Dental X-rays use a small amount of radiation to capture a picture inside the mouth. This helps dentists and orthodontists find impacted teeth, bone abnormalities, cysts, solid growths (tumors) and infections.

A panoramic X-ray shows all your teeth in a single view. It can also help dentists spot abnormalities of the jaw and facial bones.

Panoramic X-rays

Like all dental X-rays, panoramic radiographs, or OPGs (for extraoral), use short blasts of low-level radiation to create images of structures inside the body. This allows dentists to see a complete view of the head, neck, and jaw, as well as how the teeth fit together as a whole. A patient simply rests their chin on a small shelf in front of the X-ray machine and bites softly on a sterile mouthpiece to keep their mouth and head steady for the examination.

Panoramic X-rays are useful for diagnosing a variety of dental problems. They reveal impacted or unerupted teeth and can also pick up cysts, tumors, or bone loss. They can also show how teeth have shifted since the last set of X-rays were taken.

One study analyzed 76 panoramic X-rays of orthodontic patients and found that incidental pathologic findings were detected on more than half of the scans. The most common finding was a widening of the periodontal ligament (PFL) at the apex of the molars. In addition, the study identified elongated or irregularly shaped teeth, unerupted teeth, and extra or missing teeth.

These findings can help orthodontists determine the best course of action for treating a patient, which might include braces, expanders, or other treatment. Moreover, these findings can also alert orthodontists to potential issues before they cause more serious problems.

The latest incarnations of panoramic X-rays, such as those offered by Midmark, come with autofocus features that can make these X-rays even more useful for orthodontists. Greenwood says this makes the X-rays more precise and improves their diagnostic capabilities. He also notes that these newer units are more efficient from an X-ray radiation perspective, as they emit significantly less than a full-mouth series or CBCT.

Getting your panoramic X-rays is just as easy as visiting your dentist for a regular exam. Unlike other types of X-rays, you don’t have to open your mouth for a panoramic X-ray, so the process is much quicker and more comfortable. Plus, panoramic X-rays are more cost-effective than other types of dental X-rays. That’s another big reason many orthodontists are making the switch to panoramic X-rays over bitewing X-rays.

Cephalometric X-rays

X-rays are technology that uses radiation to create an image of the interior of your mouth. Hard tissues like bone and teeth block less radiation which causes them to appear lighter on the radiograph while softer structures like gums and cheeks will show up darker. Specially trained professionals can interpret these images and use them to diagnose and treat dental problems.

While x-rays are useful in diagnosing and detecting conditions like cavities, gingivitis and periodontal disease, orthodontists are more concerned about the position and shape of the jaw and teeth. This information helps them spot extra, missing or displaced teeth; long, short or misshapen roots; and the condition of the jawbone, which may indicate the need for surgery to correct an uneven bite.

In addition to identifying issues that are not visible to the naked eye, cephalometric X-rays can also be used to determine if there is enough room in the upper and lower jaw for wisdom teeth and dental implants. They can also help orthodontists detect bone abnormalities, assess impacted teeth and identify airway obstructions associated with sleep apnea, and help evaluate temporomandibular joint (TMJ) disorders.

While a few patients express anxiety about X-rays and dental imaging in general, it’s important to remember that this technology is completely safe. Professionals adhere to the As Low As Reasonably Achievable (ALARA) principle, which limits their exposure to radiation. Moreover, there are numerous benefits of this technology that outweigh any minor risks associated with it.

Dental Impressions

Dental impressions are a common preliminary step in developing many different dental appliances, from orthodontic appliances to crowns and dentures. They ensure that the appliance or prosthesis fits comfortably within the patient’s mouth and around their existing teeth and bite.

During the impression process, your dentist will dispense a putty-like impression material into plastic or metal trays that fit snugly against your teeth and surrounding tissue. After a minute or two, they will remove the trays and the impression material from your mouth. Then, they will send the impressions to a laboratory where a technician will pour plaster over them to create a mold of your teeth and oral structure.

While traditional impressions are a necessary process for creating dental appliances and restorations, digital impressions are increasingly becoming more popular. Using an intraoral scanner, this method allows the doctor to capture 3D renderings of a patient’s entire oral cavity, including their teeth and bite. Learn the cost for a 3d dental scan first before you try to decide anything.

Aside from being a more comfortable experience for the patient, digital impressions can also improve treatment planning. They allow the doctor to better visualize a patient’s oral anatomy and tooth alignment, which may help determine whether or not they require an appliance or restoration.

The first in-office digital impression system capable of full-arch intraoral scanning became available in 2008, and the technology has rapidly evolved since then. Today, several companies offer intraoral scanners that can be used to acquire 3D digital impressions for aligners and other fixed orthodontic appliances.

However, there are still some limitations with the accuracy of these types of digital impressions. In some cases, the model might not accurately replicate the shape of the teeth or gum line, which can lead to inaccurate reproductions and misfabricated appliances. Moreover, the impressions might be prone to air entrapment and distortions in places where there is a lot of soft tissue.

The best way to minimize this issue is by ensuring that the impressions are taken with an appropriate tray size and material, and that the soft tissues are effectively managed. For example, the use of retraction cords whenever necessary to expose preparation margins can prevent soft tissue from inadvertently getting into the impression.


A CBCT scan (Cone Beam Computed Tomography) is a high-resolution, three-dimensional imaging modality that allows orthodontists to accurately visualize the maxillofacial structures. The scanner produces images using a cone-shaped beam of X-rays that are more precise than conventional panoramic or cephalometric radiographs. A CBCT scan is also significantly faster than a traditional CT, and is much less expensive to operate.

The CBCT can provide information not only on the teeth but also on the surrounding bone and soft tissues, including nerve pathways. This allows us to identify and diagnose any issues that might interfere with the effectiveness of orthodontic treatment, such as impacted third molars, missing teeth, or abnormal growth patterns. In addition, the CBCT can help orthodontists evaluate airways and assess potential sleep apnea.

CBCT has become the diagnostic imaging modality of choice in orthodontia, due to its rapid, low-dose scanning, high resolution and detail, undistorted measurements, and 3D volume rendering. In addition, CBCT can provide invaluable information about the anatomy of the sinuses and TMJ, which cannot be adequately evaluated with 2D imaging alone.

In comparison to a traditional 2D panoramic or cephalometric X-ray, a CBCT is far more useful in the diagnosis of peri-orthodontic conditions and in the treatment planning process. CBCT can detect and localize impacted or extra teeth, identify cysts or other jawbone anomalies, reveal asymmetric growth, and assess root foreshortening.

Ultimately, a CBCT scan can be used to guide the placement of orthodontic bands and wires, and also to monitor progress and outcome during the course of treatment. It is also important for evaluating patients with TMJ problems, such as atrophy of the condylar surfaces or osteoarthritis.

If you are scheduled for orthodontic treatment, your dentist will likely request a CBCT before starting the process. The machine will move in a circle around your head and take multiple pictures of the inside of your mouth for less than a minute. The process is painless and does not require sedation. CBCT images will allow your orthodontist to create an accurate digital model of your mouth, which is necessary for designing correctly fitting dental prosthetics.