Dental X-rays let your dentist see what an exam alone cannot: decay between teeth, problems below the gumline, the roots of teeth and the bone that supports them. They are a routine part of dental care, but patients often have reasonable questions about how often they are needed and how safe they are. This guide explains the main types of dental X-rays, what the ADA and FDA say about safety, and how to talk with your dentist about imaging.
What dental X-rays show
The ADA’s MouthHealthy site describes X-rays as a diagnostic tool that can confirm your teeth are healthy or reveal damage or disease not visible during an exam, such as new cavities or impacted teeth (MouthHealthy: X-rays). MedlinePlus lists what they can identify, including the number, size and position of teeth, impacted teeth, tooth decay, bone loss from gum disease, abscessed teeth, a fractured jaw, and bite problems (MedlinePlus: Dental x-rays). MedlinePlus also notes that X-rays can reveal cavities before they are visible, even to the dentist.
On an X-ray, dense materials such as metal fillings block most of the energy and appear white, air appears black, and teeth and tissues appear as shades of gray.
Types of dental X-rays
MedlinePlus describes several common types:
- Bitewing. Shows the crowns of upper and lower teeth together while you bite on a tab. MedlinePlus notes many dentists take bitewings yearly to look for early cavities between teeth.
- Periapical. Shows one or two whole teeth from crown to root.
- Occlusal (palatal). Captures all the upper or lower teeth in one image.
- Panoramic. A machine rotates around your head to capture all the teeth and jaws in one image. It is used to plan implants, check for impacted wisdom teeth and look for jaw problems, but MedlinePlus says it is not the best way to find cavities unless decay is advanced.
- Cephalometric. A side view of the face, often used in orthodontics, showing how the jaws relate to each other and to other structures.
Cone beam CT (CBCT)
CBCT creates a three-dimensional image. The FDA explains that dental CBCT is used for purposes including implant planning, evaluating the jaws and face, root canal diagnosis and diagnosing dental trauma. It also notes that while CBCT doses are generally lower than other CT exams, dental CBCT typically delivers more radiation than conventional dental X-rays (FDA: Dental cone-beam computed tomography). If you are planning an implant or a bone graft before an implant, a CBCT scan is often part of that planning.
How often do you need X-rays?
There is no fixed schedule that fits everyone. MouthHealthy says how often X-rays are taken depends on your current oral health, your age, your risk of disease and any signs or symptoms. Children and teens may need them more often because their teeth and jaws are still developing. New patients may get X-rays to establish a baseline.
MouthHealthy also notes that 2024 recommendations from an ADA expert panel say X-rays should be taken only when your dentist believes they will provide necessary diagnostic information. You may not need X-rays at every visit. Our guide to how often to see the dentist covers visit frequency more generally.
How safe are dental X-rays?
MouthHealthy says dental X-rays emit very low doses of radiation, so the risk of harmful effects is very small, and that doses are much lower than in the past because of advances in technology. MedlinePlus likewise describes very low radiation exposure, while noting that no one should receive more radiation than necessary. Many dentists use digital X-rays, which MedlinePlus says involve less radiation than traditional film methods.
The FDA notes that younger patients are more sensitive to radiation and have a longer lifetime for any effects to develop, which is why it and the ADA recommend that dental X-rays, including CBCT, be done only when necessary for diagnosis or treatment.
What about lead aprons?
Guidance here has changed. MouthHealthy says abdominal and thyroid shielding (lead aprons and collars) is no longer needed for patients of any age or health status, including pregnancy, because shields can block the main beam and lead to retakes; several professional organizations support discontinuing shielding. Some practices still use it because of local regulations. Older references, including MedlinePlus, still mention aprons. If you have a preference, ask your dentist.
X-rays and pregnancy
MedlinePlus advises telling your dentist if you might be pregnant. Our guide to dental care during pregnancy explains what MouthHealthy says about dental visits while expecting.
Questions to ask
The FDA encourages patients and parents to talk with their provider about imaging. Useful questions include:
- Why is this X-ray needed now, and what will it show?
- Are there equally useful options that use less or no radiation?
- Do you use size-based settings for children?
- Can you use X-rays my previous dentist already took?
Getting copies of your X-rays
MouthHealthy notes that if a previous dentist has images of you, your new dentist may request copies instead of taking new ones. You have a legal right to copies of your health information. Our guide on how to request your dental records explains how. Keeping your own record of imaging, as the FDA suggests, also helps.
What happens during an X-ray
MedlinePlus explains that there is no special preparation, other than removing metal objects near the area being imaged. For bitewing and periapical X-rays, a small sensor or film is placed in your mouth and you bite down to hold it in place. MedlinePlus notes that the X-ray itself causes no discomfort, though biting on the sensor makes some people gag, and slow, deep breathing through the nose usually helps. Panoramic, cephalometric and CBCT images do not require biting on a sensor; the machine moves around your head instead.
Tell the team if you have a strong gag reflex, a sore area, or trouble holding still, so they can adjust the approach.
Key takeaways
- Dental X-rays reveal problems an exam cannot, such as cavities between teeth and bone loss.
- How often you need them depends on your health, age, risk and symptoms, not a fixed schedule.
- Doses are very low, but the ADA and FDA recommend imaging only when needed.
- CBCT gives 3D detail but usually more radiation than standard dental X-rays.
- Ask for copies of your images so a new dentist can use them.
Frequently asked questions
Do I need X-rays at every checkup?
No. The ADA’s 2024 recommendations say X-rays should be taken only when your dentist believes they will provide needed diagnostic information.
Are digital X-rays safer?
MedlinePlus says digital X-rays use less radiation than traditional methods.
Why does my child need X-rays more often than I do?
MouthHealthy explains that children’s teeth and jaws are still developing, so they may need more frequent imaging. Ask the dentist how the timing was decided.
Is a CBCT scan the same as a regular X-ray?
No. CBCT makes a 3D image and, according to the FDA, typically delivers more radiation than conventional dental X-rays. It is used for specific purposes such as implant planning.
Can I refuse X-rays?
You can discuss it. Your dentist should explain why imaging is recommended and what could be missed without it, so you can make an informed choice.
Sources
By the Dentist Review Editorial Team.
This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.
Featured image: “Dornbirn-Dental X-ray unit Orthophos SL 3D-01ASD” by Asurnipal, via Wikimedia Commons, licensed CC BY-SA 4.0. Resized and compressed for the web.
Our guides are written and reviewed by the Dentist Review editorial team. We research each topic using public, authoritative sources such as the CDC, the National Institutes of Health (NIH/NIDCR), the American Dental Association (ADA) and CMS, and we update guides when guidance changes. Guides are for general information only and are not dental or medical advice; please read our disclaimer and learn more about us.