When is a periapical dental X-ray used?

Your dentist has recommended a periapical X-ray, and you may be wondering how it’s different from the dental images you’ve had before. It’s a focused view of a tooth, including its roots and the bone around them. Your dentist may use it to investigate a concern, plan treatment or check healing afterward.¹ 

The name may be unfamiliar, but the process is usually straightforward. Knowing what your dentist wants to see can help you feel more comfortable asking questions. 

What you'll learn in this article: 

• Why your dentist might need a closer look at a tooth's roots 

• How periapical images differ from bitewing and panoramic X-rays 

• What sensor placement feels like and how to speak up about discomfort 

• How your dentist decides whether an image is needed 

If you have questions before your next visit, schedule an appointment with an Aspen Dental provider to talk through your concerns. 

What does a periapical dental X-ray show? 

A periapical X-ray gives your dentist a close view of a tooth, its roots and the bone around them.¹ The word “periapical” refers to the area around a root’s tip. 

That view helps your dentist assess areas below the gumline that they can't inspect just by looking in your mouth. Depending on the concern, they may look for changes around a root or loss of supporting bone.¹

When might a dentist recommend a periapical X-ray? 

Your dentist chooses this image when a closer view of a particular area could help answer a clinical question. Common reasons include: 

• Investigating pain or swelling: The image may help your dentist look for signs of infection near a tooth’s root.¹^,² 

• Evaluating gum disease: It can help show how much bone supports a tooth, alongside measurements taken during your gum examination.¹^,²

• Assessing an injury: After a tooth has been hit, your dentist may need images to evaluate the roots and nearby bone.² 

• Planning or following treatment: Imaging can help your dentist plan treatment such as a root canal and monitor healing afterward.¹^,²

Being asked to have this X-ray doesn't automatically mean you need a root canal. Your dentist will explain what they find and what it means for your options. If treatment is recommended, knowing what to expect before and after a root canal can help you prepare. 

Periapical vs. bitewing and panoramic X-rays 

You may have had other dental X-rays before, such as bitewing and panoramic X-rays. Each type gives your dentist a different view: 

• Bitewing X-ray: Shows the crowns of upper and lower teeth together and helps check for decay between teeth and changes in nearby bone levels. 

• Panoramic X-ray: Provides a broad view of the teeth, jaws and surrounding structures. 

• Periapical X-ray: Includes the entire tooth and root area in a focused image.¹^,² 

The choice depends on what needs checking. Having one type previously doesn't necessarily give your dentist the information another type would provide. 

What happens during a periapical X-ray? 

A team member places a small sensor or piece of film inside your mouth near the area being examined. A holder may help keep it in position while the X-ray machine is lined up outside your mouth. You’ll be asked to stay still during the brief exposure.¹^,²

Positioning can feel awkward, especially near the back teeth. If the sensor presses on a tender spot or triggers your gag reflex, let the team know. You can ask for a pause or discuss a different approach before they continue. 

Once the image is ready, ask your dentist to point out what they're checking. A simple question like “What does this show that you couldn't see during my exam?” can make the explanation easier to follow. 

How does your dentist decide whether you need a periapical X-ray? 

There isn’t a fixed schedule for everyone. Your dentist considers your examination, health history, disease risk and any symptoms before recommending images, so a visit doesn’t automatically include new X-rays.³ 

A useful question is, “How will this image help guide my care?” Your team can explain whether they're investigating a new concern or comparing an area with earlier images. 

What should you know about radiation? 

Dental X-rays use low doses of radiation. Keeping exposure limited means taking images when they provide useful diagnostic information and carefully positioning you and the equipment.³

If you’re pregnant or might be, tell your dental team. According to the American Dental Association, dental X-rays are considered safe throughout pregnancy.⁴ 

You may also notice that an office no longer uses lead aprons. Current guidance no longer recommends routine abdominal or thyroid shielding for dental X-rays, including during pregnancy, although local regulations may still require it.³

To discuss an imaging recommendation or a concern about your teeth, schedule an examination with your local dental provider. 

When is a periapical dental X-ray used? FAQs 

Can I transfer X-rays from a previous dentist? 

Yes. Ask your previous office to send them to your new dental team. Existing images may avoid unnecessary repeats if they provide the information your dentist needs. Before your visit, check how the office prefers to receive them.³

What if the X-ray doesn't explain my symptoms? 

Your symptoms still matter. An image is only part of the assessment, so tell your dentist when the discomfort happens and what seems to trigger it.² They may recommend further examination, testing or imaging to work out the cause. Ask what the next step is and when to follow up if you’re still uncomfortable. 

Is a periapical X-ray the same as a full-mouth series? 

No. A periapical image covers a small area. A full-mouth series combines multiple images to assess the teeth and surrounding bone more broadly. Your dentist decides whether a focused image or a wider examination is appropriate for your situation.²

Sources 

¹ Cleveland Clinic: “Dental X-rays.” https://my.clevelandclinic.org/health/diagnostics/11199-dental-x-rays 

² U.S. Food and Drug Administration: “The Selection of Patients for Dental Radiographic Examinations.” https://www.fda.gov/radiation-emitting-products/medical-x-ray-imaging/selection-patients-dental-radiographic-examinations 

³ American Dental Association, MouthHealthy: “X-rays.” https://www.mouthhealthy.org/all-topics-a-z/x-rays 

⁴ American Dental Association: “Pregnancy.” https://www.ada.org/resources/ada-library/oral-health-topics/pregnancy