How often do I need dental x-rays?

A frequent question we hear is, “Doctor, how often do I need dental x-rays?” The guiding principle in radiation is ALARA (As Low As Reasonably Achievable). What ALARA means in lay terms: as infrequent as possible to still achieve excellent diagnosis and care.

Many patients comment that their insurance policy allows (or doesn’t allow) for a specific interval for x-rays. Their policy has to do with what the insurance company designates as ‘reasonable’ (often termed ‘usual and customary’), based on premiums and costs, NOT on a clinical examination and evaluation of a patient’s individual circumstances and needs. Dentists must apply clinical judgment in deciding when and what type of radiologic (x-ray) examination to prescribe to optimize each patient’s oral health.

There is no recommended frequency for panoramic radiograph (x-ray) or full-mouth surveys (FMX). The decision to repeat a panoramic radiograph or FMX should be based solely on the individual patient’s needs (not on the frequency allowed in the dental insurance contract). The only imaging examination with a frequency recommendation is the bitewing, and its frequency based on an assessment of the patient’s caries (decay) risk. In summary, the clinical decision is:

    • Based on findings from the patient history and the clinical examination
    • Tailored to the needs of the individual patient
    • Influenced by the patient’s risk of dental disease
    • Supported by the dentist’s knowledge of disease progression and utility of various imaging techniques

Additionally, some factors the dentist considers in deciding when to prescribe radiographs are:

  • Health status of a new or established patient
  • Date and availability of the most recent prior radiographs
  • Patient age and stage of dental development
  • Risk of dental caries (decay)
  • Clinical evidence of periodontitis (gum disease)
  • Number of teeth and desire for prosthodontics care
  • Pain, swelling or other signs or symptoms of dental disease

If you have more detailed questions about your particular circumstances, please contact Dr. Mastrovich and our helpful office team at 760-741-6650 and

We welcome your comments and general questions below, and we will try to answer as many as possible here in our Ask the Dentist blog.

Photo credit