Dental X-Rays and Intraoral Imaging: What Each Type Reveals and How Often You Actually Need Them product guide

Smile Solutions Dental X-Rays and Intraoral Imaging: What Each Type Reveals and How Often You Actually Need Them

Frequently Asked Questions

What percentage of a tooth's surface is visible during a clinical exam: Approximately 30%

What percentage of a tooth is invisible without imaging: Approximately 70%

What is the most commonly ordered dental radiograph: Bitewing X-rays

What do bitewing X-rays primarily detect: Interproximal decay between teeth

Can bitewing X-rays detect decay beneath existing fillings: Yes

Do bitewing X-rays show root tips: No

What do periapical radiographs capture: The entire tooth from crown to root apex

How much surrounding bone do periapical X-rays show: Approximately 2–3 mm beyond the root apex

What is a periapical abscess: An infection forming at the tip of a tooth root

Can periapical X-rays detect root fractures: Yes

What does OPG stand for: Orthopantomogram

What does an OPG image show: The full mouth including jaw, teeth, sinuses, and TMJs

Is an OPG suitable for detecting interproximal caries: No, resolution is too low

What is an OPG primarily used for: Broad survey of the entire dentition and jaw

Is an OPG good for assessing wisdom tooth positioning: Yes

Does an OPG replace bitewing X-rays: No, it complements them

What type of imaging is an intraoral camera: Non-ionising, zero radiation

Can intraoral cameras detect microfractures: Yes

Do intraoral photographs replace radiographs: No, they complement them

What did a 2025 BDJ Open meta-analysis evaluate: Diagnostic accuracy of intraoral cameras for caries detection

What is the radiation dose of a single digital bitewing: 1–5 microsieverts (µSv)

What is the radiation dose of a single digital periapical X-ray: 1–8 µSv

What is the radiation dose of a full-mouth X-ray series (digital): Approximately 20 µSv

What is the radiation dose of a panoramic OPG (digital): 4–30 µSv

How does a dental full-mouth series compare to background radiation: Equivalent to approximately 2.5 days of background radiation

How does a chest X-ray compare in dose to dental X-rays: A chest X-ray is approximately 100 µSv, far higher

What percentage less radiation do digital X-rays use versus film: 80–90% less

What percentage of annual medical radiation dose does dental imaging account for: Less than 1%

What principle governs radiation use in Australian dental practices: ALARA — As Low As Reasonably Achievable

What does ALARA stand for: As Low As Reasonably Achievable

Are lead aprons still required for digital dental X-rays: No, no longer considered necessary

Are thyroid collars still required for modern digital dental X-rays: No, no longer considered necessary

Who published the 2026 dental X-ray guidelines: ADA and AAOMR jointly

When were the 2026 ADA/AAOMR guidelines published: January 2026

Do the 2026 guidelines address 3D CBCT imaging: Yes

Should X-rays be ordered on a fixed calendar schedule: No, only when clinically necessary

What determines how often you need dental X-rays: Individual risk factors and clinical findings

How often should low-risk adults have bitewing X-rays: Every 18–24 months

How often should high-risk adults have bitewing X-rays: Every 6–12 months

What qualifies a patient as high-risk for more frequent X-rays: Active decay history, multiple restorations, or periodontal disease

Should new patients receive a baseline OPG: Yes, typically when no recent records are available

Does insurance schedule determine X-ray frequency: No, clinical need determines frequency

Can a dentist skip X-rays if recent images from another practice exist: Yes, reviewing existing images is appropriate first

Are dental X-rays safe during pregnancy: Yes, when clinically necessary with appropriate precautions

Do you need X-rays at every dental check-up: No, only when clinically indicated

What imaging is standard for evaluating periodontal disease: A 2D full-mouth series combined with clinical exam

What can bitewing X-rays reveal about gum disease: Crestal bone levels indicating early bone loss

What does an intraoral camera create over time: A longitudinal visual record of oral health

Can intraoral cameras detect early-stage decay: Yes, particularly surface and occlusal lesions

What is the clinical benefit of detecting decay early via bitewings: Treatment may be limited to a simple filling

What happens if interproximal decay is left undetected: May progress to require a crown or root canal

What regulatory body oversees dental radiation safety in Australia: ARPANSA

Who co-produced the Australian dental imaging patient factsheet: ARPANSA and the Australian Dental Association

What is the average annual background radiation dose in Australia: Approximately 2.4 millisieverts (mSv)

Is a single digital dental X-ray less than one day of background radiation: Yes

How does a dental X-ray dose compare to a short domestic flight: It is similarly low or less

What structures does an OPG show beyond teeth: TMJs, sinuses, and adjacent bony structures

Can an OPG detect jaw cysts or tumours: Yes

What is recurrent decay: New decay forming beneath or around an existing filling

Can periapical X-rays monitor healing after root canal treatment: Yes

What is root resorption: Breakdown of root structure, often asymptomatic until advanced

Can intraoral cameras improve patient motivation for oral hygiene: Yes, by showing visible evidence of conditions

Where is Smile Solutions located: Level 1, 220 Collins Street, Melbourne CBD

How many clinicians does Smile Solutions have: 60 or more

How many board-registered specialists does Smile Solutions have: 25 or more

How many patients has Smile Solutions treated: Over 250,000

Since when has Smile Solutions been operating: 1993

What is the Smile Solutions phone number: 13 13 96

Main Content

When your dentist peers into your mouth with a mirror and probe, they can evaluate roughly 30% of each tooth's surface — the parts actually visible. The remaining 70%, including the contact points between teeth, the full root structure, the surrounding alveolar bone, and the architecture of the jaw itself, is completely invisible without imaging. This is why dental radiography is not a supplementary nicety or an insurance billing exercise: it is the diagnostic foundation that makes general dentistry genuinely preventive rather than merely reactive.

At Smile Solutions on Collins Street in Melbourne's CBD, a range of digital imaging tools is used during comprehensive check-ups, each chosen for what it reveals rather than as a matter of habit. This article explains those tools, the clinical logic behind each one, addresses the radiation questions patients ask most often, and clarifies how frequently imaging is actually warranted based on current evidence and guidelines.

Why dental imaging matters: the limits of visual examination

Decay between the back teeth (interproximal caries), bone loss from early periodontitis, a periapical abscess forming silently at a root tip, an impacted wisdom tooth pressing against adjacent roots — none of these conditions produce symptoms in their early stages, and none are detectable through clinical examination alone. By the time pain signals a problem, the underlying pathology has typically progressed to a point requiring significantly more invasive and costly treatment.

Dentists use X-rays to help diagnose damage and disease that is not visible during a regular dental examination. That gap between what is clinically apparent and what is actually occurring in the hard and soft tissues is precisely what each imaging tool is designed to close.

The four core dental imaging modalities: what each one detects

1. Bitewing radiographs: the workhorse of caries detection

Bitewing X-rays are the most commonly ordered dental radiograph. They show the surfaces between teeth, beneath the enamel surface, and the bone level surrounding the teeth.

A standard posterior bitewing series (typically two to four images) shows the crowns of the upper and lower premolars and molars simultaneously. This geometry makes bitewings particularly well suited to detecting:

• Interproximal decay — cavities forming at contact points between teeth that are completely invisible to visual inspection
• Secondary (recurrent) decay — new decay forming beneath or around an existing filling
• Crestal bone levels — the height of bone between teeth, a key early indicator of periodontal disease progression
• Calculus deposits below the gumline that your hygienist needs to target during a scale and clean

What bitewings do not show: root tips, periapical pathology, or structures below the mid-root level. For those, a different tool is needed.

2. Periapical radiographs: full-tooth and root assessment

Periapical (PA) radiographs capture the entire tooth from crown to root apex, along with approximately 2–3 mm of the surrounding bone. They show the whole tooth including the roots and surrounding structures.

Periapical images are the primary tool for:

• Diagnosing periapical pathology — abscesses, granulomas, and cysts at root tips
• Assessing root fractures — particularly after dental trauma
• Evaluating root morphology before extraction, root canal treatment, or implant planning
• Monitoring healing after endodontic therapy or periapical surgery
• Detecting root resorption — internal or external, often asymptomatic until advanced

In the context of a toothache investigation (see our guide on Toothache Causes, Triage & Treatment), a periapical radiograph of the symptomatic tooth is almost always the first imaging step, as it can confirm or exclude a periapical abscess within seconds of viewing.

3. Panoramic radiograph (OPG): the broad-view survey

The orthopantomogram, or OPG, is an extraoral radiograph that sweeps around the entire dentition to produce a single wide-format image of the upper and lower jaws, all teeth, the temporomandibular joints (TMJs), the sinuses, and adjacent bony structures.

An OPG provides a view of the full mouth, including the jaw, teeth, sinuses and eye sockets, and is commonly used to review tooth development and wisdom tooth positioning, for planning orthodontic treatment, and to support the treatment of conditions affecting a wider area of the mouth.

The OPG is the preferred option when your clinician needs to:

• Survey the entire dentition in a new patient with no previous radiographic records
• Assess third molars (wisdom teeth) — their position, angulation, and proximity to the inferior alveolar nerve (see our guide on Emergency Dental Care in Melbourne CBD for what happens when an impacted wisdom tooth becomes acutely symptomatic)
• Evaluate jaw pathology — cysts, tumours, or bony lesions across a wide field
• Screen for generalised bone loss in a periodontal assessment
• Plan implant placement at a preliminary level before more detailed imaging

The OPG's limitation is resolution: it is a survey image, not a diagnostic close-up. Interproximal caries, for example, are poorly detected on an OPG because of image overlap and magnification distortion. An OPG does not replace bitewings or periapicals — it works alongside them.

4. Intraoral photographs: the non-ionising diagnostic layer

Intraoral photography, captured using a high-magnification wand-style camera, is not an X-ray modality, but it forms an essential part of the imaging suite at Smile Solutions. What makes this technology useful is its ability to reveal details that the human eye or even traditional dental mirrors cannot catch — small fractures, early-stage decay in tight spaces between teeth, microscopic plaque buildup, and subtle signs of gum inflammation all become visible under the camera's magnification.

Intraoral photographs serve two clinical purposes: diagnosis and documentation. The images are saved digitally as part of your permanent dental record, creating a visual timeline that allows your dentist to track changes from visit to visit and monitor how well treatments are working.

A 2025 systematic review and meta-analysis published in BDJ Open (Nature) compared the diagnostic accuracy of intraoral cameras against radiographic and histological methods for caries detection, evaluating performance based on lesion type, lesion location, and examiner-dependent factors. This body of evidence positions intraoral photography not as a replacement for radiographs, but as a complementary, radiation-free tool that is particularly valuable for surface and occlusal lesion monitoring.

For patients who feel anxious about radiation (see our guide on Dental Anxiety at the Dentist), intraoral photography offers a zero-dose way to document and monitor early-stage changes before a radiograph is clinically warranted.

Radiation dose: putting the numbers in perspective

Radiation concern is one of the most common reasons patients decline or delay dental imaging, and it is largely a concern born of imprecise comparisons. Here is what the evidence actually shows.

Dental imaging methods such as X-rays are routinely used as part of general dental examinations and for diagnostic purposes, and each procedure involves exposure to a small amount of ionising radiation. The key question is: how small?

Radiation dose comparison table

Sources: ARPANSA Dental Imaging Factsheet; Contrast Oral Radiology (2024); Katy Cypress Oral Surgery (2024); Liv Hospital (2025)

A full-mouth series with a digital sensor using rectangular collimation has an effective dose of 20 µSv, equivalent to 2.5 days of background radiation. A panoramic radiograph sits at a similar level.

The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) estimates the mean effective radiation dose from all sources in Australia at approximately 2.4 millisieverts (mSv) per year, with about half from natural sources. Dental imaging accounts for less than 1% of the estimated collective annual effective dose received from medical imaging.

The shift to digital technology has been significant for patient safety. Digital dental X-rays use 80–90% less radiation than conventional film, meaning you are exposed to minimal radiation whilst your dentist still receives the detailed images needed for accurate diagnosis.

In Australia, this safety framework is formalised through regulatory oversight. ARPANSA and the Australian Dental Association have produced a factsheet for patients explaining different types of dental imaging and the associated levels of radiation exposure.

According to ARPANSA, the radiation from a single digital dental X-ray is so low that it is often less than what you would be exposed to during a short domestic flight.

One notable recent development: thyroid collars and lead abdominal aprons are no longer considered necessary, given the low radiation levels and optimisation of modern dental X-ray techniques. This reflects the dramatically reduced doses delivered by current digital equipment, a finding that surprises many patients accustomed to being draped in lead aprons.

How often do you actually need dental X-rays?

This is the question patients ask most often, and the honest answer is: it depends on your individual clinical picture, not on a fixed calendar interval, and certainly not on what your health fund allows per year.

The 2026 ADA/AAOMR guidelines: the current gold standard

In January 2026, the first dental X-ray recommendations published by the ADA in more than a decade confirmed that dental X-rays should be ordered only when clinically necessary. These new recommendations are also the first from the ADA to address both 2D (planar) and 3D (CBCT) imaging and specific clinical scenarios to inform their use during patient visits.

The guidelines, co-published with the American Academy of Oral and Maxillofacial Radiology (AAOMR) in the Journal of the American Dental Association, make the clinical logic explicit: you wouldn't get an X-ray of another part of your body unless the doctor believed there was reason to order one after an examination. Dental X-rays should be ordered only after reviewing your medical and dental histories, prior X-ray images, and current clinical exam findings.

Rather than a one-size-fits-all schedule, imaging frequency should reflect your individual risk factors, including age, dental development, caries risk, periodontal status, and signs or symptoms of disease.

Risk-stratified frequency: a practical framework

Low-risk adult patients (no active decay, no periodontal disease, excellent home care, no restorations at risk):

• Posterior bitewings: every 18–24 months is generally appropriate
• Periapicals: only when a clinical finding warrants investigation
• OPG: no fixed frequency — indicated when a broad survey is clinically justified

Moderate-to-high-risk adult patients (active decay history, multiple restorations, early periodontal disease, dry mouth from medications, high-sugar diet):

• Posterior bitewings: every 6–12 months
• Periapicals: as directed by clinical findings
• Adults are recommended to receive posterior bitewings between 6–18 months based on need, risk, and clinical findings

Periodontal patients: a 2D full-mouth series combined with a clinical exam remains the standard for evaluating periodontal disease management. Frequency thereafter is guided by disease activity and treatment response (see our guide on Gum Disease Explained).

New patients: an OPG and/or selected periapicals are typically warranted at the initial comprehensive examination to establish a baseline, particularly when no recent radiographic records are available from a previous practice.

The overarching principle governing all of this in Australia is ALARA — As Low As Reasonably Achievable. Australian dental practices follow the ALARA principle, which ensures that X-rays are only used when necessary and that the benefits outweigh any potential risks.

One point that separates a thorough check-up from a cursory one (see our guide on Dental Check-Ups at Smile Solutions Melbourne CBD): reviewing previously obtained images, whether from your own records or another provider, is a best practice to avoid unnecessary duplication. If you bring recent radiographs from another practice, you should not be re-imaged simply because you are new to a clinic — a clinical review of existing images is the appropriate first step.

The role of intraoral cameras at Smile Solutions: diagnosis without radiation

The intraoral camera used during your check-up at Smile Solutions adds diagnostic information that radiographs alone cannot provide, particularly for surface pathology, crack detection, and patient communication.

These cameras capture intricate details of tooth surfaces, identifying microfractures, pits, and fissures where decay might start — a level of detail that matters for accurate diagnosis and personalised treatment planning.

If you are ever wondering whether a filling is actually necessary, or what a cracked cusp looks like, the intraoral camera turns an abstract clinical recommendation into something visible and understandable. Visual evidence of oral health conditions can also motivate better home care — by showing you images of plaque buildup, gum inflammation, or early decay, your dentist can make a concrete case for the habits that will actually protect your teeth.

The combination of digital radiography and intraoral photography creates a comprehensive visual audit of your dentition, each tool revealing what the other cannot. Bitewings catch the interproximal decay invisible to the camera; the camera catches the occlusal crack invisible on the X-ray. Together, they close the diagnostic gap that neither could close alone.

This imaging foundation also directly informs restorative decisions. When decay is identified early through bitewing radiography, treatment can often be limited to a simple composite filling. Left undetected until symptomatic, the same lesion may require a crown or root canal (see our guide on Tooth Fillings in Melbourne CBD: Composite, Porcelain (CEREC), and Amalgam Options Compared). The case for appropriate imaging frequency is, in this sense, self-evident — both clinically and practically.

Addressing common patient concerns

"I had X-rays six months ago — do I really need them again?"

Not necessarily. You do not need a dental X-ray at every check-up. X-rays are only recommended when there is a clinical need, based on your oral health and risk factors. If your previous images were recent and your clinical examination reveals no new concerns, your dentist may defer imaging entirely.

"I'm pregnant — are X-rays safe?"

Studies of pregnant patients receiving dental care have affirmed the safety of dental treatment. The doses involved in routine dental radiography are extremely low, and when imaging is clinically necessary, it can be performed safely with appropriate precautions. Your wellbeing, and that of your baby, is always the first consideration.

"My health fund only covers X-rays every two years — does that mean I only need them every two years?"

No. Imaging frequency should not be based on what your dental health fund allows. The only imaging examination with a frequency recommendation is the bitewing, and that frequency is based on your individual clinical needs. Health fund benefit schedules reflect administrative limits, not clinical guidelines. (See our guide on Dental Health Fund & Private Health Insurance at a Melbourne CBD Dentist for more on how to interpret your extras cover.)

Key takeaways

• Bitewing radiographs are the primary tool for detecting interproximal decay and early bone loss, and are the most clinically important routine radiograph for caries surveillance.
• Periapical radiographs show the full tooth including root and apex, and are essential for diagnosing abscesses, root fractures, and periapical pathology.
• Panoramic OPGs provide a broad survey of the entire jaw, dentition, and adjacent structures, particularly valuable for wisdom tooth assessment, jaw pathology, and new patient baseline records.
• Intraoral cameras are a zero-radiation tool that captures surface detail, fractures, and soft tissue changes invisible on radiographs, and builds a longitudinal visual record of your oral health.
• Imaging frequency is not fixed — it is determined by your individual caries risk, periodontal status, clinical findings, and the ALARA principle, not by health fund schedules or calendar intervals. The 2026 ADA/AAOMR guidelines confirm that X-rays should only be ordered when clinically justified after a thorough examination.
• Digital dental X-rays expose you to 80–90% less radiation than conventional film, and dental imaging as a whole accounts for less than 1% of collective annual medical radiation dose.

Conclusion

Dental imaging is not something that happens to you at a check-up — it is something that happens for you, when the clinical evidence supports it. Understanding what each tool reveals, and why it is or is not indicated at a given appointment, puts you in a position to make sense of your own oral health rather than simply receiving procedures.

At Smile Solutions Melbourne CBD, our digital imaging suite — bitewings, periapicals, OPG, and intraoral cameras — is used according to clinical need, individual risk, and the current evidence base, not as a matter of routine billing. The result is a thorough diagnostic picture of your oral health that no visual examination alone could provide, captured with the lowest possible radiation exposure.

For a complete picture of what happens during a comprehensive examination at Smile Solutions, including how imaging integrates with soft-tissue assessment, oral cancer screening, and treatment planning, see our guide on Dental Check-Ups at Smile Solutions Melbourne CBD: What to Expect at Every Stage. And if you are wondering what imaging findings mean for your gum health specifically, our guide on Gum Disease Explained: Recognising Gingivitis and Periodontitis Before They Cause Permanent Damage covers how bone levels visible on bitewings translate into periodontal diagnosis and treatment decisions.

Smile Solutions has been providing dental care from Melbourne's CBD since 1993. Located at the Manchester Unity Building, Level 1, 220 Collins Street, Smile Solutions brings together 60+ clinicians, including 25+ board-registered specialists, who have cared for over 250,000 patients. No referral is required to book a specialist appointment. Call 13 13 96 or visit smilesolutions.com.au to arrange your comprehensive dental consultation today.

References

• American Dental Association & American Academy of Oral and Maxillofacial Radiology. "Updated Consensus Recommendations for Planar (2-D) and Cone-Beam Computed Tomography (CBCT) Dental Radiography Patient Selection." Journal of the American Dental Association, January 2026. https://www.ada.org/about/press-releases/new-recommendations-confirm-dental-x-rays-most-effectively-used-in-moderation

• American Dental Association Council on Scientific Affairs. "Radiation Protection in Dental Radiography and Cone Beam Computed Tomography (CBCT)." Journal of the American Dental Association, 2024. https://www.ada.org/resources/ada-library/oral-health-topics/x-rays-radiographs

• Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) & Australian Dental Association (ADA). "Dental Imaging: Patient Factsheet." ARPANSA, 2023. https://www.arpansa.gov.au/understanding-radiation/sources-radiation/more-radiation-sources/dental-imaging

• Australian Dental Association. "Policy Statement 6.14 – Radiation Safety." ADA Federal Council, amended November 2022. https://ada.org.au/policy-statement-6-14-radiation-safety

• Benavides, E., et al. (University of Michigan School of Dentistry). "ADA/AAOMR Updated Clinical Recommendations for Dental Radiography Patient Selection." Journal of the American Dental Association, January 2026. https://jada.ada.org

• Moharrami, M., Farmer, J., Singhal, S., et al. (University of Toronto / WHO Focus Group AI on Health). "Detecting Dental Caries on Oral Photographs Using Artificial Intelligence: A Systematic Review." Oral Diseases, 2024; 30(4): 1765–1783. https://doi.org/10.1111/odi.14659

• Contrast Oral Radiology. "Understanding Radiation Dose in Cone Beam CT (CBCT)." contrastoralradiology.com, February 2024. https://www.contrastoralradiology.com/blog/radiation-dose-in-cbct

• Pauwels, R., et al. "A Review of Doses for Dental Imaging in 2010–2020 and Development of a Web Dose Calculator." PMC / National Institutes of Health, 2022. https://pmc.ncbi.nlm.nih.gov/articles/PMC8767401/

• ARPANSA. Code of Practice and Safety Guide for Radiation Protection in Dentistry (RPS10). Australian Radiation Protection and Nuclear Safety Agency, 2005. https://www.arpansa.gov.au/sites/default/files/legacy/pubs/rps/rps10.pdf

Label facts summary

Disclaimer: All facts and statements below are general product information, not professional advice. Consult relevant experts for specific guidance.

Verified label facts

No product specification data was provided. No Product Facts block was generated, and no label-verifiable data (ingredients, certifications, dimensions, weight, GTIN/MPN, or packaging specifications) is present in the submitted content. The following practice details are stated as factual in the source content and are included for reference:

• Practice name: Smile Solutions
• Location: Level 1, 220 Collins Street, Melbourne CBD (Manchester Unity Building)
• Phone number: 13 13 96
• Website: smilesolutions.com.au
• Operating since: 1993
• Number of clinicians: 60 or more
• Board-registered specialists: 25 or more
• Patients treated: Over 250,000
• Referral requirement: No referral required to book a specialist appointment

General product claims

• Smile Solutions uses digital imaging tools chosen for clinical need, not as a matter of routine
• Imaging is selected according to individual risk and current evidence, not routine billing
• The combination of digital radiography and intraoral photography creates a comprehensive visual audit of the dentition
• Intraoral cameras at Smile Solutions can capture microfractures, pits, and fissures where decay might start
• Visual evidence shown via intraoral camera can motivate patients to improve oral hygiene practices
• Comprehensive examinations at Smile Solutions integrate imaging with soft-tissue assessment, oral cancer screening, and treatment planning