What This Guide Covers
This guide explains why dental X-rays are used for children and whether they are safe. It is written for parents and caregivers who want clear, factual answers about radiation exposure during dental visits.
Many parents feel uneasy when a dentist recommends X-rays for a young child. That concern is understandable. Radiation is a word that carries weight. But the doses used in modern dental imaging are extremely small. Understanding the actual numbers and safety protocols can help you make informed decisions.
Below, you will find details on the types of X-rays used in pediatric dentistry, how often they are needed, what safety measures are in place, and what these images actually reveal about your child's oral health. The information here aligns with guidance from the American Dental Association (ADA) and the American Academy of Pediatric Dentistry (AAPD). [1] [2]
How Dental X-Rays Work and Why Children Need Them
Dental X-rays use a small dose of radiation to create images of teeth, bone, and soft tissue that a visual exam cannot reveal.
Types of Dental X-Rays Used for Children
There are several types of dental X-rays. Each one serves a different purpose depending on your child's age and dental needs.
Bitewing X-rays show the upper and lower back teeth in a single image. They are the most common type used to check for cavities between teeth. Periapical X-rays capture the entire tooth from crown to root tip and the surrounding bone. They help detect infections, abscesses, or root problems. Panoramic X-rays produce a single wide image of the entire mouth, including developing permanent teeth, the jawbone, and the temporomandibular joints (jaw joints). Pediatric dentists often use panoramic images to monitor growth and check for impacted teeth. [1]
Occlusal X-rays show the floor or roof of the mouth and can help track the development of a full arch of teeth. Dentists choose the type of X-ray based on what specific information they need.
What Dental X-Rays Can Detect in Children
A visual exam, even a thorough one, has limits. Cavities that form between teeth or beneath existing fillings are often invisible to the naked eye. X-rays reveal these hidden areas of decay before they grow larger and cause pain.
Beyond cavities, dental X-rays can detect bone loss from infection, cysts or other growths in the jaw, the position of permanent teeth developing beneath the gums, extra teeth (supernumerary teeth), missing permanent teeth (congenitally absent teeth), and impacted teeth that may be blocked from erupting normally. [1] For children, tracking the development of permanent teeth is especially valuable because early detection of problems allows for earlier, often simpler treatment.
Without X-rays, a dentist would have to wait until a problem becomes visible or causes symptoms. By that point, treatment is typically more involved.
- Cavities between teeth or under existing restorations
- Infections at the root tip (periapical abscess)
- Impacted or missing permanent teeth
- Extra teeth or abnormal tooth development
- Bone loss or cysts in the jaw
- Spacing and eruption patterns for orthodontic planning
How Much Radiation Do Dental X-Rays Produce?
The radiation dose from a dental X-ray is very small. A single digital bitewing X-ray delivers roughly 0.001 to 0.005 millisieverts (mSv) of radiation. To put that in context, the average person receives about 3.1 mSv per year from natural background radiation, which comes from the sun, soil, and even the food we eat. [2]
A set of two bitewing X-rays is roughly equivalent to a few hours of natural background radiation. A panoramic X-ray delivers a slightly higher dose, typically around 0.01 to 0.03 mSv, which is still a fraction of one day's background exposure.
Digital X-ray technology has significantly reduced these doses. Compared to traditional film X-rays, digital sensors require less radiation to produce a clear image. This reduction is typically estimated at up to 80%, though the exact figure depends on the equipment and technique used. [2]
How Often Children Need Dental X-Rays
There is no one-size-fits-all X-ray schedule for children. Frequency depends on each child's individual risk factors and dental history.
ADA and AAPD Recommendations
The ADA recommends that dental X-rays be taken only when clinically necessary, meaning the dentist has a specific reason to take them. [2] The AAPD follows a similar approach, emphasizing that X-ray decisions should be individualized based on the child's risk for dental disease. [1]
For children at low risk for cavities, bitewing X-rays may be recommended every one to two years. Children at higher risk, such as those with a history of cavities, visible plaque buildup, or certain dietary habits, may need X-rays every six to twelve months. A child's first set of dental X-rays is often taken when the back baby teeth begin touching each other, usually around age five or six, because that is where cavities most commonly hide.
For adolescents, a panoramic X-ray may be recommended to evaluate wisdom teeth and overall jaw development. Again, the decision is based on clinical need, not a fixed calendar.
Factors That Affect How Often X-Rays Are Needed
Several factors influence a child's cavity risk and, by extension, how frequently X-rays are recommended. These include a history of previous cavities, the presence of deep grooves or pits in teeth, frequent snacking on sugary foods, poor oral hygiene habits, dry mouth conditions, and certain medical conditions that affect enamel formation.
If your child has not had any cavities and maintains good oral hygiene, the dentist may extend the interval between X-rays. If a new cavity appears, the dentist may recommend more frequent imaging for a period of time to monitor the situation.
- Previous cavity history increases recommended X-ray frequency
- Diet high in sugar or frequent snacking raises risk
- Poor brushing or flossing habits may prompt closer monitoring
- Some medical conditions or medications affect tooth enamel and cavity risk
- Children with crowded teeth may need X-rays to monitor eruption patterns
Preparing Your Child for Dental X-Rays
A little preparation can make the experience easier for your child. Explain what will happen in simple, calm language. You might say, "The dentist is going to take a picture of your teeth with a small camera. It will only take a few seconds."
For young children, practicing opening wide and biting down on a piece of cardboard at home can help them feel more comfortable with the sensor or film holder. Some pediatric dental offices use child-sized sensors, which are smaller and more comfortable than adult versions. If your child has a strong gag reflex, let the dental team know in advance so they can use techniques to help.
What Happens During a Pediatric Dental X-Ray
The process is quick and painless. Most dental X-rays take only a few seconds per image.
First, the dental assistant will place a lead apron over your child's chest and abdomen. A thyroid collar, which is a smaller lead shield, is placed around the neck to protect the thyroid gland. The thyroid is particularly sensitive to radiation in children, so this step is standard practice. [2]
Next, a small sensor or film packet is positioned inside the mouth. The child bites down gently to hold it in place. The X-ray machine is positioned outside the cheek, and the image is captured in about one to two seconds. The child does not feel anything during the exposure.
For a panoramic X-ray, no sensor goes inside the mouth. Instead, the child stands still while the machine rotates around the head. This takes about 15 to 20 seconds. The child needs to hold very still during this time, which can be tricky for very young children.
Safety Measures During the Procedure
Several protocols are in place to keep radiation exposure as low as reasonably achievable. This principle is known as ALARA (As Low As Reasonably Achievable), and it guides how dental professionals use X-ray equipment. [2]
Lead aprons and thyroid collars block scattered radiation from reaching the body and thyroid. Digital sensors reduce the radiation needed for each image. Rectangular collimation, a technique that narrows the X-ray beam to the size of the sensor, can reduce radiation exposure even further compared to a round beam. The dental team also leaves the room or stands behind a protective barrier during the exposure, which is a standard radiation safety practice.
Modern dental X-ray machines are inspected and calibrated regularly to ensure they deliver only the minimum radiation needed for a diagnostic-quality image.
- Lead apron and thyroid collar placed on the child before every X-ray
- Digital sensors require less radiation than traditional film
- Rectangular collimation narrows the beam to reduce unnecessary exposure
- ALARA principle guides every X-ray decision
- Equipment is regularly inspected for proper calibration
Cost of Dental X-Rays for Children
Dental X-rays for children are typically among the least expensive dental procedures. Costs vary by location, provider, and case complexity.
A set of bitewing X-rays generally ranges from $25 to $50. A panoramic X-ray may cost between $80 and $150. A full mouth series, which includes multiple periapical and bitewing images, may range from $100 to $250. These are general estimates and actual costs can differ.
Most dental insurance plans cover diagnostic X-rays for children, often at 100% under preventive benefits. Plans may limit the number of X-rays covered per year. If your child is enrolled in Medicaid or the Children's Health Insurance Program (CHIP), dental X-rays are typically covered as part of the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit.
If you do not have dental insurance, ask the dental office about their fees before the appointment. Many offices post their imaging fees or can provide an estimate over the phone.
When to See a Pediatric Dentist for X-Rays
A pediatric dentist is a dentist who has completed additional training specifically focused on treating infants, children, and adolescents, including those with special health needs.
Many general dentists are comfortable taking and interpreting dental X-rays for children. However, there are situations where a pediatric dentist may be the better choice. If your child is very young (under age three), has significant anxiety about dental visits, has special health care needs, or has a complex dental history, a pediatric dentist's training and child-friendly office environment can make a meaningful difference.
Pediatric dental offices typically use child-sized X-ray sensors, which are more comfortable for small mouths. The staff is trained to work with children who may be nervous, uncooperative, or unable to sit still. A pediatric dentist is also more likely to have experience interpreting X-rays of developing teeth and mixed dentition (the stage when a child has both baby teeth and permanent teeth).
If a general dentist identifies something unusual on your child's X-rays, such as a developmental abnormality, an impacted tooth, or a jaw growth concern, they may refer you to a pediatric dentist or an oral surgeon for further evaluation and treatment.
Find a Pediatric Dentist Near You
If you are looking for a pediatric dentist experienced in safe, low-dose dental imaging for children, visit the pediatric-dentistry page on My Specialty Dentist to search by location and read about providers in your area.
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