Panoramic X-Ray (Dental Panoramic Radiograph)

What Does a Panoramic X-Ray Show

A panoramic X-ray provides a broad structural overview of the mouth and jaws. It can reveal:

• All erupted teeth and any teeth still developing beneath the gumline
• Impacted teeth, including wisdom teeth that have not broken through
• Bone loss associated with gum disease
• Cavities, particularly between teeth and in areas difficult to examine clinically
• Dental abscesses and signs of infection at the root tips
• Malocclusion — how the upper and lower teeth align
• Cysts, tumors, or other abnormalities within the jaw bone
• TMJ (jaw joint) irregularities
• Sinus conditions that may have a dental origin
• Tooth development in children — assessing whether teeth are erupting in the correct sequence and position
• Early signs of pathology, including changes that may indicate oral cancer

Because it captures such a wide field of view, a panoramic X-ray is particularly useful for identifying conditions that would not be visible during a routine clinical examination.

How Is a Panoramic X-Ray Different from Other Dental X-Rays

Different types of dental X-rays serve different diagnostic purposes.

• Panoramic X-Ray (OPG)

  Captures the full mouth, both jaws, and surrounding structures in one image. Taken from outside the mouth. Excellent for screening, treatment planning, and whole-arch assessment — though with lower resolution than intraoral X-rays for fine detail on individual teeth.

• Bitewing X-Rays

  Small sensors placed inside the mouth that show the upper and lower back teeth side by side. Used primarily to detect cavities between teeth and assess bone levels. High detail for a limited area.

• Periapical X-Rays

  Show one or two teeth in full — from the crown to the tip of the root. Used to examine a specific tooth in detail, particularly for root canal treatment planning or infection assessment.

• CBCT (Cone Beam Computed Tomography)

  A three-dimensional imaging scan providing cross-sectional views of teeth, bone, nerves, and soft tissues. Used when greater depth and precision is required — for example, implant planning, complex oral surgery, or detailed TMJ assessment. Per American Dental Association’s 2026 recommendations, panoramic radiography is the appropriate first step before dental implant procedures, with CBCT used for presurgical planning where indicated.

A panoramic X-ray is often the starting point for imaging. If more detailed information is needed about a specific area, the dentist or specialist may request additional X-rays.

When Is a Panoramic X-Ray Recommended

Your dentist may request a panoramic X-ray in a number of situations:

• New patient assessment — to establish a baseline view of all dental structures before beginning treatment
• Orthodontic planning — to assess jaw size, tooth position, and the development of all teeth before starting treatment with a Specialist Orthodontist
• Wisdom tooth evaluation — to determine the position of impacted teeth and assess whether extraction is necessary
• Dental implant planning — to evaluate available bone volume and identify the location of nerves before implant placement
• Jaw pain or TMJ symptoms — to assess the structure and condition of the jaw joints
• Children's dental development — to monitor how adult teeth are forming and whether any are missing, extra, or out of position
• Pre-surgical planning — before orthognathic jaw surgery or complex Oral & Maxillofacial Surgery procedures
• Screening for pathology — including cysts, bone lesions, and early signs of jaw or sinus abnormalities

Panoramic X-rays are also routinely used in pediatric dentistry to track tooth development and identify issues such as missing teeth, extra teeth (like mesiodens), or delayed eruption.

How Is a Panoramic X-Ray Taken

The procedure is straightforward and takes only a few minutes from start to finish.

You will be asked to stand or sit in front of the panoramic X-ray machine. Metal objects — glasses, earrings, hairpins, and any removable dental appliances — are removed beforehand, as they can interfere with the image.

You bite gently on a small sterile mouthpiece and rest your chin on a support, with your head stabilized by side guides or a forehead rest. This keeps your head steady throughout the scan.

The machine arm then rotates around your head in an arc — from roughly one side to the other — typically taking between 12 and 20 seconds to capture the image. You remain still throughout. Nothing is placed inside the mouth during the scan.

With modern digital equipment, the image is available within seconds for the dentist to review.

For patients with dental anxiety: Because a panoramic X-ray requires nothing inside the mouth, many patients who find intraoral X-rays uncomfortable tolerate this scan significantly better. If you experience dental anxiety, let the team know — they will talk you through every step before you begin.

Is a Panoramic X-Ray Safe

Yes. A panoramic X-ray involves a very low dose of ionizing radiation.

Modern digital panoramic systems deliver doses at the lower end of the measurable range — the International Atomic Energy Agency (IAEA) cites an effective dose range of 4 to 30 microsieverts (µSv) for panoramic procedures, depending on the equipment and technique used. Even at the higher end of that range, the dose is equivalent to only a few days of natural background radiation.

For context, dental imaging as a whole accounts for less than 1% of the estimated collective annual effective dose received from all medical imaging combined, according to the American Dental Association.

The guiding principle in dental radiography is ALARA — As Low As Reasonably Achievable. X-rays are taken only when clinically necessary, not on a routine fixed schedule regardless of clinical need.

• Updated guidance on shielding

  The ADA (2024) and the American Academy of Oral and Maxillofacial Radiology (2023) have both formally recommended discontinuing the routine use of lead aprons and thyroid collars for dental X-rays. At the low doses involved in panoramic imaging, shielding offers no meaningful protective benefit — and can inadvertently block the primary X-ray beam, potentially requiring the scan to be repeated. Dose is managed most effectively through proper equipment calibration, correct patient positioning, and appropriate technique.

• For children

  Panoramic X-rays are safe for children and are used routinely in pediatric and orthodontic assessments. Technique is adapted to suit smaller jaw dimensions.

• During pregnancy

  When clinically necessary, a panoramic X-ray can be performed during pregnancy. Your dentist will assess necessity and advise on timing.