ADA states x-rays should only be taken when necessary, per updated guidelines

Earlier this week, the American Dental Association (ADA) updated its dental x-ray recommendations, stating that x-rays should be ordered "only when clinically necessary" to minimize radiation exposure.

Updated protocol

Originally published in the Journal of the American Dental Association, the ADA's new guidelines are the first to address 2D (planar) and 3D (cone beam computed tomography) imaging and rely on unique clinical cases to inform x-ray protocol. An expert panel established by the ADA Council on Scientific Affairs and endorsed by the American Academy of Oral and Maxillofacial Radiology (AAOMR) collaborated on this venture.¹

Prior to now, the latest x-ray update was back in 2012. Since then, the ADA's clinical recommendations have evolved to include considerations for issues like cracked teeth, endodontics, implant planning and placement, and temporomandibular disorders (TMD) in addition to their stance on radiation.

Dr. Erika Benavides, lead author and clinical professor in the Department of periodontics and Oral Medicine at the University of Michigan School of Dentistry, said: "You wouldn't get an x-ray of another part of your body unless the doctor believed there was reason to order one after an examination. Similarly, dental x-rays should be ordered only after first examining the patient's medical and dental histories, prior x-ray images, and current clinical exam findings."¹

X-ray radiation exposure

As it stands, the amount of radiation issued from a standard dental x-ray is minimal and restricted to the area of exposure. For example, the total amount of radiation for four bite-wing x-rays taken once a year would be 0.005 millisieverts. In comparison, bananas (which are naturally radioactive due to their high levels of potassium) would contain roughly 0.001 millisieverts of radiation.² In fact, a 2024 study published by ADA found that lead aprons thyroid collars are no longer necessary due to the advanced x-ray techniques capable of significantly reducing radiation exposure.¹ It is important to note that the use of lead aprons is mandated by many states.

Still, as Benavides noted in a press release, "it is important to follow the ALARA (As Low As Reasonably Achievable) principle recognized in both dentistry and medicine to minimize exposure over a patient's lifetime."¹

References

1. New recommendations confirm dental x-rays most effectively used in moderation. American Dental Association. January 5, 2026. Press release.

2. Godshall L. Bananas versus dental radiographs: Which has more radiation? RDH. October 24, 2024. https://www.rdhmag.com/patient-care/radiology/article/55237562/bananas-versus-dental-radiographs-which-has-more-radiation