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How Often Should You Get Dental X-Rays Taken?

I've gotten a few emails lately asking about how often dental x-rays should be taken.  An extreme example involved a young girl who had nearly 50 x-rays taken of one tooth over the course of a few years.

Another common example involves an adult who has never had a cavity.  Her dentist wants to take x-rays of her teeth every year.

Dental Panoramic X-RayThe main problem with getting so many x-rays is that whenever your body gets exposed to radiation, there is a risk of damaging your DNA, which could lead to cancer.  The amount of radiation from x-rays is very small, so this isn't something to worry about, but getting lots of dental x-rays every year can add up to a lot of radiation exposure over your whole life!

Do people really need to have x-rays taken this often?  Let's find out below!

How Often You Should Have Dental X-Rays Taken

The answer really depends on your oral health and your age.  For example, a 35-year old woman who has never had a cavity would require x-rays less often than than an 8-year old boy who has had several cavities in the past and doesn't brush his teeth.

In order to provide the best answer to the question of how often to have x-rays taken, I will break it down into five different answers based on age and oral health.  Hopefully you can identify the category that  most closely resembles your situation to get a general idea of how often you need to have dental x-rays taken.

One more note: To figure out whether you fall into the low cavity risk or high cavity risk category, think about how many cavities you've had in the past, whether you've had any recent cavities, the amount of sugar you eat or drink, and whether or not you brush and floss daily.  People with previous cavities and poor oral hygiene are usually at a higher risk for getting cavities and would need to have x-rays taken more often.

How Often Does a Child (Under 18) with a High Cavity Risk Need Dental X-Rays?

A child with cavities or at a high risk for getting cavities would generally need dental x-rays taken every 6 to 12 months.

If there are spaces between your child's teeth and the dentist can clinically inspect those teeth, then x-rays are generally not necessary.  It is always important to weigh the benefits and risks of having x-rays taken.

How Often Does an Adult (Over 18) with a High Cavity Risk Need Dental X-Rays?

An adult with frequent cavities or at a high risk of getting cavities would need dental x-rays taken every 6 to 18 months.

How Often Does a Child (Under 12) with a Low Cavity Risk Need Dental X-Rays?

A child younger than 12 years old with no current cavities and at a low risk of getting cavities would need dental x-rays taken every 12 to 24 months.  Again, many children have spaces between their teeth.  If this is the case, the dentist can usually detect cavities simply by looking in the mouth and would not need to take x-rays on those teeth.

How Often Does a Teenager (12-18) with a Low Cavity Risk Need Dental X-Rays?

A teenager with no current cavities and at a low risk of getting cavities would need dental x-rays taken every 18 to 36 months.

How Often Does an Adult (Over 18) with a Low Cavity Risk Need Dental X-Rays?

An adult with no current cavities and at a low risk of getting cavities would need dental x-rays taken every 24 to 36 months.

Other Scenarios Where Dental X-Rays May Be Necessary

The scenarios above are mainly to diagnose cavities and refer to the routine bitewing radiographs that dentists take.  There are many other situations when a dentist would want to take different x-rays where I couldn't find clear guidelines, such as for monitoring periodontal disease, monitoring teeth that are at an increased risk for developing disease, and for monitoring growth in adolescents.

However the situation that I described above in which a young girl had nearly 50 x-rays taken on one tooth over a few years is definitely too many!

At my dental school, we used the book Treatment Planning in Dentistry by Stefanac and Nesbitt to learn about when and how often to prescribe dental x-rays.  I am basing the recommendations for the timing of dental x-rays found above on information found in that textbook, which coincide with the recommendations from the American Dental Association (PDF).

Conclusion

As you can see, dentists may recommend x-rays for diagnosing cavities anywhere from every six months to every three years — depending on your oral health.

Keep in mind that the above guidelines are just that — guidelines.  You may need x-rays taken more or less often depending on what you and your dentist think is best for you.  For example, if you have spaces between all of your teeth and the dentist can see whether or not you have cavities just by looking in your mouth, then there probably isn't a need for dental x-rays.

Do you have any questions or comments on the timing of dental x-rays?  I'd love to hear what you have to say in the comments section below.  Thanks for reading!


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32 Comments |  Leave A Comment

  1. What about when you are pregnant? is it ever OK then? or should xrays be avoided until after the baby comes? and what about when you are breastfeeding, is it OK then?

    • Hi myrebel - During pregnancy x-rays should be avoided if possible. However, in some cases x-rays are necessary to diagnose and treat a pregnant woman's dental problem. Dental x-rays have been shown to be very safe even during pregnancy.

      The book Dental Management of the Medically Compromised Patient by Little says the following:

      "The safety of dental radiography has been well established... Animal and human data clearly support the conclusion that no increase in gross congenital anomalies or intrauterine growth retardation occurs as a result of exposures during pregnancy totaling less than 5 to 10 centiGray (cGy)."

      To put that in perspective, a full mouth series of dental x-rays (around 16-20 individual x-rays) with a lead apron on would expose the fetus to 0.00001 cGy, at least 500,000 times lower than what has been shown to be safe.

      As far as I know, there are no problems with getting dental x-rays when you're breastfeeding. I hope that answers your questions! Thanks for your comment.

  2. Thanks for clarifying the x-ray issue. Great article!

    • I have some follow-up comments and questions:

      What is your take on low-risk patients (i.e., no history of cavities) refusing to have x-rays performed? Is it appropriate for a dental practice to refuse to see a patient for a routine cleaning if x-rays aren't done, on the claim that the dentist could get in trouble with the state dental board? Is there any validity to the dental board issue? I figure that, should a question arise later from the board regarding the lack of regular x-rays on a particular patient, a dentist is protected by documenting the x-ray refusal on the patient's chart.

      I know that x-rays are routine every 3-5 years to check for decay that may not be visible during an exam, but refusing x-rays, especially when the patient has no history of tooth decay, seems like a basic right that should be respected.

      • I am a dental hygienist and in our practice the dentists malpractice insurance requires us to have up to date full mouth series radiographs or risk losing the malpractice insurance. We require up to date radiographs and if the patient refuses we have to dismiss them from our practice.

  3. I work as a veterinary assistant and as a part of my job I restrain horses and hold film plates for taking x-rays in the field. I wear my lead vest and dosimeter badge each time.

    Since I am exposed to more radiation than the normal person who does not work in such conditions I am always cautious about getting unnecessary x-rays. I visit the dentist twice a year, and sometimes more since all of my teeth are capped and I have a tooth pop off now and then. Every single time I go to the dentist they insist on taking x-rays, I received 12 last year between my 2 dental cleanings and the two times I had caps pop off. I just now started declining x-rays, but the dental staff has been almost rude to me and treated me as if I were stupid for not wanting x-rays taken that day knowing that my last set was just taken 6 months prior. I have not had a cavity in over 7 years since my caps were placed, I brush regularly and floss every day. Is it wrong of me to decline these x-rays, considering my work history?

    • Hi Charlotte - For someone who hasn't had a cavity in the last seven years, I would think that you don't need x-rays every time that you go into the dentist. According to the guidelines above, you'd probably only need x-rays every 2-3 years.

      Or course, any time a crown comes off, it's a good idea to get an x-ray to make sure that the tooth is alright and that the crown has been fully re-seated correctly onto the tooth.

      I hope that helps. Let me know if you have any other questions. Thanks for your comment, Charlotte!

  4. Hello, thanks for the article. I recently had to get my wisdom tooth taken out. In the process I had 1 panoramic x ray done, a few digital ones also done and a cone beam done by the dental surgeon. Today because of some recurring swelling, i had a bite wing done on the right side. They also removed a OKC from one of the tooth so i need regular checkups. A total of 4 visit to the dentist in 2 months a different x-ray done every time and more to come, should I be concerned and are there any alternatives?

    • Hi Steve - Since you had an OKC, there's really no better way to visualize it completely than with a cone beam CT. I wouldn't be too concerned. A cone beam CT actually gives you a lot less radiation than a regular CT scan. Many new patients at my dental school get at least 18 x-rays taken to visualize every part of their mouth.

      I hope that helps, Steve. Let me know if you have any other questions. Thanks for your comment!

  5. Hi - I really like your common sense approach. Many years ago I was a certified dental assistant (before expanded duties came along.... although I love dentistry, I ended up with an MBA in business) so I some dental background.
    My daughter who is 19 had a cleaning this week and also received 4 bitewings, and 2 PA's in the upper/lower anterior. She has no cavities, or fillings - none. She has had had full ortho and had her wisdom teeth out last year. A perfect mouth, never any pain, very good general health, doesn't smoke. I was thinking that 2 bitewings every 12-18 months would be very sufficient. I called the dental office today and spoke with the hygienist; she stated that it is the "office practice" with the 6 x-rays quoting an (obviously) rare case of a young man with a tumor in his upper anterior that lost 6 teeth - I think it is bull. (In this case considering her health as an individual) Am I overreacting? I have already left this practice for another dentist myself because this same dentist wanted to pull a 12 yr molar that I was willing to get a root canal and crown on. I left the kids at this practice because they liked the office staff, but I think it is time to "move on.com”! Thanks for your input

    • Hi Marcie - In an adult who has never had any cavities, I would say that bitewings every three years is sufficient. We generally recommend a panoramic x-ray every five years to catch beginning pathology. Unfortunately, the dentist may be nervous about getting sued if they were to miss anything, so they take extra x-rays - exposing their patients to more radiation - to make sure.

      Overall, the excess radiation probably wouldn't do any harm, but nobody really knows for sure since it's so hard to study. For example, if your daughter were to get cancer when she's 70 years old, it would be hard to pinpoint excess dental x-rays from 50 years before as a cause.

      I hope that helps - Thanks for your comment! Let me know if you have any other questions, Marcie.

  6. hi,my name is maria I am a dental assistant I take more than twenty bitewings a day and like the same amount of PA am I in damger if they r digital.

    • Hi Maria - As long as you are standing behind a lead-shielded wall, you should be fine.

      I hope that helps - Thanks for your comment, Maria. Let me know if you have any other questions.

  7. As a practicing Dental Hygienist in Florida, I can say that the "x-ray debate" is the most common subject that comes up during my patient's recall visits. The problem as I see it is NOT just a radiation issue, it is also a MONEY issue! My patients without insurance don't like the added expense of taking bitewing x-rays, which can be important not only for cavity detection but also for bone loss concerns with periodontally inclined patients as well. The two things they say the most are, "Well, if you SEE something while you're cleaning, then we can go ahead." & "I'm sure I'm doing fine, I don't have any pain". It is extremely important to get to the reason behind their reluctance to take x-rays when the dentist or hygienist feels they are needed, and I have found that having a release form for the patients to sign helps. My form explains the need for the xrays, the problem of undetected pathology if we don't take them, and the release of responsibility of the practice should something serious arise from not being detected on the x-ray in time. I explain to the patient that I would like to update their xrays today, why in their case we feel it is time to check their teeth at this visit radiographically, the possibility of a lower cost to them if we can fix a possible problem earlier and thus more conservatively, and that a copy of their release if they sign will be given to them and also placed in their chart. Almost always the hedging will begin... "Well", the patient will offer, "maybe we should go ahead and take them just to be sure", or "Let's go ahead and take them at the NEXT appointment"! Nine times out of ten, I end up taking them that day. My dentist is completely on board with the call- by-call evaluation for the necessity of taking xrays, and every patient knows the xrays aren't something we routinely take whether they have a need for them or not! I feel I am lucky to have the dentist agree with me, because I have been a substitute for the day in many offices where I was told that it was their policy to take xrays every 6 months or every year because "the insurance will cover it". Sigh. Patient education and good listening skills go a long way towards avoiding the "xray debate". We need to use our heads when making decisions about what xrays to take and when on each individual patient, and NOT let the insurance company or an outdated "office policy" rob us of our common sense on these matters.

    • Hi Lisa - Most of the patients that we deal with in dental school haven't been to the dentist in a while and they know that they need x-rays. I haven't yet dealt with anyone who declined getting x-rays although there have been some people who are hesitant.

      That does sound like a good way to let patients know that we're not taking them simply to charge them more - we really want to be able to give them a full, accurate diagnosis and treatment plan. It seems like a lot of dentists simply rush patients through the exam and x-ray process without giving the patients time to get answers to their questions. Communication definitely is key.

      I did like the quote about taking x-rays "if you see anything." If we could see interproximally, we probably wouldn't need the x-rays!

      Thanks for your comment, Lisa!

  8. What would the recommendation be if the dentist did not do the Xray, but instead had to refer to an outside facility, not owned by the dentist. Where is the data for better outcome with routine Xrays every 24 months. By better outcome I mean for the patient, not for the dentist's income. (snark)

    • Hi Blueash - Since cavities can form quickly in some people, it's a good idea to get x-rays in order to ensure that your teeth stay healthy. We also look at the area around the tooth and the bone to make sure that it is healthy and there aren't any cysts/tumors forming.

      In any case, of you don't feel like there's a problem and don't want to pay for them, you can always decline having x-rays taken. Thanks for your comment - let me know if you have any other questions!

  9. Hi,

    I recently got my wisdoms taken out, I just realized that the surgeon did not issue me an apron during the cone beam scan. Should I be worried? How much more radiation is a cone beam than a regular x ray?

    Thanks.

    • Hi Stephen - In my oral radiology book, it shows that cone beam CT scans give you anywhere from 20 to 599 micro Sieverts of radiation. Most likely, it was somewhere around 70 micro sieverts. This is equivalent to 9 days of natural radiation that you receive just by living on earth.

      That's about 7 times more than the radiation you would receive from one dental x-ray at my dental school. I wouldn't be too worried, as most of the radiation was directed at your face, which wouldn't be shielded by the lead apron anyways.

  10. Hi Tom: In follow-up to your post on 8/25, I was wondering if you could explain the difference between ultraviolet and x-ray radiation. I often hear dentist compare x-ray exposure to exposure of "natural" radiation emmitted from the sun, just like you did in your post. As far as I know, x-ray radiation penetrates deeply into the tissue and affects the DNA while radiation from the sun may only burn our skin and does not change DNA.

    • Hi Kate - The main difference between UV and X-Ray radiation is the wavelength, or energy of the radiation. As far as I know, UV rays do damage the DNA in our skin, which can give rise to skin cancer later in life. X-rays may also damage DNA. Just as spending a day in the sun probably wouldn't cause skin cancer, getting x-rays periodically isn't likely to cause cancer.

      It's a good analogy - thanks for bringing it up. I'll keep it in mind for a future article. Thanks for your comment, Kate! Let me know if you have any other questions.

  11. Hi, I am so glad to have found this. I called to schedule an appt for my daughter on Friday and I know she has some issues that we need to fix. I was unclear on how often an xray is needed and so I was asking why she needed an xray at this appt if they took xrays at her last appt about 6 months ago. My Mom became ill in February and died in May due to complications from gallbladder cancer. I think it would help if an office properly trained their staff on how to explain the importance of an xray the way you did here. When she said my daughter would be getting an xray I asked why, they have xrays from March and she said just to see better. I kept asking why they can't use the old xray (sorry, I am not the expert :)) and she had no clear answer which put me on guard. SO she went and asked the dentist and he said it is proptocol for each and every check up/cleaning (which I still don't feel comfortable with and may be looking for another dentist for my daughter). I asked again why this is necassary and she put me on hold while she went to look at the old xray and came back and told me they would not need a full mouth xray, just 2 little ones. I asked if that is supposed to be safer and she said "Ummm, yah." which didn't sound very reassuring. I almost called and cancelled the appt this morning after talking to friend who has worked in a dental office for 15 yrs told me they only do xrays if the pt comes in with pain or an issue of some kind. Otherwise they only do xrays every year or 2. I asked this lady at my daughters office what if I said no to the xray and she told me they have to have to do it for proper diagnosis. Anyway, I am sure I came off as nuts even though I explained to her that my Mom just passed recently and I have been reading up on causes and risks and maybe I am just being paranoid. I have a question, though. If they say a child's skull is not fully develpoed until they are 12 or so, shouldn't the dentist be weary of taking xrays 2 or more times a yr on an 8 yr old? It's not about the money for me, I am concerned about the harms of radiation going to my child's brain and I think this is a ligit concern for parents. And I think many parents would be put at ease if the professionalls had common sense answers like I just read here instead of getting the feeling they are taking guesses with the answers.Thanks for your informative article.

    • Hi Amy - I would be leery of a dentist who says it is protocol to take x-rays every 6 months. IF your child is at very high risk for getting cavities, then x-rays can be taken every six months. If this is the case, I think that it should be determined after the dentist looks in your child's mouth and deems it necessary to prescribe the x-rays.

      By the way, depending on their x-ray system, the two small x-rays could very well expose your child to more radiation than the large x-ray that goes around her head. You can learn more about how much radiation you get from dental x-rays here.

  12. I was talked into getting braces to correct 1 tooth that was out of line on my bottom teeth after the age of 40 by my denist who was also a friend. Prior to having the braces installed, a full set of x-rays were taken at a lab as requested by the orthodontist. While the braces were on for almost 2 years, I continued to have regular check-ups with my dentist. X-rays were never taken. After removal of braces only bite-wing x-rays were taken by my dentist. While wearing braces, I also had a gum graft on the one tooth that was out of line. Approximately 8 months after the braces were removed I noticed my teeth were shifting even thought I constantly wore the removable retainer. While at a check-up with the periodontist, she became upset that a permanent retainer had not been installed to keep the bottom front teeth in place. She told me to go back to the orthodontist and have her re-install the braces and then have a permanent retainer affixed when the braces were removed again 6 months later. I now find out that I have root resorption on all teeth with severe root resorption on the bottom 4 front teeth. The only thing keeping the 4 front bottom teeth in place now is the permanent retainer. My orthodontist says although she never formally requested x-rays, she assumed since I was making regular visits to my dentist that she would be taking x-rays and notifying her if she saw anything. My dentist just says not her fault. What is the typical protocal for taking x-rays in this situation?

  13. Hi Tom. It is interesting what you are trying to do. But when you start to actually practice Dentistry, you will find that it is really different. Patient healthcare changes so fast. I have seen patients healthy with no decay for years and 6 months after there is enamel destruction. A visual exam is not sufficient. And you hear from the patient saying "Why didn't you see this?" I have been working in this field for 13 years. In my oppinion, part of the prevention are bitewings every 12 months and FMX every 4 or 5 years. Now with digital x-ray it safe to do that.

  14. My 8 yo so with CP,GAD,OCD and numerous other dx had an accident in his wheel chair that knocked his permanent two front teeth out. They have been put back in and attached well.. Dentist wants us to come in every 2-3 weeks for X-rays for three months.. To monitor for infection etc.. Is this safe? He has such high anxiety that an endontist is hesitant to see him now so he has agreed to monitor the X-rays. I'm concerned about too much radiation.. He doesn't need anything else on his plate!

  15. I found this article informative. I used to take my boys to the same dentist I went to. I never questioned the X-rays he gave the boys but one day I asked why I needed X-rays every year when I hadn't had a cavity in 30 years. I have never had gum disease. The dentist actually got angry with me. A few years later we ended up at another dentist and I noticed the boys were only receiving 2 bitewing X-rays every year. The other dentist was giving them 4 bite wings and 2 PA's per year. Neither boy is cavity prone.

    I know now to ask how many X-rays are you giving and why.

  16. I am a 70 year old lady and yes,I've had plenty of dental work over my lifetime. However, as a kid I grew up in a very small rural town where most of the time there was no dentist. When one finally arrived, I couldn't go to him without learning I had five/six cavities so am wondering if many of my fillings are not due to just plain drilling and making a hole to fill...but of course no proof..however he finally lost his license for drinking on the job. I take good care of my teeth and visit a dentist regularly. However, in the older times a dentist never x-rayed teeth unless you told them you had a problem and one that wasn't visible with just the eye. Now, every dentist seems to want to take x-rays. I just don't understand why, if I don't have a problem, and I don't want the x-rays I should be forced into them. You say the radiation exposure is not much but I never see the x-ray tech. stay in the same room when doing them. I have been for over a year without any cavities and when I just refused x-rays, my dentist told the hygienist to tell me if I wouldn't have x-ray to not come back next year. I really didn't think him too professional when, he himself, wouldn't discuss this with me. And besides this, when I first went to this dentist, we had the discussion about x-rays and he told me if I didn't want them I would have to sign a paper...which I did. When I go to a medical Dr. for a physical I'm not required to have any x-ray's. I feel people should be able to make their own decisions especially when it comes to health...

  17. Hi-

    I just got new dental insurance and had to switch to a new dentist. I am used to having the normal bite-wings and panorama x-rays done.

    This new dentist did about 18 x-rays, including a panorama. I have talked to someone else who said when she went to a new dentist and forgot to forward her old x-rays (like I did), they did about 14 x-rays on her. Is this standard procedure? Seems a bit overkill if they also used a panoramic machine too.

    Thank for any advice you may give!

  18. I had full mouth xrays taken 3 times within 3 weeks. I am 83 years old. Should I be concerned

  19. Every dentist or specialist I see demands to take full mouth digital x-rays for their records. They refuse to provide copies to the patient or another dentist in DICOM format and are only willing to provide small blurry paper prints, which is unacceptable to another dentist. Some will send out .jpgs that cannot be enlarged and are out of focus and lack any identifying information. I don't want the extra radiation or expense. HIPPA law says I have a right to the x-rays in the format of my choice. DICOM readers are available for download. Why are many dentists so secretive and uncooperative about patient x-rays not wanting to share quality images? Medical facilities readily put digital x-rays and mri's on CD's or DVD's sometimes including the interpretative reports free of charge. When will the dental profession get on board with providing quality copies of x-rays to avoid unnecessary radiation and expense? Insurance companies have limits.

  20. this needs to be updated with most offices now using digital x=rays. They have 25% less radiation then the old x-rays

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Tom, Creator of Oral AnswersHi, I'm Tom. I recently graduated from dental school and am now a dentist in Bridgewater, Virginia. I started this blog to help people take better care of their teeth. You can learn more about me or ask me a question.

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