and expose patients to more significant radiation than digital X-rays.

Alternatively, digital X-rays are user-friendly, efficient and images are available within seconds, which allows the clinician to analyze the images in real-time. If an image is distorted or out of focus, the clinician or assistant can recognize the error and quickly retake the photo.

Dental X-rays are categorized based on the area of the mouth being captured.

Bitewing

  • Assess bone loss
  • Detects decay between teeth
  • Images opposing teeth in a single image
  • Difficult w/mandibular tori (bony growth)

Periapical

  • May elicit gauge reflex
  • Images roots and related pathology
  • Detects decay and apical infection
  • Technique sensitive

Panoramic

  • Detects pathology
  • Evaluates the position of wisdom teeth
  • Analyzes eruption status
  • Visualizes sinus and other related structures
  • Visualizes the position of the Inferior Alveolar Nerve (IAN)

Cone Beam CT

  • 3D Image
  • Essential for implant placement
  • Assess bone in buccal/lingual direction
  • Primarily located in the specialist’s office
  • 20x more radiation than a panoramic x-ray

Dental Radiation Exposure

Dental X-rays require a low dose of radiation exposure, and the risk of potentially harmful effects is small.

However, it’s essential to put radiation exposure into context. We’re exposed to background radiation daily from the sun, soil, rocks, buildings, etc.

A single day of background radiation is equal to a four-hour flight. Similarly, a single day of background radiation is equivalent to two bitewing images or one panoramic x-ray.

Panoramic x-rays are unique because they capture all the teeth in one image and help detect pathology, analyzing eruption patterns and wisdom teeth.

Before taking X-rays, the assistant will place a lead vest and thyroid collar on you to protect your organs from unnecessary radiation exposure.

Are you pregnant? Be sure to let your clinician know before having x-rays taken.

According to the American College of Obstetricians and Gynecologists, dental care, including dental X-rays, are safe during pregnancy. Also, dental X-rays do not need to be delayed if you are breastfeeding or trying to get pregnant.

If you have any questions or concerns, speak with your dentist or OBGYN.

How Often Are X-rays Taken?

The American Dental Association (ADA) recommends prescribing dental X-rays, but they are subject to clinical judgment and may not apply to every patient. Let’s take a closer look at the recommendations.

Child (No Permanent Teeth)

  • First visit: Select images ONLY if interproximal contacts can’t be visualized or probed
  • Recall visit w/cavities: Posterior bitewings every 6-12 months
  • Recall visit w/o cavities: Posterior bitewings every 12-24 months

Child (Some Permanent Teeth)

  • First visit: Posterior bitewings, select periapical images and panoramic X-ray
  • Recall visit w/cavities: Posterior bitewings every 6-12 months
  • Recall visit w/o cavities: Posterior bitewings every 12-24 months

Adolescent (Permanent Teeth)

  • First visit: Full mouth series recommended (14-20 X-rays) and panoramic X-ray
  • Recall visit w/cavities: Posterior bitewings every 6-12 months
  • Recall visit w/o cavities: Posterior bitewings every 18-36 months

Adult (Permanent Teeth)

  • First visit: Full mouth series recommended (14-20 X-rays) and panoramic X-ray
  • Recall visit w/cavities: Posterior bitewings every 6-18 months
  • Recall visit w/o cavities: Posterior bitewings every 24-36 months

Remember, these are recommendations. Your clinician will have the final say regarding what X-rays will be prescribed and how often. This information should be used as a reference to limit unnecessary radiation exposure.

If you present to your clinic for an emergency, your clinician will first assess if X-rays need to be taken. If x-rays are desired, the assistant will often take a panoramic x-ray, site-specific bitewing, and periapical images.

X-rays & Gagging

Male and female dentist looking at dental xrays | Common questions about dental xrays


Many patients have a difficult time getting through a complete series of X-rays.

However, there are ways to manage these issues, whether the sharp plastic digging into your gums or the sensor causing you to gag.

If you’ve had problems taking X-rays or easily gag, let your assistant know, they will do their best to capture clear images while keeping you comfortable.

If you have issues gagging, a pinch of salt on your tongue may help you get through the X-rays.

Most offices have salt for this situation; however, you can bring some from home.

Another technique is lifting and holding either leg up during the X-rays. Remember to calm your mind and take deep breaths through your nose.

It’s okay if you need to take longer breaks between images.

Related: Best MDA Recommended Products

My Experience & Expertise

Dental X-rays can be challenging and, at times, scary.

However, they serve an essential purpose for your clinician to evaluate and assess the dental disease accurately. Have you recently had x-rays taken only to discover dental problems exist?

My Dental Advocate’s team of board-certified dentists can provide a second opinion on your planned treatment. We look forward to bringing you peace of mind by verifying your treatment plan, suggesting an alternative, or answering your questions.

Need a second opinion? We can help! Learn more. Knowledge is power when cultivating healthy dental habits. The more informed you are, the better positioned you’ll be to prevent avoidable and potentially costly dental procedures for you and your family. Watch for future blog posts, where we’ll continue sharing important information, product reviews and practical advice!

About the Author

Dr. Matthew Hannan, also known as “Dr. Advocate,” is a board-certified dentist on a mission to provide accurate dental patient education. He attended Baylor University before completing dental school at UT Health San Antonio School of Dentistry. He now lives in Arizona with his beautiful wife and 4 kids. Dr. Hannan believes everyone should access easy-to-read dental resources with relevant, up-to-date dental research and insight to improve their oral health.

Matt Hannan, DDS Signature | My Dental Advocate

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