As dentistry is evolving every day, it is bringing in new technologies and techniques to increase the efficiency of dental diagnosis.

There are a variety of dental x-rays which are used in different cases, one of them is the Panoramic X-ray.

As the name suggests, a panoramic dental x-ray captures the entire mouth of the patient on a radiographic film.

Instead of taking multiple regular dental x-rays, a dentist can take a look at the entire mouth by using a panoramic dental x-ray.

These x-rays provide the details about the placement of teeth, their health and assist in finding the location and alignment of wisdom teeth.

In a nutshell, a panoramic x-ray provides an insight into the potential dental problems that may be present in a patient.

With the advanced technology, a panoramic dental x-ray is taken externally, scanning the mouth of the patient. It is quick and easy.

Let us read further to understand the need for panoramic dental x-rays in diagnosing a dental condition and learn about its benefits and risks.

What is a panoramic dental x-ray?

Panoramic dental radiographs, also referred to as Orthopantomogram, is an advanced dental x-ray which scans the entire mouth of the patient.

It can provide details about the jaws, the teeth, and the surrounding structures.

Unlike the traditional dental x-rays, a panoramic radiograph provides a single image in two dimensions and includes all the structures of the mouth, especially the hard tissues of the oral cavity.

What is the use of a panoramic x-ray?

A panoramic dental x-ray is a choice of a radiograph for oral surgeons and dentists to examine the oral cavity thoroughly. It is taken in a day to day dental practice as a diagnostic tool. (1)

A panoramic x-ray provides details about various dental problems such as –

  • Check the alignment and location of a wisdom tooth before extraction
  • Diagnose periodontal and periapical problems
  • To measure the height and condition of alveolar bone for implant placement
  • Orthodontic assessment
  • Check for secondary caries or interdental caries
  • Diagnosis of oral conditions like ameloblastoma, osteoblastoma of the jaw
  • To check for ankyloses of dislocation of temporomandibular joints
  • As a pre-op radiograph for any maxillofacial surgeries
  • As a diagnostic tool for routine dental examination
  • Diagnosis of developmental anomalies like cleidocranial dysplasia (2)

A panoramic x-ray provides a two-dimensional flat representation of the jaws and other structures to aid in diagnosis and treatment planning.

What is the procedure of taking a panoramic dental x-ray?

A panoramic x-ray is an extra-oral dental x-ray where the radiographic film is placed outside the mouth.

The equipment consists of two arms set on each end of the mouth respectively. One arm holds the x-ray film and the other contains the imaging tube pointed towards the mouth of the patient.

Panoramic dental x ray of mouth left and right side

The patient is asked to stand still, positioning the mouth using a chin and a forehead rest. Now the patient is asked to bite on a bite-blocker which helps to keep the mouth open and stable.

When everything is in position, the machine is started. Both arms begin to move in a semi-circle around the mouth of the patient to record the details.

Earlier, large radiographic films were used to record the image produced. But now the picture is electronically stored and viewed. The entire procedure takes about 12-20 seconds to complete.

This makes the process easy, accessible and efficient. The digital advancement allows the dentist to change the contrast, brightness or darkness to get a better visualization of a particular area which was not possible in standard radiographic films.

What are the safety concerns?

Before getting a panoramic x-ray, you will have to remove any metal objects like jewelry, eyeglasses, hair clips, etc., that may interfere with the image to be taken.

A lead apron is mandatory to wear as a safety precaution to protect the delicate organs of the body, such as thyroid gland in the neck, from any scattered radiation that comes during the procedure.

Many radiographic tests are not performed during pregnancy to protect the fetus from radiation. It is advised to inform the dentists about your pregnancy before the procedure.

If a dental x-ray is necessary, proper protective wear should be worn by the patient to minimize the effect of radiation on the baby.

What are its benefits and risks associated with panoramic x-rays?

Every dental procedure has its ups and downs. Though panoramic dental x-ray is one of the best diagnostic tools in dentistry, it is associated with certain risk factors as well.

Benefits

  • A panoramic dental x-ray provides a comprehensive view of the entire mouth within a few seconds.
  • A single x-ray suffices for diagnosing multiple dental problems
  • There are no residual x-ray radiations left in the patient’s body once the procedure is completed
  • There are no severe side-effects of the radiation produced
  • They are useful in diagnosing dental problems in children, as the film is not placed inside the mouth

Risks

  • The radiation exposure from one panoramic radiograph (0.02 millisieverts) is twice the amount of radiation produced by a bitewing (0.005 millisieverts) on a routine dental x-ray examination.
  • It is a topic of concern for diagnosis requirements in a pregnant patient

What are the limitations of a panoramic x-ray?

A panoramic dental x-ray is typically used for routine radiographic examination of the teeth, bone and surrounding structures.

Since it is a two-dimensional representation of curved three-dimensional structures, it sometimes produces a slightly blurry image where accurate measurements of the teeth and the jaw cannot be done.

In the case of implant placement, where the dentist needs to calculate the bone height and proximity of the implant to the nerves, a CT Scan may be recommended. (3)

Take away message

Dentistry is a field of medicine that is continuously evolving and advancing regarding technology, accuracy, and efficiency.

A quick panoramic x-ray can provide every detail of the entire mouth in a single frame within seconds. It has proved to be the best among all other diagnostic tools used in a day to day dental practice.

A few precautions, such as wearing of the protective apron, are mandatory to follow that will protect the patient from the harmful x-ray radiations.

Be upfront about any medical conditions like problem associated with thyroid gland or pregnancy with your dentist. It will help the dentist in planning the requirements keeping your safety in mind.

Panoramic dental radiographs, also referred to as Orthopantomogram, is an advanced dental x-ray which scans the entire mouth of the patient.