Radiograph Selection Criteria

Principles

Radiographs are prescribed for each patient after the history and clinical exam, based on the patient's needs and risk, never on a fixed schedule or as a screening before the exam.
The ADA/FDA table (2012) set the familiar recommendations; the ADA/AAOMR update (JADA, January 2026) kept the same recall bitewing intervals.
CBCT is not for routine use; when indicated, use the smallest field of view that answers the clinical question.
The same criteria apply during pregnancy.

Patient	Typical recommendation
Child, primary dentition	Individualized exam: selected periapical or occlusal views and/or posterior bitewings if proximal surfaces cannot be seen or probed; a child with no evidence of disease and open contacts may not need radiographs
Child, transitional dentition	Individualized: posterior bitewings with a panoramic image, or bitewings with selected periapicals
Adolescent and dentate adult	Individualized: posterior bitewings with a panoramic image or with selected periapicals; a full-mouth intraoral series is preferred with generalized oral disease or extensive treatment history
Edentulous adult	Individualized, based on clinical signs and symptoms

Patient	Clinical caries or increased risk	No caries and no increased risk
Child (primary or transitional dentition)	Every 6–12 months, if proximal surfaces cannot be seen or probed	Every 12–24 months, if proximal surfaces cannot be seen or probed
Adolescent	Every 6–12 months	Every 18–36 months
Adult (dentate)	Every 6–18 months	Every 24–36 months

Recall patients with periodontal disease: clinical judgment on bitewings and/or selected periapicals where disease is present.
Growth and development monitoring: clinical judgment (e.g., panoramic or periapicals to assess developing third molars in late adolescence).

Taking bitewings every 6 months for a low-risk adult.
Ordering a panoramic or CBCT image as a screening before the clinical exam.
Saying radiographs are contraindicated in pregnancy.
Mixing up adolescent (18–36 months) and adult (24–36 months) low-risk intervals.

Pick an answer to see right away whether it is correct and why.

A 35-year-old recall patient has no caries and no increased risk. Bitewings are recommended every:
A 15-year-old recall patient with two new cavitated lesions needs bitewings every:
A new adult patient has many crowns, root canal treatments and generalized periodontitis. The preferred initial imaging is:
A 4-year-old new patient has open contacts and no clinical signs of disease. The recommendation is:
Which statement about CBCT in general dental practice is correct?

0 of 5 answered

Answer key: 1 A · 2 C · 3 D · 4 A · 5 A