Dental Panoramic X-ray (OPG):what to expect

Your dentist or orthodontist may request an OPG to:

• Assess the position of unerupted teeth, especially wisdom teeth.
• Plan orthodontic treatment.
• Evaluate before dental implant placement.
• Look for cysts, tumours, or other abnormalities in the jaw bones.
• Investigate jaw pain, particularly TMJ-related pain.
• Assess fractures of the jaw after trauma.
• Screen for infection around the roots of teeth.
• Evaluate the developing dentition in children.

The OPG shows:

• All upper and lower teeth (erupted and unerupted).
• The shape and structure of the upper and lower jaw bones.
• The temporomandibular joints (where the jaw meets the skull).
• Parts of the maxillary sinuses above the upper teeth.
• The nasal floor.
• Any retained roots, impacted teeth, cysts, or tumours.
• Generalised bone loss patterns associated with gum disease.

It is excellent for overview but does not show the fine detail of an individual tooth that a periapical X-ray would. The two types of X-ray are complementary, not interchangeable.

No. The OPG is painless and contactless apart from the chin rest and bite block. You feel the bite block in your mouth and stay still while the machine rotates, but there is no discomfort.

The radiation dose is small but not zero, so:

• Tell the team if there is any chance of pregnancy. A clinically necessary dental X-ray can still be performed. Current radiation-protection guidance does not recommend routine patient shielding because a shield can obscure anatomy or interfere with exposure controls; the team should instead justify the examination, limit the beam, and use an optimised technique.
• For children, the dose can be reduced further. Dentists do not request OPGs routinely in children unless there is a clinical question.

A cone-beam CT (CBCT) is a 3D dental scan that gives detailed cross-sectional images of the jaws and teeth — much more detail than an OPG, but at a higher radiation dose. CBCT is reserved for specific complex questions: implant planning in difficult anatomy, third molar removal where the nerve is close, root canal complexity, jaw tumour assessment.

For most dental purposes, a panoramic OPG is enough. CBCT is added when the clinical question demands it.

The small intraoral X-rays taken in the chair (bitewings, periapicals) show one or a few teeth in fine detail. The OPG shows everything in a single overview but with less detail per tooth. Most dentists rely on a combination — periodic bitewings for cavity surveillance, OPG every few years or when a broader assessment is needed.

A panoramic image is a two-dimensional overview. It is less detailed than small intraoral dental X-rays for individual teeth and is not reliable for precise implant measurements or every cavity, root fracture, soft-tissue problem, or temporomandibular-joint disorder. Your dentist may need targeted dental films, CBCT, CT, MRI, or clinical examination depending on the question.

• No fasting required.
• Remove jewellery, glasses, hearing aids, and hairpins from your head and neck.
• Tell the team if there is any chance of pregnancy.
• If you have severe difficulty standing still, mention it so the team can adjust the setup.

• You remove any earrings, necklaces, glasses, hairpins, or hearing aids that could obstruct the image.
• You stand or sit in front of the panoramic machine, which has a chin rest and bite block.
• You bite gently onto the bite block to position your jaw, and you grasp the handles on either side.
• The radiographer makes small adjustments to your head position.
• You are asked to stand still, close your lips, and place your tongue on the roof of your mouth.
• The X-ray arm slowly rotates around your head, capturing a single panoramic image. The rotation takes about 15 to 20 seconds.
• The whole appointment takes 5 to 10 minutes.

The dentist or orthodontist usually reviews the image immediately, often during the same appointment. If a radiologist's report is requested separately, it typically arrives within a few working days.

• RadiologyInfo.org: Panoramic dental X-ray
• FDA: Radiography
• RadiologyInfo.org: Radiation safety

A dental panoramic X-ray is a fast, low-dose overview of the teeth and jaws. It may help with selected extractions, orthodontic planning, implants, and jaw disease, but it is not automatically required for every patient and does not replace clinical examination or targeted dental images.