Panoramic X-ray vs. bitewing X-rays: Which one do you need?

Both types of dental X-rays show what your eyes can't see, but they serve different purposes. A panoramic X-ray shows your whole mouth in one wide image. Bitewing X-rays zoom in close on a small group of teeth. Your dental provider chooses the right one based on what they're looking for and what's happening in your mouth right now.

What you'll learn in this article:

• Panoramic X-rays show the big picture. They're used for new patients, growing children and specific concerns like impacted wisdom teeth or jaw problems.

• Bitewing X-rays are a close-up tool. They catch cavities between teeth and track bone loss around your gums, often at routine checkups.

• You may need both at different times. One type doesn't replace the other.

• Knowing why your dental provider recommends an X-ray helps you ask better questions and feel more at ease.

If you're unsure which X-ray you need, schedule an appointment with an Aspen Dental provider for a personalized evaluation.

What is a panoramic X-ray?

A panoramic X-ray takes one wide image of your entire mouth — your upper and lower jaw, all your teeth, your sinuses and your jaw joints. You stand still while the machine rotates around your head. It takes less than a minute.

When should I get a panoramic X-ray?

Your dental provider will suggest a panoramic X-ray when you're a new patient with no recent records on file, when wisdom teeth need evaluating, or when a jaw joint issue or cyst is suspected. It's also used to plan orthodontic treatment. Children and teens get them to track how adult teeth are developing. Adults don't need them every year — your provider will decide when the timing makes sense.

What are bitewing X-rays?

Bitewing X-rays focus on a small section of your mouth at a time. You bite down on a small sensor, and the image shows the upper and lower teeth in that area together. Your dental provider usually takes four images to cover the back teeth on both sides.

When should I get bitewing X-rays?

Bitewings are the X-ray used most often at routine checkups. Lab research has found that they detect between-tooth cavities more accurately than panoramic X-rays.¹ They also show the bone level around your teeth; if gum disease is thinning that bone, bitewings catch it early. For people with a low cavity risk and healthy gums, how often you need bitewings depends on your age and individual risk.

Do you ever need both?

Yes. Panoramic and bitewing X-rays answer different questions, and neither replaces the other. On a first visit, your dental provider may take both. After that, bitewings handle routine monitoring. A panoramic X-ray returns when something specific calls for a wider view.

Are dental X-rays safe?

Dental X-rays use very low doses of radiation. The American Dental Association (ADA) notes that X-rays should only be taken when they provide diagnostic information that helps your oral health.² For more information about X-rays, talk with your dental provider and ask them why a particular type is being recommended.

Panoramic X-ray vs. bitewing X-rays: Which one do you need? FAQs

Here are a few questions patients commonly ask about dental X-rays.

Can I get dental X-rays if I'm pregnant?

The ADA says dental X-rays are considered safe at any stage of pregnancy when they are needed.³ Your dental provider will take steps to limit your exposure and discuss the timing with you. Always let your provider know you're pregnant before any imaging.

What if I haven't had X-rays in several years?

Tell your dental provider at your visit. They'll review your history and decide which images give them the clearest picture of where things stand now. Starting fresh with a full set is common when records are out of date.

Do I still need a lead apron during dental X-rays?

The ADA now says leaded aprons and thyroid collars are no longer necessary for patients of any age.² Modern dental X-ray equipment limits the beam to a very small area, keeping exposure low.

Sources

¹PubMed (Dentomaxillofac Radiol): “Proximal caries detection accuracy using intraoral bitewing radiography, extraoral bitewing radiography and panoramic radiography.” https://pubmed.ncbi.nlm.nih.gov/22868296/

²American Dental Association: “X-Rays/Radiographs.” https://www.ada.org/resources/ada-library/oral-health-topics/x-rays-radiographs

³American Dental Association: “Pregnancy.” https://www.ada.org/resources/ada-library/oral-health-topics/pregnancy