What is a panoramic dental X-ray?
A panoramic dental X-ray is a basic diagnostic tool that captures all the structures of the mouth and jaws in one two-dimensional image.
The image stretches from one jaw joint to the other, covering both jaws, the bone around the roots, developing teeth at different stages of eruption, the sinuses and the path of the nerve canal in the lower jaw. Unlike a standard intraoral X-ray, the panoramic machine rotates around the head while you stay still, so a single exposure gives a broad anatomical overview. With a digital X-ray, the image can be viewed immediately and specific areas enlarged on screen. It is also known as an OPG (orthopantomogram) or a "panorex".
What is a panoramic X-ray used for?
A panoramic X-ray serves as a comprehensive first look that helps assess the health of the mouth and jaws before planning treatment.
In practice, it is used to detect hidden findings in the jawbones, such as cysts or other lesions that need further investigation, and to assess the position of unerupted teeth, mainly impacted wisdom teeth that need surgical planning before extraction.
For complex dental implant treatment, it gives a first estimate of the available bone height, the course of the mandibular canal containing the nerve and blood vessels, and the distance to the sinus. Bone width is not visible on a two-dimensional image, so a 3D CBCT scan is sometimes needed as well.
The panoramic X-ray also helps assess bone loss after extractions, bone loss linked to advanced gum disease, and the effects of orthodontic treatment on the roots and the surrounding bone.
Main reasons for a panoramic dental X-ray
A panoramic X-ray is considered when an overall view is needed that goes beyond what selective intraoral X-rays can show.
- Planning dental implants or extensive restoration in both jaws
- Assessing the position of impacted wisdom teeth before wisdom teeth removal
- Following dental development in children and teenagers with eruption problems
- Detecting hidden disease such as cysts, tumors or deep infections
- Assessing chronic gum disease with advanced bone loss
- Assessing facial trauma when a jaw fracture is suspected
- Planning complex orthodontic treatment that requires a full map of unerupted teeth
A panoramic X-ray is not taken routinely for every patient: it is done when the clinical examination raises a question the X-ray can answer, and its findings are combined with the examination for a complete diagnosis.
What can a panoramic X-ray detect?
A panoramic X-ray can reveal problems that cause no symptoms yet, at an early stage.
Root and nerve problems
It can show lesions around the root tips (periapical lesions) that indicate a dead nerve not yet causing pain, and changes in the space around the root. It also shows unusual resorption of baby teeth roots, which affects the timing of treatment in young patients.
Cysts and tumors of the jaw
It can show changes in bone density, cysts of dental origin and tumors in the jawbones, some of which need further investigation. Comparing both sides of the jaw can reveal asymmetries that may point to developmental or one-sided disease not visible in a standard examination.
Panoramic X-ray, CBCT scan or bitewing X-ray?
The three types of image complement each other, and the dentist chooses between them according to the question raised by the examination.
| Type of image | What it shows | When it is used |
|---|---|---|
| Panoramic X-ray (2D) | All the teeth, both jaws, the jaw joints and the sinuses in one image | General assessment: wisdom teeth, planning implants and orthodontics, findings in the bone |
| CBCT scan (3D) | Bone volume and width, and the position of nerves and sinuses, in a defined area | Implant planning, impacted wisdom tooth removal, and when the 2D image is not enough |
| Bitewing X-ray | The back teeth of both jaws and the bone level between them, in fine detail | Detecting decay between the teeth, at intervals based on your personal risk of decay |
Examination, treatment plan and price quote
detailed and personalized
During the consultation, Dr Haim Aseriel examines your teeth, explains all the options and gives you a transparent price quote, with no obligation. The clinic is at 12 HaTnufa Street, Jerusalem.
How is a panoramic X-ray taken?
You are positioned carefully in the machine so that the image is sharp and free of distortion.
Positioning
You stand or sit, rest your chin on the chin support and bite gently on a bite block with a disposable cover; your lips close around it and your tongue rests against the palate.
The scan
The machine rotates around your head while emitting a low dose of X-rays. The scan lasts a few seconds, and you need to stay still to avoid blurring. Digital systems generally use a lower dose than older film-based machines.
Reading the image
The digital image appears on screen immediately. The dentist reviews all the structures and combines the findings with the clinical examination; when 3D information is needed, a complementary CBCT scan of a specific area may be recommended, also taken at the clinic.
How to prepare for a panoramic dental X-ray
Preparation is minimal and does not change your daily routine. Before the X-ray, removable dentures, jewelry, glasses, hearing aids and any metal object around the head and neck are removed, because they cast shadows (artifacts) on the image and can hide important structures.
If you are pregnant, tell your dentist before the X-ray; when it is needed, a dental X-ray is considered safe in pregnancy (see below). No fasting or change of medication is needed, and you can return to your normal activities right away.
How often should you have a panoramic X-ray?
There is no fixed schedule: according to the ADA and FDA guidelines, X-rays are taken only when the information is expected to change treatment, and at the lowest reasonable radiation dose (the ALARA principle). There is therefore no recommendation for a "routine" panoramic X-ray every few years; the decision depends on the clinical examination, your dental history, your personal risk factors and the planned treatment.
Before implant treatment, a recent X-ray is needed, because bone can change in a relatively short time. During complex orthodontic treatment, follow-up X-rays are sometimes needed to check the roots for possible resorption at the tips.
Can children have dental X-rays?
A panoramic X-ray in children is acceptable when it is clinically justified, with age-adapted settings that reduce exposure. It is considered to follow dental development, identify impacted or missing teeth, assess developmental problems or plan early orthodontic treatment (see pediatric dentist in Jerusalem).
In very young children, an X-ray is taken only when the information cannot be obtained another way, without radiation. Parents are told why the X-ray is needed and what the exposure involves.
Is a dental X-ray safe during pregnancy?
When they are needed, dental X-rays are considered safe during pregnancy. According to the American Dental Association (ADA) and the American College of Obstetricians and Gynecologists (ACOG), preventive, diagnostic and restorative dental care, including X-rays needed for diagnosis, can be done throughout pregnancy, and urgent treatment should not be delayed. The X-ray beam is aimed at the mouth and jaws, not the abdomen.
According to the updated recommendations of the ADA (2024) and the American Academy of Oral and Maxillofacial Radiology, a lead apron or thyroid collar is no longer necessary, including during pregnancy. Tell your dentist that you are pregnant and your obstetrician about the planned treatment; each case is assessed individually, in consultation with your doctor when needed.
Where can you get a panoramic X-ray?
A panoramic X-ray is taken at a dental clinic that has the right equipment, or at an imaging center on your dentist's referral.
At the clinic in Talpiot, Jerusalem, the X-ray is taken on site with a Planmeca ProMax 3D unit, which takes both two-dimensional panoramic X-rays and 3D CBCT scans. The image can therefore be taken during your visit, when the dentist decides it is needed, and completed with a 3D scan when required.
Panoramic X-ray cost: what affects the price?
The cost of a panoramic X-ray depends on the type of imaging, where it is taken (at a dental clinic or an imaging center) and whether a detailed report is included. A 3D CBCT scan, when needed, usually costs more than a two-dimensional panoramic X-ray.
The price usually covers taking the image and the dentist's interpretation. When the X-ray is used to plan implants or complex restoration, it may be combined with a CBCT scan and an intraoral scan, as needed. Ask for a written quote beforehand that lists what is included. Some Israeli health funds and insurers reimburse part or all of the cost depending on the policy and the medical indication; the clinic provides itemized receipts you can submit to your insurer (coverage depends on your policy).
Why a panoramic X-ray matters for diagnosis
A panoramic X-ray is an important diagnostic tool, but it complements the clinical examination and does not replace it. The conservative approach followed by Dr Haim Aseriel depends on understanding the existing structures, detecting problems early and planning treatment that preserves natural teeth; when it is needed, the panoramic X-ray provides that overall picture of the teeth and jaws.
At the consultation, held in English, your mouth is examined, you decide together whether an X-ray is needed and which one, and you receive a personalized treatment plan. The clinic is at 12 HaTnufa Street in Talpiot, south Jerusalem.
Panoramic dental X-ray: frequently asked questions
A panoramic X-ray takes a few seconds: the machine rotates around your head, and you need to stay still so the image is not blurred. No fasting or special preparation is needed, and you can return to your normal activities right after the X-ray.
No. A panoramic X-ray complements the clinical examination and does not replace it: the dentist combines what the image shows with the examination of your mouth, your dental history and your symptoms. Sometimes another type of image is also needed, such as a 3D CBCT scan or a bitewing X-ray.
Dental X-rays, when they are needed, are considered safe during pregnancy. According to the latest recommendations of the American Dental Association (ADA), a lead apron or thyroid collar is no longer necessary; tell your dentist that you are pregnant before the X-ray.
Before a panoramic X-ray, removable dentures, jewelry, glasses, hearing aids and hair clips are removed, because they cast shadows on the image and can hide important structures.
The cost of a panoramic X-ray depends on the type of imaging (two-dimensional, or 3D CBCT when needed), where it is taken (at a dental clinic or an imaging center) and whether a detailed report is included. Some health funds and insurers reimburse part of the cost depending on the policy and the medical indication, so ask for a written quote in advance.
Sources
- American Dental Association / U.S. Food and Drug Administration, The Selection of Patients for Dental Radiographic Examinations, 2012 – View source
- Benavides E et al., Journal of the American Dental Association, 2023 – View source
- American Dental Association, Updated Recommendations to Enhance Radiography Safety in Dentistry, 2024 – View source
- Lingam AS et al., common errors in digital panoramic radiographs, 2023 – View source
- American Dental Association, Pregnancy (Oral Health Topics), 2025 – View source
- American College of Obstetricians and Gynecologists, Committee Opinion 569, 2013 – View source
