What’s the difference between Panoramic X-Ray and Individual X-Ray?

During one of our visits, a patient asked why there are different x-rays and why some dentists choose one over the other. So I want to answer the question to best of my knowledge as a dentist.

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Panoramic X-ray

• Overview: A panoramic X-ray, also known as a panorex, captures a single, wide view of the entire mouth area—upper and lower jaws, all teeth, and sometimes sinus areas and jaw joints. This is done in one round, with the camera moving around the patient's head.
• Use: It is generally used to plan treatment for dental implants, detect impacted wisdom teeth, examine jaw problems, and diagnose bony tumors and cysts.

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Individual Mouth X-ray

• Overview: This consists of a series of individual X-rays taken of all the teeth. The series usually includes bitewing, periapical, and occlusal X-rays, providing detailed views of each tooth from different angles.
• Use: More detailed for diagnosing cavities, periodontal disease, or other specific oral health issues at the level of individual teeth.

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Government Recommendations and Radiation

• Guidelines: The American Dental Association (ADA) along with government health agencies recommend that dental professionals follow the ALARA principle (As Low As Reasonably Achievable) regarding radiation. The frequency of X-rays depends on the patient's specific health needs.
• Safety: Both types of X-rays are considered safe when used appropriately, with protective measures such as lead aprons and thyroid collars often employed to minimize exposure.

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Radiation Dosage & Recommendations:

• The choice between a panoramic X-ray and a full mouth series often depends on the specific diagnostic needs. For broad overviews and initial assessments, panoramic X-rays are typically sufficient and preferred. For detailed analysis of specific teeth or dental conditions, a full mouth series (18 x-rays) may be necessary despite the higher radiation exposure.
 
• Panoramic X-Rays at low & normal setting can emit lower dose of radiation compare to a full set of X-rays, known as full mouth series (18 x-rays). But if a dentist wants a detailed view of their tooth, including cavities on each tooth, the dentist would have to increase the radiation level to higher settings, which ends up being more dose of radiation in the end.
 
• And last, but not least, how many times have you visited a dentist and they take all 18 x-rays? Based on initial examination, the dentist will often choose between 4-8 X-rays, unless you have a major oral issue!

When considering dental X-rays, it's important to discuss with your dentist the reasons for the X-ray, the expected benefits, and any potential risks, including radiation exposure. This helps in making an informed decision that balances safety with effective dental care.