Different X-ray types capture different views - and each is used for specific clinical purposes. Here is the field guide.
Bitewing X-rays
The most common dental X-ray. The patient bites on a tab while the sensor captures the back teeth of one side. A standard set is 4 bitewings.
What they show: Cavities between back teeth, the height of bone between teeth, leaking margins on existing fillings/crowns, and overhangs on restorations.
When taken: Yearly for most adults; every 6 months for high-cavity-risk patients.
Periapical X-rays
Focused images of one or two teeth from crown to root tip.
What they show: The entire length of a tooth and its root, the surrounding bone, abscesses or cysts at root tips, root canal anatomy.
When taken: When evaluating a specific tooth - pain, possible root canal, extraction, or post-treatment follow-up.
Panoramic X-rays
A rotating arm captures the entire upper and lower jaw, sinuses, and TMJ in a single curved image.
What they show: All teeth, wisdom teeth position, jaw fractures, sinus issues, TMJ bony anatomy, eruption patterns in growing children, cysts and tumors.
When taken: Comprehensive baseline X-ray for new patients, every 3-5 years for adults, before orthodontic treatment or wisdom tooth removal.
Occlusal X-rays
A larger sensor placed on the biting surface, capturing the entire arch of teeth from above or below.
What they show: Full upper or lower arch, supernumerary teeth, impacted teeth, jaw fractures, salivary stones in the floor of mouth.
When taken: Less common in routine practice; specific clinical situations like pediatric patients with developing dentition.
CBCT 3D imaging
Cone-beam CT produces a 3D model of the jaw and teeth. The patient stands or sits while a beam rotates 360°.
What they show: 3D bone volume for implant planning, root anatomy for complex endodontics, TMJ anatomy, airway dimensions for sleep apnea evaluation, impacted teeth in 3D, and complex pathology.
When taken: Implant planning is the most common use. Higher dose than 2D imaging - ordered selectively, not routinely.
Frequently asked questions
- Which X-ray do most dentists take at routine visits?
- Bitewings (4 images) yearly are the most common. Panoramic every 3-5 years. CBCT only when there is a specific clinical indication.
- Can I see my own X-rays?
- Absolutely - and you should ask. We display X-rays on chairside monitors during exams. You can request copies for your records.
- Do children need different X-rays than adults?
- Yes. Children typically need fewer and smaller X-rays. First bitewings usually around age 4-6 once back teeth contact each other.
- How are digital X-rays different from film?
- Digital sensors are more efficient (lower dose), produce instant images, can be enhanced with software, and store permanently in your chart.